• Corpus ID: 30801390


  author={Peter John Kirkpatrick and Kwan-Hon Chan},
The study of large numbers of head-injured patients has identified clinical and radiological features which indicate the severity of the initial cerebral trauma. (Born et al., 1985; Jennett et al., 1979; Marshall et al., 1991; Miller, 1985; Miller, 1992). In some individuals, secondary neuronal injury follows the primary injury (Chan et al., 1992a; Gopinath et al., 1994; Kirkpatrick et al., 1995; Miller, 1986; Robertson et al., 1989). These secondary insults may, in part, account for the poor… 

Theme: neurology--optic nerve sheath diameter measurement as a risk marker for significant intracranial hypertension.

Estimation of optic nerve sheath diameter using ocular sonography or MRI has been shown to correctly estimate the risk of raised ICP in various settings, including traumatic brain injury, and may be of great clinical value, aiding in the detection of patients at risk ofraised ICP.

Effects of Sensory and Cognitive Vigilance Tasks on Cerebral Blood Flow Velocity

Results are consistent with prior neuroimaging findings of right hemisphere dominance in vigilance, but not with arguments that signal detections and response time are equivalent measures of the same underlying process (Buck, 1966).

[Non-invasive evaluation of intracranial pressure: how and for whom?].



Head injury and brain ischaemia--implications for therapy.

  • J. Miller
  • Medicine
    British journal of anaesthesia
  • 1985
Brain ischaemia may be the single most important mechanism in the production of secondary brain dysfunction and damage after severe head injury.

Acute regional cerebral blood flow changes caused by severe head injuries.

In patients without surgical mass lesions, the findings suggest that CBF in the first few hours after injury is often low, followed by a hyperemic phase that peaks at 24 hours, which underscores the need to define regional CBF abnormalities in victims of severe head injury if treatment is intended to prevent regional ischemia.

The significance of posttraumatic increase in cerebral blood flow velocity: a transcranial Doppler ultrasound study.

Using transcranial doppler ultrasonography, cerebral blood flow velocity was measured daily from both middle cerebral arteries in 121 patients who had suffered minor, moderate, or severe brain injury, and NCI did not occur in any patient with increased MFV that was associated with global hyperemia.

Impaired Carbon Dioxide Reactivity Predicts Poor Outcome in Severe Head Injury: A Transcranial Doppler Study

Regional cerebral blood flow is often reduced over the first few days after severe head injury, but it may also be increased, and earlier methods of assessing CO2 responsiveness were invasive, expensive, time-consuming and inaccurate.

Evaluation of posttraumatic cerebral blood flow velocities by transcranial Doppler ultrasonography.

The occurrence of a secondary infarction in a patient with severe MCA spasm suggests that, at least in some cases, spasm may influence the prognosis, and there was a significant correlation between the occurrence of vasospasm and the quantity of cisternal or intracerebral blood seen on a computed tomographic scan.

Multimodal monitoring in neurointensive care.

Continuous monitoring techniques for different variables concerning the health of the brain are now available, and these include measurements of ICP, cerebral perfusion pressure (CPP), jugular venous oxygen saturation (Sjo2), and cortical electrical activity.

Transcranial Doppler monitoring in head injury: relations between type of injury, flow velocities, vasoreactivity, and outcome.

Hyperperfusion, as based on ICA flow velocities, and vasospasm were correlated with diminished vasoreactivity, however, disturbed vasoreactivities, particularly during the first days, were common and did not necessarily predict an unfavorable outcome.

A multicenter trial of the efficacy of nimodipine on outcome after severe head injury. The European Study Group on Nimodipine in Severe Head Injury.

A trend toward a favorable effect was seen in patients who exhibited traumatic subarachnoid hemorrhage on the computerized tomography (CT) scan obtained prior to entry into the study, consistent with the effect of nimodipine on secondary ischemia following spontaneous SAH.

Minor, moderate and severe head injury.

In severe injury future efforts will be to prevent early secondary insults and to find better methods of controlling raised intracranial pressure, and in moderate injuries CT will assume a major role in detecting hematoma early and identifying contusions.

Measuring the burden of secondary insults in head-injured patients during intensive care.

The most significant predictors of mortality in this patient set were durations of hypotensive, pyrexic, and hypoxemic insults, which occurred in all severities of head trauma, at all ages, and at every level of Injury Severity Score.