Hemispheric asymmetry and temporal profiles of cerebral pressure autoregulation in head injury

E W Lang; K Yip; J Griffith; Jim Lagopoulos; Y Mudaliar; N W Dorsch

doi:10.1016/S0967-5868(03)00197-8

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Hemispheric asymmetry and temporal profiles of cerebral pressure autoregulation in head injury

Journal article

Peer reviewed

Hemispheric asymmetry and temporal profiles of cerebral pressure autoregulation in head injury

E W Lang, K Yip, J Griffith, Jim Lagopoulos, Y Mudaliar and N W Dorsch

Journal of Clinical Neuroscience, Vol.10(6), pp.670-673

2003

DOI: https://doi.org/10.1016/S0967-5868(03)00197-8

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Abstract

dynamic cerebral pressure autoregulation

transcranial Doppler ultrasound

hemisphere asymmetry

temporal profiles

A moving correlation index (Mx-ABP) between arterial blood pressure (ABP) and mean middle cerebral artery blood flow velocity (CBFV) can be used to monitor dynamic cerebrovascular autoregulation (CA) after traumatic brain injury (TBI). In this study we examined hemispheric CA asymmetry and temporal CA profiles, their relationship with ABP and CBFV, and their prognostic relevance. Mx-ABP was calculated for each hemisphere in 25 TBI patients second-daily for as long as they were receiving sedation and analgesia. Forty-nine recordings were obtained, between one and six per patient. Four time periods were defined: immediate - postinjury days (PID) 0 and 1; early - PID 2 and 3; intermediate - PID 4 and 5, and late - PID 6 and later, GOS was estimated at discharge, GOS 4 and 5 were considered favorable (15 patients) and GOS 1-3 unfavorable outcome (10 patients). A Mx difference >0.2 was classified as hemispheric asymmetry (HA). HA was observed at least once in 12 of the 25 patients (48%) and in 18 of 49 recordings (37%). It was observed during all time periods: 35%, 43%, 25%, 43%, respectively, and was not related to outcome. There was no difference in mean CBFV or ABP between patients with and without HA. HA was not related to interhemispheric CBFV differences. A significant improvement in Mx was seen over time. Hemispheric CA asymmetry is common after traumatic brain injury. It does not bear significant clinical or predictive relevance, and it is unrelated to CBFV or ABP. CA is most profoundly disturbed during the immediate postinjury phase and improves gradually during the ICU course. Further studies are needed to investigate CA during post ICU recovery and rehabilitation. Crown Copyright © 2003 Published by Elsevier Ltd. All rights reserved.

Details

Title: Hemispheric asymmetry and temporal profiles of cerebral pressure autoregulation in head injury
Authors: E W Lang (Author) - University of Sydney
K Yip (Author) - University of Sydney
J Griffith (Author) - University of Sydney
Jim Lagopoulos (Author) - University of Sydney
Y Mudaliar (Author) - University of Sydney
N W Dorsch (Author) - University of Sydney
Publication details: Journal of Clinical Neuroscience, Vol.10(6), pp.670-673
Publisher: Churchill Livingstone
Date published: 2003
DOI: 10.1016/S0967-5868(03)00197-8
ISSN: 0967-5868
Organisation Unit: University of the Sunshine Coast, Queensland; Thompson Institute
Language: English
Record Identifier: 99449491202621
Output Type: Journal article

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Collaboration types: Domestic collaboration; International collaboration
Web Of Science research areas: Clinical Neurology; Neurosciences

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