Changes of cerebral microcirculation, oxygenation and brain hydration in posttraumatic penumbra at moderate traumatic brain injury

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Abstract

the aim was to study the changes of cerebral microcirculation, oxygenation, and hydration in the foci of posttraumatic "penumbra" (PP) in patients with isolated moderate traumatic brain injury (TBI). Materials and Methods. Seventy-seven adult patients with moderate TBI (women 35; men 42, median age 37 years) were included in a retrospective, non-randomized, single-center study. Inclusion criteria: Glasgow Coma Scale (GCS) < 13 and > 10 at admission; perfusion computed tomography (PCT) performed within 2 days after injury and admission; unilateral frontal/frontotemporal lesions. All patients underwent PCT, which measured net water uptake (NWU) in the PP, as well as microcirculation parameters: cerebral blood flow (CBF), regional cerebral blood volume (CBV), mean transit time (MTT), and time to peak concentration (TTP). Cerebral saturation (SctO2) was assessed using near-infrared spectroscopy in the frontal lobes simultaneously with PCT or immediately after it. Data are presented as median [interquartile range]. Parametric and nonparametric statistical methods were used for the analysis. Results. Elevated NWU values in PP zone were statistically significantly correlated with CBV (p < 0.001) and inversely correlated with TTP, CBF, and SctO2 (p < 0.05). No significant correlations were found between NWU in PP and MTT (p > 0.05). Conclusion. Brain edema after moderate TBI correlates with cerebral microcirculation and saturation parameters (CBF, CBV, TTP and SctO2).

About the authors

A. O Trofimov

Privolzhsky Research Medical University; Saratov State University; Clinic "Persona", Nizhny Novgorod

N. A Eremina

Clinic "Persona", Nizhny Novgorod; Lobachevsky State University of Nizhny Novgorod

K. A Trofimova

Privolzhsky Research Medical University

G. V Kalentev

City Clinical Hospital №10, Nizhny Novgorod

D. E Bragin

University of New Mexico School of Medicine, Albuquerque, USA; Lovelace Biomedical Research Institute, Albuquerque, NM, USA.

F. A Sevryukov

Privolzhsky Research Medical University

Email: fedor_sevryukov@mail.ru
ORCID iD: 0000-0001-5120-2620

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