Evaluation of cerebral hemodynamics by transcranial Doppler ultrasonography and its correlation with intracranial pressure in an animal model of intracranial hypertension.
Matheus Schmidt Soares, Almir Ferreira de Andrade, Sérgio Brasil, Marcelo DE-Lima-Oliveira, Alessandro Rodrigo Belon, Edson Bor-Seng-Shu, Ricardo de Carvalho Nogueira, Daniel Agustin Godoy, Wellingson Silva Paiva
Author Information
Matheus Schmidt Soares: Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil. ORCID
Almir Ferreira de Andrade: Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil. ORCID
Sérgio Brasil: Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil. ORCID
Marcelo DE-Lima-Oliveira: Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil. ORCID
Alessandro Rodrigo Belon: Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil. ORCID
Edson Bor-Seng-Shu: Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil. ORCID
Ricardo de Carvalho Nogueira: Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil. ORCID
Daniel Agustin Godoy: Hospital Carlos G. Malbrán, Sanatorio Pasteur, Unidad de Cuidados Intensivos, Catamarca, Argentina. ORCID
Wellingson Silva Paiva: Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil. ORCID
BACKGROUND: Transcranial Doppler has been tested in the evaluation of cerebral hemodynamics as a non-invasive assessment of intracranial pressure (ICP), but there is controversy in the literature about its actual benefit and usefulness in this situation. OBJECTIVE: To investigate cerebral blood flow assessed by Doppler technique and correlate with the variations of the ICP in the acute phase of intracranial hypertension in an animal model. METHODS: An experimental animal model of intracranial hypertension was used. The experiment consisted of two groups of animals in which intracranial balloons were implanted and inflated with 4 mL (A) and 7 mL (B) for controlled simulation of different volumes of hematoma. The values of ICP and Doppler parameters (systolic [FVs], diastolic [FVd], and mean [FVm] cerebral blood flow velocities and pulsatility index [PI]) were collected during the entire procedure (before and during hematoma simulations and venous hypertonic saline infusion intervention). Comparisons between Doppler parameters and ICP monitoring were performed. RESULTS: Twenty pigs were studied, 10 in group A and 10 in group B. A significant correlation between PI and ICP was obtained, especially shortly after abrupt elevation of ICP. There was no correlation between ICP and FVs, FVd or FVm separately. There was also no significant change in ICP after intravenous infusion of hypertonic saline solution. CONCLUSIONS: These results demonstrate the potential of PI as a parameter for the evaluation of patients with suspected ICP elevation.
