Interest of Transcranial Doppler (TCD) in Emergency in Traumatic Brain Injury Patients at Gabriel Touré University Hospital, Bamako, Mali  

作　　者：Abdoulhamidou Almeimoune Moustapha Mangane Madane Thierno Diop Mahamadoun Coulibaly Amadou Gamby Dramane Sanogo Alfousseini Soumare Adama Coulibaly Ababacar Salaha Harouna Sangaré Diango Djibo Mahamane Abdoulhamidou Almeimoune;Moustapha Mangane;Madane Thierno Diop;Mahamadoun Coulibaly;Amadou Gamby;Dramane Sanogo;Alfousseini Soumare;Adama Coulibaly;Ababacar Salaha;Harouna Sangaré;Diango Djibo Mahamane(Department of Intensive Care Anesthesia and Emergency Medicine, CHU Gabriel Toure, Bamako, Mali;Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technology of Bamako, Bamako, Mali;Department of Intensive Care Anesthesia, CHU Luxembourg, Luxembourg City, Luxembourg)

机构地区：[1]Department of Intensive Care Anesthesia and Emergency Medicine, CHU Gabriel Toure, Bamako, Mali [2]Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technology of Bamako, Bamako, Mali [3]Department of Intensive Care Anesthesia, CHU Luxembourg, Luxembourg City, Luxembourg

出　　处：《Open Journal of Emergency Medicine》2024年第3期114-121,共8页急诊医学（英文）

摘　　要：Introduction: Transcranial Doppler is a simple, non-invasive and inexpensive examination which allows the assessment of cerebral perfusion. In countries with limited resources, which do not have a means of monitoring intracranial pressure, this examination offers hope of survival for patients with traumatic brain injury. This study was designed to investigate the incidence of early cerebral circulation abnormalities after traumatic brain injury using transcranial Doppler (TCD). Methodology: A descriptive and analytical study was conducted over one year, including patients with traumatic brain injury and an initial Glasgow Coma Scale (GCS) score of less than 15. Non-inclusion criteria: Stroke, brain tumor, cerebral abscess. Exclusion criteria: Inadequate insonation window. Results: Out of 854 traumatic brain injury patients admitted to the emergency department, 112 were included in the study. The average age was 30.14 years, with a sex ratio of 4.1. Initially, 83.5% had moderate traumatic brain injury, and 12.1% had severe traumatic brain injury. Brain CT scans were performed in 95.7% of the patients. Edematous-hemorrhagic contusion was observed in 95% of the patients. On initial TCD, the pulsatility index in the middle cerebral artery was greater than 1.3 in 49.4% of the patients. Diastolic velocity was less than 20 cm/s in 46.4% of cases, and mean velocity was greater than 150 cm/s in 8.7% of cases. In this group, low diastolic velocity indicated cerebral hypoperfusion suggestive of intracranial hypertension. When the pulsatility index was greater than 1.9, no patient had a normal diastolic velocity. Among patients with severe traumatic brain injury, 61.5% had an abnormal pulsatility index compared to 42.3% of patients with moderate traumatic brain injury. Conclusion: TCD is a simple tool for analyzing intracerebral hemodynamics.Introduction: Transcranial Doppler is a simple, non-invasive and inexpensive examination which allows the assessment of cerebral perfusion. In countries with limited resources, which do not have a means of monitoring intracranial pressure, this examination offers hope of survival for patients with traumatic brain injury. This study was designed to investigate the incidence of early cerebral circulation abnormalities after traumatic brain injury using transcranial Doppler (TCD). Methodology: A descriptive and analytical study was conducted over one year, including patients with traumatic brain injury and an initial Glasgow Coma Scale (GCS) score of less than 15. Non-inclusion criteria: Stroke, brain tumor, cerebral abscess. Exclusion criteria: Inadequate insonation window. Results: Out of 854 traumatic brain injury patients admitted to the emergency department, 112 were included in the study. The average age was 30.14 years, with a sex ratio of 4.1. Initially, 83.5% had moderate traumatic brain injury, and 12.1% had severe traumatic brain injury. Brain CT scans were performed in 95.7% of the patients. Edematous-hemorrhagic contusion was observed in 95% of the patients. On initial TCD, the pulsatility index in the middle cerebral artery was greater than 1.3 in 49.4% of the patients. Diastolic velocity was less than 20 cm/s in 46.4% of cases, and mean velocity was greater than 150 cm/s in 8.7% of cases. In this group, low diastolic velocity indicated cerebral hypoperfusion suggestive of intracranial hypertension. When the pulsatility index was greater than 1.9, no patient had a normal diastolic velocity. Among patients with severe traumatic brain injury, 61.5% had an abnormal pulsatility index compared to 42.3% of patients with moderate traumatic brain injury. Conclusion: TCD is a simple tool for analyzing intracerebral hemodynamics.

关 键 词：Traumatic Brain Injury TCD Neuroresuscitation Sub-Saharan Africa 

分 类 号：R74[医药卫生—神经病学与精神病学]