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Page 28
allied
academies
Nov12-13, 2018 | Paris, France
Central Nervous System & Therapeutics
International Conference on
Journal of Neurology and Neurorehabilitation Research | Volume 3
Transcranial doppler in non-severe Traumatic Brain Injury
Infante Valenzuela Adrián
University Hospital, USA
Background:
The role of Transcranial Doppler Ultrasound (TDU)
in the prognostic orientation of cases with severe TBI is known,
but its application to evaluate cases with mild or moderate
severity is actually unknown.
Methods:
Patients with non-severe TBI were prospectively
evaluated to demonstrate the applicability of transcranial
doppler in the acute period for orientation in pronostic, with
its probable inclusion among the variables of prognostic
calculators; as well as the association of variables as serum
biomarkers and with the different types of lesions evidenced
with Computed Axial Tomography.
Forty no severe Traumatic Brain Injury patients were evaluated
within the first 24 hours of the lesion, a computerized axial
tomography image was obtained, parameters were measured
by transcranial doppler of bilateral middle cerebral artery; in
addition to obtaining serum sample (3 vials of 1cc) that were
kept freezing at -80 degrees for subsequent measurement of
IL-1, IL-6 and tumor necrosis factor alpha, neurospecific enolase
and S100beta. Statistical analysis was performed with SPSS V.23
software.
Results:
The results with cytokines did not show a significant
difference between the medians of IL-1, IL-6 and THF-alpha and
the groups with and without alteration in UDT (hypoperfusion
and non-hypoperfusion); in the analysis by type of lesion on
CT, patients with wubdural hemtoma by CT and a substantially
lower concentration of IL-1 (45pg/ml), IL-6 (460pg/ml, p=0.029)
and TNF- α (94pg/ml, p=0.0001) compared to patients who
did not have this lesión (186 pg/ml, 649 pg/ml and 388 pg/
ml, respectively). A decrease perfusion by transcranial doppler
(VMF below 35 cm/s) correlated positively with the presence
of Subarachnoid Hemorrhage and Parenchymal Hemorrage
(p=0.045, p=0.039, respectively). We conclude that, in patients
with non-severe traumatica brain injuries, the evaluation with
transcranial doppler also plays an important role in prognostic
orientation; in addition and even without the computerized
axial tomography data, it can facilitate the classification for risk
of development secondary neurologic complication.
e:
adrinfante@hotmail.com