• Mitsuru Honda, Shigeru Sase, Kyosuke Yokota, Ryo Ichibayashi, Katsunori Yoshihara, Hiroyuki Masuda, Hiroyuki Uekusa, Jun Nomoto, Nobuo Sugo, Taichi Kishi, and Yoshikatsu Seiki.
• Department of Critical Care Center, Toho University Medical Center, Tokyo, Japan. mhonda@toho-u.ac.jp
• Acta Neurochir. Suppl. 2013 Jan 1;118:259-63.

IntroductionTraumatic brain injury (TBI) is widely known to cause dynamic changes in cerebral blood flow (CBF). In particular, secondary brain insults have been reported to decrease CBF. The purpose of this study was to clarify the cerebral circulation in different types of TBI.MethodsSixty-nine patients with TBI were divided into four groups, the subdural hematoma group, the contusion/intracerebral hematoma group, the diffuse axonal injury group, and the diffuse brain swelling group. In these patients, we simultaneously performed Xe-CT and perfusion CT to evaluate the cerebral circulation on post-injury days 1-3. We measured CBF using Xe-CT and mean transit time using perfusion CT and calculated the cerebral blood volume using the AZ-7000 W98 computer system.ResultsThere were no significant differences in the Glasgow Coma Scale score on arrival or the Glasgow Outcome Scale score between the groups. The patients who had suffered focal TBI displayed more significant cerebral circulation disturbances than those that had suffered diffuse TBI. We were able to evaluate the cerebral circulation of TBI patients using these parameters.ConclusionModerate hypothermia therapy, which decreases CBF, the cerebral metabolic rate oxygen consumption (CMRO2), and intracranial pressure might be effective against the types of TBI accompanied by cerebral circulation disturbance. We have to use all possible measures including hypothermia therapy to treat severe TBI patients according to the type of TBI that they have suffered.

21 keywords...

hide…