TRANSCRANIAL DOPPLER VERSUS COMPUTED TOMOGRAPHY IN EVALUATION OF BRAIN EDEMA IN PATIENTS WITH TRAUMATIC BRAIN INJURY

Document Type : Preliminary preprint short reports of original research

Authors

1 Professor of Critical Care Medicine Department of Critical Care Medicine, Faculty of Medicine, Alexandria University

2 Assistant Professor of Critical Care Medicine, Department of Critical Care Medicine, Faculty of Medicine, Alexandria University

3 Department of Critical Care, Faculty of Medicine, Alexandria University

4 Department of Critical Care Medicine, Faculty of Medicine, Alexandria University

Abstract

Abstract
Introduction: Traumatic brain injury (TBI) is a major cause of morbidity and mortality worldwide, often complicated by cerebral edema and elevated intracranial pressure (ICP), which can worsen neurological outcomes. Early detection and monitoring of cerebral edema are critical for timely intervention. While computed tomography (CT) is the standard imaging modality, it is not always feasible for frequent monitoring.Transcranial Doppler (TCD) ultrasonography is a noninvasive, bedside technique that enables real-time assessment of cerebral blood flow dynamics. Parameters such as mean flow velocity (MFV) and pulsatility index (PI) have shown potential in reflecting intracranial pathophysiological changes.
Aim: to compare between transcranial doppler derived indices and computed tomography in assessment of brain oedema in patients with traumatic brain injury before and after receiving hyperosmolar therapy.
Patients & methods: This was an observational comparative prospective study that was done in Critical Care Department of Alexandria University Hospitals on 70 critically ill studied cases.
Demographic information and detailed clinical history were obtained for all participants. Baseline laboratory evaluations, including complete blood count, serum electrolytes, blood urea nitrogen, and serum creatinine levels, were conducted to assess the patients' physiological status. The severity of cerebral edema was determined through computed tomography (CT) imaging, interpreted in accordance with validated radiological scoring systems. Transcranial Doppler ultrasonography was performed utilizing a low-frequency (2 MHz) probe applied via the temporal acoustic window. Intracranial pressure was estimated using a standardized formula derived from peak systolic and end-diastolic velocity measurements.

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