INTRACRANIAL BLOOD-FLOW VELOCITY AFTER HEAD-INJURY - RELATIONSHIP TO SEVERITY OF INJURY, TIME, NEUROLOGICAL STATUS AND OUTCOME
INTRACRANIAL BLOOD-FLOW VELOCITY AFTER HEAD-INJURY - RELATIONSHIP TO SEVERITY OF INJURY, TIME, NEUROLOGICAL STATUS AND OUTCOME
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DOI：
10.1136/jnnp.55.9.787
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发表时间：
1992-09-01
影响因子：
11
通讯作者：
DEARDEN, NM
中科院分区：
文献类型：
--
作者：
CHAN, KH;MILLER, JD;DEARDEN, NM
通过经颅多普勒超声检查，每天对 121 名重度（50 例）、中度（16 例）和轻度（55 例）头部损伤患者住院期间的大脑中动脉（MCA）血流速度进行测量，并将结果与对照组的结果进行比较。与正常对照 60.1 (56.9-63.3) cm/s 相比，严重头部损伤后的入院 MCA 速度显着降低，平均为 35.8 (31.9-39.7) cm/s（95% 置信限），中度为 45.5 (49.0-51.0) cm/s，轻微为 51.7 (47.9-55.5) cm/s。严重头部损伤的初始平均速度显着低于中度和轻微损伤。出院时，严重损伤时的 MCA 流速仍低于正常值 46.2 (43.2-49.0) cm/s，而中度和轻微损伤时的流速已恢复正常。入院时 MCA 速度与格拉斯哥昏迷评分 (GCS) 之间存在相关性（r = 0.46，p < 0.01），但出院时则无相关性。 72 小时内死亡（早期死亡）的所有 10 名患者均发现流速持续较低。入院 MCA 速度低于 28 厘米/秒，正确预测了 80% 的早期死亡。六个月后恢复良好或仅有中度残疾的患者的速度显着增加，从入院时的 36.2 (31.5-41.2) cm/s 到出院时的 47.8 (43.7-51.9) cm/s，而严重残疾的患者的速度通常仍然较低。
Middle cerebral artery (MCA) blood flow velocity was measured daily by transcranial Doppler ultrasonography in 121 patients with severe (50), moderate (16) and minor (55) head injury during their hospital stay, and the results compared with findings in control subjects. Admission MCA velocity was significantly lower after severe 35.8 (31.9-39.7) cm/s, mean (95% confidence limits), moderate 45.5 (49.0-51.0) cm/s and minor 51.7 (47.9-55.5) cm/s head injury when compared with normal controls 60.1 (56.9-63.3) cm/s. Initial mean velocity in severe head injury was significantly lower than in moderate and minor injury. At discharge, MCA velocity in severe injury remained below normal 46.2 (43.2-49.0) cm/s, whereas, in moderate and minor injury flow velocity had returned to normal. Correlation (r = 0.46, p < 0.01) was found between MCA velocity and Glasgow Coma Score (GCS) on admission but not on discharge. Persistently low flow velocity was found in all 10 patients who died within 72 hours (early deaths). An admission MCA velocity of less than 28 cm/s correctly predicted 80% of the early deaths. Patients who made a good recovery or had only moderate disability at six months showed a significant increase in velocity from admission 36.2 (31.5-41.2) cm/s to discharge 47.8 (43.7-51.9) cm/s in contrast to those who were severely disabled, in whom velocity generally remained low.