Microcirculatory Biomarkers of Secondary Cerebral Ischemia in Traumatic Brain Injury.

ABSTRACT

AIM: The purpose of this study was to study changes in cerebral microcirculation parameters in the development of secondary cerebral ischemia (SCI). METHODS: A total of 202 patients with a Glasgow Coma Scale score ≤ 12 after experiencing a traumatic brain injury (TBI) were recruited for the study within 6 h of the injury. All patients were subjected to perfusion computed tomography. The cerebral blood flow velocity was recorded using transcranial Doppler ultrasound. The arterial blood pressure was measured noninvasively. The cerebrovascular resistance (CVR), cerebral arterial compliance (CAC), cerebrovascular time constant (CTC), and critical closing pressure (CCP) were measured using the neuromonitoring complex. All patients had unilateral foci of posttraumatic ischemia. Statistical analysis was performed using a paired Student's t test and factor analysis. RESULTS AND CONCLUSION: The CVR and CCP were significantly increased in patients who developed SCI after TBI, whereas the CAC and CTC were significantly decreased (P < 0.05). Factor analyses revealed that the CVR, CAC, and CTC were significantly associated with development of posttraumatic ischemia (P < 0.05). The changes in the CVR and CCP in patients with TBI were significantly associated with SCI development (P < 0.05).