Should we measure cerebral blood flow in head-injured patients?

Details

Serval ID
serval:BIB_B70CCFB38522
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Title
Should we measure cerebral blood flow in head-injured patients?
Journal
British Journal of Neurosurgery
Author(s)
Steiner L.A., Czosnyka M.
ISSN
0268-8697
Publication state
Published
Issued date
2002
Peer-reviewed
Oui
Volume
16
Number
5
Pages
429-439
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Review
Publication Status: ppublish
Abstract
Inadequate cerebral blood flow (CBF) after head injury is an important cause of secondary ischaemic damage. Rapid identification of episodes of hypo- or hyperperfusion would allow timely intervention and would possibly improve outcome. Despite a large number of methods to estimate CBF, this concept is only marginally implemented in clinical practice. The methods to detect such episodes are limited for technical reasons, but also because the thresholds of ischaemia and hyperaemia are variable after head injury. Furthermore, we are not always able to manipulate CBF in a controlled manner. Accordingly, it is not surprising that attempts to compare a CBF-targeted strategy with another management option have failed to demonstrate a clear benefit. Methods need to be developed that allow either identification of thresholds for critically low or high CBF in individual patients, allow monitoring oxygen extraction fraction, representing circulatory reserve, or alternatively provide a measure of the volume of ischaemic or hyperaemic brain.
Keywords
Brain/blood supply, Carbon Dioxide/physiology, Cerebrovascular Circulation/physiology, Craniocerebral Trauma/physiopathology, Homeostasis/physiology, Humans, Intracranial Pressure/physiology, Laser-Doppler Flowmetry, Magnetic Resonance Angiography, Monitoring, Physiologic/methods, Oximetry, Spectroscopy, Near-Infrared, Tomography, Emission-Computed, Tomography, X-Ray Computed/methods, Treatment Outcome, Xenon/diagnostic use
Pubmed
Web of science
Create date
29/12/2009 17:10
Last modification date
20/08/2019 15:25
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