Predictive value of cerebral blood velocity for traumatic cerebral infarction

Objective To observe the serial change of postoperative mean blood velocity in the patients with severe traumatic brain injury , and to determine the predictive value of mean blood velocity for occurrence of traumatic cerebral infarction. Methods 104 severe traumatic brain injury patients that have undergone surgical procedures and 40 healthy controls were included in this study. The mean blood velocities of anterior , middle and posterior cerebral arteries were determined by TCD ultrasonography. All data were analyzed statistically. Results Postoperationally,the mean blood velocities of anterior,middle and posterior cerebral arteries in patients with severe traumatic brain injury increased during the 24-hour period immediately,peaked in 3 days,decreased gradually thereafter,and were substantially higher than that in healthy controls during the 14-day period (P0.001). The mean blood velocities of anterior,middle and posterior cerebral arteries in patients with traumatic cerebral infarction were statistically significantly higher than those in patients without traumatic cerebral infarction (P0.05). A receiver operating characteristic curve identified cutoff levels of mean blood velocities of anterior,middle and posterior cerebral arteries that predicted occurrence of traumatic cerebral infarction with the high sensitivity and specificity values (P0.05). Area under curve of mean blood velocity of middle cerebral artery was statistically significantly larger than those of anterior and posterior cerebral arteries (P0.05). Conclusion Cerebral arterial vasospasm may play an important role in secondary brain injury after head trauma,and can be involved in pathophysiology of traumatic cerebral infarction. The mean blood velocity of cerebral arteries , especially middle cerebral artery,can predict occurrence of traumatic cerebral infarction.