Đánh giá sự thay đổi của siêu âm doppler xuyên sọ ở bệnh nhân tăng áp lực nội sọ do chảy máu não cấp tính

Abstract

To evaluate changes in selected transcranial Doppler (TCD) parameters of the middle cerebral artery in patients with acute intracerebral hemorrhage associated with elevated intracranial pressure and/ severe clinical conditions. Subject and method: The study included 42 patients with acute intracerebral hemorrhage, with a total of 274 bilateral middle cerebral artery TCD examinations, conducted at the Institute of Neurology, 108 Military Central Hospital. Result: No statistically significant differences were observed between the TCD parameters of the bilateral middle cerebral arteries. During coma (Glasgow Coma Scale ≤ 8) or in patients with early mortality, the pulsatility index (PI) tended to increase; however, this difference was not statistically significant (p>0.05). Patients with elevated intracranial pressure (≥ 20 mmHg) demonstrated significantly higher PI values (right/left: 1.83 ± 0.63/1.87 ± 0.67) and lower end-diastolic flow velocity (FVD) (right/left: 13.59 ± 13.8/13.96 ± 14.14cm/s) compared with those with normal intracranial pressure (< 20mmHg) (PI right/left: 1.33 ± 0.59/1.36 ± 0.59; FVD right/left: 20.66 ± 14.06/19.25 ± 12.45cm/s), with p<0.05. In contrast, systolic flow velocity (FVS) and mean flow velocity (FVM) did not differ significantly between the two groups. Conclusion: Middle cerebral artery transcranial Doppler in patients with acute intracerebral hemorrhage and elevated intracranial pressure shows characteristic changes, including increased pulsatility index and decreased end-diastolic flow velocity. Monitoring these parameters may help track trends of intracranial pressure elevation at the bedside.