| Objective: To probe the law of cerebral vessels hemodynamic after the craniocerebral injury and supply some references for clinical craniocerebral injury treatment, by detecting cerebral hemodynamics changes of those patients, analyzing the relationship among cerebral hemodynamics change and head injury degree, traumata style, traumata hour ,cure means and prognosis.Methods: Clinical data of 98 cases of craniocerebral injury patients, who were hospital treated from July 2003 to July 2007, was collected and analyzed. Transcranial Doppler(TCD) was operated to investigate the changes of their cerebral blood flow 0～3 days, 5～7 days ,10～14 days, 14 days after the injury, that were the changes of peak systolic velocity(Vs), diastolic velocity(Vs), mean velocity(Vm), pulsatility index(PI) and resistance index(RI) of bilateral middle cerebral artery(MCA), anterior cerebral artery(ACA), posterior cerebral artery(PCA) in period of contraction. After recording the variation of these indexes and handling these data by statistical methods, we investigated the variance of those patients' cerebral hemodynamics changes comparing with normal values.Results: 68(69.4%) of these 98 patients were detected having abnormal brain blood flow, 57 cases(58.2%) of that were faster, 11 cases(11.2%) were slower, 33 cases(33.7%) had their PI value increased. Comparison of cerebral hemodynamics changes in light, midst and serious cerebral injury patients. In the 30 light cerebral injury patients, 12(40%) had abnormal hemodynamics, all of which had increasing cerebral blood flow. 3 cases(10%) of them had a high pulsatility index. In the 35 midst head injury patients, 27(77.1%) had abnormal hemodynamics, in which 22(62.9%) had a faster and 5(14.3%) got a slower cerebral blood flow, 12(34.3%) of them had a high pulsatility index. In the 33 serious cerebral injury cases, 29 (87.8%) had abnomal hemodynamics, in which 23 (69.7%) had a faster and 6(18.2%) had a slower cerebral blood flow, 18 of them(54.5%) had a high pulsatility index. Cerebral blood flow abnormalities in midst and serious cerebral injury had a high incidence, there was no significant difference between midst and serious cerebral injury. But significant difference could be seen when they were compared with the light head injury, P<0.01.There were significant differences among PI values in various types of brain injury, P<0.01. There were 45 cases of light and serious cerebral injury with cerebral blood flow velocity accelerating. 30 cases of which were treated with operation while 15 cases handled with conservative treatment. In the surgery group, 18 cases still had the symptom of cerebral blood flow velocity accelerating after a week of surgery and 6 cases after two weeks, while 12 cases after a week and 8 cases after two weeks in the conservative treatment group. There were significant differences between the two treatment groups, P<0.01. After 1 week's treatment, sharp cerebra blood flow rate remained separately 6,11, 19 cases in light, midst and serious cerebral injury patients. The recovery of abnormal cerebral hemodynamics of serious head injured patients was slow, compared to light and midst injury ones, P<0.01. Significant difference could be seen in abnormal cerebral hemodynamics: in open head injury, 18 in 20(90%), while in closed trauma of head 50 in 78(64.1%).Conclusion: 1. Abnormal brain hemodynamics existed in most patients with head injury, in which sharp blood flow comprises the main part. 2. Cerebral hemodynamics changes had a close relation with degree of head injury, the heavier, the faster incidence of abnormal cerebral hemodynamics in midst and serious head injury had a predominance difference comparing with light head injury. 3. The heavier head injury emerged, the slower brain hemodynamics recovered. 4. Surgical therapy could shorten the brain hemodynamics recovery time effectively. 5. TCD is a reliable, economical and convenient method for cerebral hemodynamics examination. |
PDF Full Text Request