Trofimova KA, Agarkova DI, Trofimov AO, Lidji-Goryaev C, Semyachkina-Glushkovskaya O, Abashkin AY, Bragin DE. Critical Closing Pressure of Cerebral Circulation at Concomitant Moderate-to-Severe Traumatic Brain Injury.
ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022;
1395:157-161. [PMID:
36527631 PMCID:
PMC10042480 DOI:
10.1007/978-3-031-14190-4_27]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND
Critical closing pressure (CrCP) is the pressure below which local pial blood pressure is inadequate to prevent blood flow cessation. The state of cerebral CrCP in patients with concomitant moderate-to-severe traumatic brain injury (cTBI) after brain lesions surgery remains poorly understood.
AIM
The aim of our study was to establish the dynamics of CrCP after intracranial surgery in traumatic brain injury (TBI) patients with polytrauma.
MATERIAL AND METHODS
Results of the treatment of 70 patients with moderate-to-severe сTBI were studied (Male: Female - 39:31, mean age -33.2 ± 12.2 years). Depending on intracranial surgery, patients were divided into 2 groups. All patients were subjected to transcranial Doppler of both middle cerebral arteries, and evaluation of mean arterial pressure (MAP). Based on the data obtained, CrCPs were calculated. Significance was preset to P < 0.05.
RESULTS
Mean CrCP values in each group were significantly higher than a reference range (р < 0.01). There was no significant difference in CrCP values between the left and right hemispheres in the group 1 (p = 0.789). In the group 2, mean CrCP values on the unoperated side remained significantly lower than on the operated side (p = 0.000011) even after intracranial surgery. In group 1, mean CrCP values were significantly lower than on the surgery side in the group 1 (Z = 3,4; р = 0.043).
CONCLUSION
CrCP values in concomitant moderate-to-severe TBI after removing brain lesions and without surgery were significantly higher than referral data. Even after removal of brain lesions volumes in patients with concomitant moderate-to-severe TBI, CrCP values on the surgery side remained markedly higher than on the side opposite to the removed lesion volumes.
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