THE ASSESSMENT OF SPECTRAL INDICES OF HEMODYNAMICS OF EXTRA- AND INTRACRANIAL ARTERIES IN AN ACUTE SEVERE craniocerebral injury

Abstract

Objective: to identify the indices of spectral Doppler intra- and extracranial arteries, as well as the diagnostic value of the indices of internal carotid arteries to assess the cerebral blood flow in an acute severe craniocerebral injury. Material and methods. The state and hemodynamic indices of the internal carotid artery (ICA) were studied in 26 patients with severe craniocerebral injuries. In 23 (88.5 %) cases ultrasonic characteristics were evaluated in the artery cerebri media (MCA). All patients (n = 26) were divided into 2 groups based on the width of the transverse displacement of the medial structures of the brain: the first group (n = 19) had dislocation ≤ 5 mm, the second group (n = 7) - offset > 5 mm. For comparative analysis and identification of correlations between the ICA and MCA hemodynamic indices, patients (n = 23) who had underwent homolateral ultrasound scanning of the arteries were picked out from subgroups 1a (n = 17) and 2a (n = 6). Results. The comparative analysis of the ICA hemodynamic parameters in the groups 1 and 2 revealed an increase in the indices of peripheral resistance in the extracranial cerebral arteries in patients with lateral dislocation more than 5 mm (p < 0.05). The study of the spectral indices of the blood flow in the homolateral arteries in the 1a group showed the presence of a close inverse correlation between the Gosling index in the ICA and Vps in MCA and significant inverse correlation between Ved and TAMX. The patients of the 2a group showed a strong direct correlation between Vps, PI in the ICA and PI in the MCA, as well as RI of both the arteries. Conclusion. The spectral indices of the ICA blood flow (Vps, PI and RI) acquire diagnostic value in the evaluation of cerebral hemodynamics in patients with dislocation of midline structures more than 5 mm.