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Evaluation of Intracranial Pressure Gradients by Means of Transcranial Doppler Sonography

  • Conference paper
Neurotraumatology: Progress and Perspectives

Part of the book series: Acta Neurochirurgica ((NEUROCHIRURGICA,volume 55))

Summary

The authors investigated the effects of intracranial pressure gradients generated by a unilateral intracranial mass on transcranial Doppler (TCD) readings. Eleven patients harbouring a symptomatic chronic or subacute subdural haematoma underwent pre- and postoperative TCD examinations of the intracranial internal carotid and middle cerebral arteries. Mean values of velocity and pulsatility index (PI) were compared to the contra-lateral counterpart. The haematomas were evacuated by means of burr hole drainage under local anaesthesia.

Symptomatic subdural haematomas lowered the ipsilateral blood velocity in the internal carotid and middle cerebral arteries by a mean side-to-side difference of 15.64 ± 3.01 m.sec−1. The ipsilateral PI was higher than the contralateral values by an average of 0.23 ± 0.04. Low mean velocity and high PI values were associated with high subdural pressure. Abnormal pre-operative ipsilateral TCD readings returned to normal following haematoma drainage.

We postulate that intracranial pressure gradients generated by the subdural mass lesion are responsible for the asymmetry of TCD readings. These differences should be considered in the interpretation of post-subarachnoid haemorrhage vasospasm, as it is frequently associated with lateral clots. Our findings also provide a useful method for non-invasive monitoring of intracranial pressure gradients.

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Abbreviations

CT:

= computerized tomography

GCS:

= Glasgow Coma Scale

ICP:

= intracranial pressure

NSD:

= no significant difference

PI:

= pulsatility index

SAH:

= subarachnoid hemorrhage

TCD:

= Transcranial Doppler

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Author information

Authors and Affiliations

  1. Cerebral Hydrodynamics Research Laboratory, Departments of Surgery, Health Sciences Centre, Winnipeg, Manitoba, Canada

    Dr. Erico R. Cardoso (Director)

  2. Departments of Nursing Education and Research, Health Sciences Centre, Winnipeg, Manitoba, Canada

    J. A. Kupchak

Authors
  1. Dr. Erico R. Cardoso
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  2. J. A. Kupchak
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Editor information

Editors and Affiliations

  1. Department of Neurophysiology, Hospital Santo Antonio, Porto, Portugal

    A. Martins da Silva

  2. Unit of Human Physiology, Biomedical Institute “Abel Salazar”, University of Porto, Portugal

    A. Martins da Silva

  3. Department of Neurosurgery, Hospital Santo Antonio, Porto, Portugal

    A. Rocha Melo

  4. Neurochirurgische Universitätsklinik, Homburg/Saar, Federal Republic of Germany

    F. Loew

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© 1992 Springer-Verlag

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Cardoso, E.R., Kupchak, J.A. (1992). Evaluation of Intracranial Pressure Gradients by Means of Transcranial Doppler Sonography. In: da Silva, A.M., Melo, A.R., Loew, F. (eds) Neurotraumatology: Progress and Perspectives. Acta Neurochirurgica, vol 55. Springer, Vienna. https://doi.org/10.1007/978-3-7091-9233-7_1

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  • DOI: https://doi.org/10.1007/978-3-7091-9233-7_1

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-9235-1

  • Online ISBN: 978-3-7091-9233-7

  • eBook Packages: Springer Book Archive

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