Interest of Transcranial Doppler (TCD) in Emergency in Traumatic Brain Injury Patients at Gabriel Touré University Hospital, Bamako, Mali

Introduction: Transcranial Doppler is a simple, non-invasive and inexpensive examination which allows the assessment of cerebral perfusion. In countries with limited resources, which do not have a means of monitoring intracranial pressure, this examination offers hope of survival for patients with traumatic brain injury. This study was designed to investigate the incidence of early cerebral circulation abnormalities after traumatic brain injury using transcranial Doppler (TCD). Methodology: A descriptive and analytical study was conducted over one year, including patients with traumatic brain injury and an initial Glasgow Coma Scale (GCS) score of less than 15. Non-inclusion criteria: Stroke, brain tumor, cerebral abscess. Exclusion criteria: Inadequate insonation window. Results: Out of 854 traumatic brain injury patients admitted to the emergency department, 112 were included in the study. The average age was 30.14 years, with a sex ratio of 4.1. Initially, 83.5% had moderate traumatic brain injury, and 12.1% had severe traumatic brain injury. Brain CT scans were performed in 95.7% of the patients. Edematous-hemorrhagic contusion was observed in 95% of the patients. On initial TCD, the pulsatility index in the middle cerebral artery was greater than 1.3 in 49.4% of the patients. Diastolic velocity was less than 20 cm/s in 46.4% of cases, and mean velocity was greater than 150 cm/s in 8.7% of cases. In this group, low diastolic velocity indicated cerebral hypoperfusion suggestive of intracranial hypertension. When the pulsatility index was greater than 1.9, no patient had a normal diastolic velocity. Among patients with severe traumatic brain injury, 61.5% had an abnormal pulsatility index compared to 42.3% of patients with moderate traumatic brain injury. Conclusion: TCD is a simple tool for analyzing intracerebral hemodynamics.

Brain and spinal cord trauma:what we know about the therapeutic potential of insulin growth factor 1 gene therapy

Although little attention has been paid to cognitive and emotional dysfunctions observed in patients after spinal co rd injury,several reports have described impairments in cognitive abilities.Our group also has contributed significantly to the study of cognitive impairments in a rat model of spinal co rd injury.These findings are very significant because they demonstrate that cognitive and mood deficits are not induced by lifestyle changes,drugs of abuse,and combined medication.They are related to changes in brain structures involved in cognition and emotion,such as the hippocampus.Chronic spinal cord injury decreases neurogenesis,enhances glial reactivity leading to hippocampal neuroinflammation,and trigge rs cognitive deficits.These brain distal abnormalities are recently called te rtiary damage.Given that there is no treatment for Tertiary Damage,insulin growth factor 1 gene therapy emerges as a good candidate.Insulin growth factor 1 gene thera py recove rs neurogenesis and induces the polarization from pro-inflammato ry towards anti-inflammatory microglial phenotypes,which represents a potential strategy to treat the neuroinflammation that supports te rtiary damage.Insulin growth factor 1 gene therapy can be extended to other central nervous system pathologies such as traumatic brain injury where the neuroinflammatory component is crucial.Insulin growth factor 1 gene therapy could emerge as a new therapeutic strategy for treating traumatic brain injury and spinal cord injury.

Modified constraint-induced movement therapy enhances cortical plasticity in a rat model of traumatic brain injury:a resting-state functional MRI study

Modified constraint-induced movement therapy(mCIMT)has shown beneficial effects on motor function improvement after brain injury,but the exact mechanism remains unclear.In this study,amplitude of low frequency fluctuation(ALFF)metrics measured by resting-state functional magnetic resonance imaging was obtained to investigate the efficacy and mechanism of mCIMT in a control co rtical impact(CCI)rat model simulating traumatic brain injury.At 3 days after control co rtical impact model establishment,we found that the mean ALFF(mALFF)signals were decreased in the left motor cortex,somatosensory co rtex,insula cortex and the right motor co rtex,and were increased in the right corpus callosum.After 3 weeks of an 8-hour daily mClMT treatment,the mALFF values were significantly increased in the bilateral hemispheres compared with those at 3 days postoperatively.The mALFF signal valu es of left corpus callosum,left somatosensory cortex,right medial prefro ntal cortex,right motor co rtex,left postero dorsal hippocampus,left motor cortex,right corpus callosum,and right somatosensory cortex were increased in the mCIMT group compared with the control cortical impact group.Finally,we identified brain regions with significantly decreased mALFF valu es at 3 days postoperatively.Pearson correlation coefficients with the right forelimb sliding score indicated that the improvement in motor function of the affected upper limb was associated with an increase in mALFF values in these brain regions.Our findings suggest that functional co rtical plasticity changes after brain injury,and that mCIMT is an effective method to improve affected upper limb motor function by promoting bilateral hemispheric co rtical remodeling.mALFF values correlate with behavio ral changes and can potentially be used as biomarkers to assess dynamic cortical plasticity after traumatic brain injury.

Safety and efficiency of Wharton’s Jelly-derived mesenchymal stem cell administration in patients with traumatic brain injury:First results of a phase I study

BACKGROUND Traumatic brain injury(TBI)is characterized by a disruption in the normal function of the brain due to an injury following a trauma,which can potentially cause severe physical,cognitive,and emotional impairment.Stem cell transplantation has evolved as a novel treatment modality in the management of TBI,as it has the potential to arrest the degeneration and promote regeneration of new cells in the brain.Wharton’s Jelly-derived mesenchymal stem cells(WJ-MSCs)have recently shown beneficial effects in the functional recovery of neurological deficits.AIM To evaluate the safety and efficiency of MSC therapy in TBI.METHODS We present 6 patients,4 male and 2 female aged between 21 and 27 years who suffered a TBI.These 6 patients underwent 6 doses of intrathecal,intramuscular(i.m.)and intravenous transplantation of WJ-MSCs at a target dose of 1×106/kg for each application route.Spasticity was assessed using the Modified Ashworth scale(MAS),motor function according to the Medical Research Council Muscle Strength Scale,quality of life was assessed by the Functional Independence Measure(FIM)scale and Karnofsky Performance Status scale.RESULTS Our patients showed only early,transient complications,such as subfebrile fever,mild headache,and muscle pain due to i.m.injection,which resolved within 24 h.During the one year follow-up,no other safety issues or adverse events were reported.These 6 patients showed improvements in their cognitive abilities,muscle spasticity,muscle strength,performance scores and fine motor skills when compared before and after the intervention.MAS values,which we used to assess spasticity,were observed to statistically significantly decrease for both left and right sides(P<0.001).The FIM scale includes both motor scores(P<0.05)and cognitive scores(P<0.001)and showed a significant increase in pretest posttest analyses.The difference observed in the participants’Karnofsky Performance Scale values pre and post the intervention was statistically significant(P<0.001).CONCLUSION This study showed that cell transplantation has a safe,effective and promising future in the management of TBI.

Is Goshinjo therapy effective in cognitive impairment after severe traumatic brain injury?

We report a case of a 21-year-old man who had severe traumatic brain injury as a result of an accident at the age of 16 years. Two years and 4 months after the trauma, at the age of 19 years, he still had severe right hemiplegia and cognitive dysfunction including aphasia and attention and memory disturbance. Conventional rehabilitation programs cou（d not resolve all of the neuropsychological problems. He started receiving Goshinjo therapy over a period of 22 months. Following the therapy, significant improvements in verbal intelligence quotient （assessed by the Wechsler Adult Intelligence Scale-Third Edition） and attention and concentration function （using the Wechsler Memory Scale-Revised）, and remission of traumatic epilepsy were observed. Goshinjo therapy is suspected to be effective in the treatment of cognitive dysfunction in the chronic stage after severe traumatic brain injury.

Drug-and cell-based therapies for targeting neuroinflammation in traumatic brain injury

TBI pathology： Traumatic brain injury （TBI） is caused by an external force to the head, resulting in trauma to the brain. Approximately 1.7 million Americans suffer from TBI every year. Out of the 1.7 million suffering from TBI, an estimated 52,000 injuries result in death, leaving a mass amount of peo- ple with symptoms that could last a few days, a few years, or their entire life （Faul et al., 2010）. TBI can be classified as mild, moderate and severe. Depending on the classification and the extent of the injury, TBI can cause both physical symptoms and cognitive disorders （Lozano et al., 2015）.

Efficacy of super-pulsed 905 nm Low Level Laser Therapy (LLLT) in the management of Traumatic Brain Injury (TBI): A case study

Traumatic brain injury is a major health concern worldwide with massive financial and social impact. Conventional treatments primarily focus on the prevention of further damage to the brain parenchyma, while failing to address the already existent symptoms. Previous clinical studies have shown that Low Level Laser Therapy (LLLT) can significantly reduce pain and induce temporary vasodilation in capillaries, which the authors hypothesize can be used to improve the quality of life in TBI patients by treating their current symptoms, which are predominately migraine-like headaches. This case report illustrates the use of LLLT in the treatment of a patient with a TBI and the great clinical success achieved in the reduction of pain, as measured by VAS—achievable within five treatments of 10 minutes in duration.

The endogenous progenitor response following traumatic brain injury:a target for cell therapy paradigms

Although there is ample evidence that central nervous system progenitor pools respond to traumatic brain injury,the reported effects are variable and likely contribute to both recovery as well as pathophysiology.Through a better understanding of the diverse progenitor populations in the adult brain and their niche-specific reactions to traumatic insult,treatments can be tailo red to enhance the benefits and dampen the deleterious effects of this response.This review provides an overview of endogenous precursors,the associated effects on cognitive recovery,and the potential of exogenous cell therapeutics to modulate these endogenous repair mechanisms.Beyond the hippocampal dentate gyrus and subventricular zone of the lateral ventricles,more recently identified sites of adult neurogenesis,the meninges,as well as circumventricular organs,are also discussed as targets for endogenous repair.Importantly,this review highlights that progenitor prolife ration alone is no longer a meaningful outcome and studies must strive to better chara cterize precursor spatial localization,transcriptional profile,morphology,and functional synaptic integration.With improved insight and a more targeted approach,the stimulation of endogenous neurogenesis remains a promising strategy for recovery following traumatic brain injury.

Multi-watt near-infrared light therapy as a neuroregenerative treatment for traumatic brain injury

Infrared light represents a broad spectrum of light with wavelengths from 700 nm to 1 million nm（1,000 microns）.At its shortest wavelengths（referred to as near-infrared）,it merges with the red spectrum of visible light.At the longest end（referred to as far-infrared）,it blends into the range of microwaves.

Magnetic resonance imaging and cell-based neurorestorative therapy after brain injury

Restorative cell-based therapies for experimental brain injury, such as stroke and traumatic brain injury,substantially improve functional outcome. We discuss and review state of the art magnetic resonance imaging methodologies and their applications related to cell-based treatment after brain injury. We focus on the potential of magnetic resonance imaging technique and its associated challenges to obtain useful new information related to cell migration, distribution, and quantitation, as well as vascular and neuronal remodeling in response to cell-based therapy after brain injury. The noninvasive nature of imaging might more readily help with translation of cell-based therapy from the laboratory to the clinic.

Treatment of radiation-induced brain injury with bisdemethoxycurcumin

Radiation therapy is considered the most effective non-surgical treatment for brain tumors.However,there are no available treatments for radiation-induced brain injury.Bisdemethoxycurcumin(BDMC)is a demethoxy derivative of curcumin that has anti-proliferative,anti-inflammatory,and anti-oxidant properties.To determine whether BDMC has the potential to treat radiation-induced brain injury,in this study,we established a rat model of radiation-induced brain injury by administe ring a single 30-Gy vertical dose of irradiation to the whole brain,followed by intraperitoneal injection of 500μL of a 100 mg/kg BDMC solution every day for 5 successive weeks.Our res ults showed that BDMC increased the body weight of rats with radiation-induced brain injury,improved lea rning and memory,attenuated brain edema,inhibited astrocyte activation,and reduced oxidative stress.These findings suggest that BDMC protects against radiationinduced brain injury.

Acupuncture-induced oxygen therapy inhibits oxyradical injury and improves microcirculation following brain injury

BACKGROUND： Acupuncture-induced oxygen therapy combines acupoint theory in traditional Chinese medicine and modern oxygen therapy. Clinical studies have shown that acupuncture-induced oxygen therapy results in favorable outcomes for brain injury. However, the mechanisms of action remain poorly understood. OBJECTIVE： To determine pathological changes and malondialdehyde （MDA） content, superoxide dismutase （SOD） and nitric oxide synthase （NOS） activity, as well as hemorheological brain alterations following acupuncture-induced oxygen therapy, and to explore possible mechanisms of acupuncture-induced oxygen therapy on brain injury. DESIGN, TIME AND SETTING： A randomized, controlled, animal experiment was performed at the Animal Experimental Center of Xi＇an Medical University from January 2006 to April 2009. MATERIALS： An oxygen delivery device, through the use of acupuncture （oxygen delivery machine ＋ silver hollowed needle, 0.5 mm inner diameter）, was purchased from Research Center ol Machine, Shaanxi University of Science and Technology in China. METHODS： A total of 180 Sprague Dawley rats were randomly assigned to six groups （n = 30）： normal, sham-surgery （dura mater exposure）, model （brain injury induced by free-falling of heavy object to head）, Xiantaimixture （0.417 mL/100 g following brain injury）, electroacupuncture [acupuncture at Baihui （DU 20）, Housanfi （ST 36）, Yanglingquan （GB 34）, and Sanyinjiao （SP 6） following brain injury], and acupuncture-induced oxygen therapy （oxygen delivery through hollowed needle to Baihui （DU 20）, Housanfi （ST 36）, Yanglingquan （GB 34）, and Sanyinjiao （SP 6） following brain injury, 0.01 mL/minute）. Group intervention was performed once a day for 14 consecutive days. MAIN OUTCOME MEASURES： Pathological changes, MDA content, SOD and NOS activity, and hemorheological alterations in the brain. RESULTS： Obvious pathological changes were observed, such as hemorrhage, edema, and cell necrosis, following brain injury. These alterations were significantly improved following 14 days of treatment with Xiantai mixture, electroacupuncture, and acupuncture-induced oxygen therapy. In particular, acupuncture-induced oxygen therapy resulted in recovery to normal conditions. In the Xiantai mixture, electroacupuncture, and acupuncture-induced oxygen therapy groups, MDA content was significantly reduced （P 〈 0.01）, SOD activity was significantly increased （P 〈 0.01）, NOS activity was significantly decreased （P 〈 0.01）, and hemorheological indices were reduced, compared with the model group, in particular, acupunture-induced oxygen therapy resulted in the most obvious changes （P 〈 0.01）. CONCLUSION： Acupuncture-induced oxygen therapy improved pathological changes following brain injury by possibly improving blood supply, ameliorating ischemia/hypoxia, and inhibiting peroxidation and free radicals.

Experimental study on ex vivo retrovirus-mediated aFGF gene transfer therapy in traumatic brain injury

Objective:To exploretheeffectsof ex vivo retrovirus-mediatedgenetransfertherapywithacidicfibroblast growthfactor(aFGF)in themanagementof traumaticbraininjury.Methods:PLXSN-SPaFGF,a recombinantretroviral vectorexpressingbiologicallyactiveaFGFwas constructedandtransfectedintoculturedembryonicastroglialcellswhich wereinjectedintothesurroundingareasof thecontusionin theratleftparietalcortex.From3d to1monthaftertheim-plantation,thesurvivalof andaFGFgeneexpressionintheimplantedastroglialcellswereexamined,andneuronalapopto-sisandratmotorfunctionimpairmentevaluated.Re sults:TheimplantedaFGF-transducedastroglialcellssurvivedandex-pressedaFGFmRNAandproteinevidentlyat3d aftergrafting.Thenumberof andaFGFgeneexpressionintheastroglial cellsincreasedremarkebly7d anddecreasedto someextent1monthaftertheimplantation.ThereweresignificantaFGF mRNA andproteinexpressionin theneuronssurroundingthecontusionat7d thatdecreasedto relativelylow levels1monthaftertheimplantationof aFGF-transduedastrocytes.Diminishedneuronalapoptosis(P<0.05)andsignificantlyim-provedinthepreviouslyimpairedmotorfunction(P<0.05)of theratswereobservedfrom7d to1monthaftertheimplan-tation.Con clu sion:Thisexperimentsuccessfullyconductedex vivo aFGFgenetransfertherapyin traumaticbraininjury whichprovedto be effectiveinrescuinginjurednervecellfromdeathandenhancingrecoveryof neurologicaldeficiency.

Effect of rehabilitation training combined with neurotrophic therapy on the nerve cytokine secretion and oxidative stress in rehabilitation period of patients with traumatic brain injury

Objective:To study the effect of rehabilitation training combined with neurotrophic therapy on the nerve cytokine secretion and oxidative stress in rehabilitation period of patients with traumatic brain injury.Methods:A total of 98 patients in rehabilitation period of traumatic brain injury who were treated in our hospital between July 2013 and September 2016 were collected and divided into control group and observation group according to the random number table method, and 49 cases in each group. Control group received regular neurotrophic therapy, and observation group received rehabilitation training combined with neurotrophic therapy. The differences in the contents of nerve cytokines and oxidative stress indexes were compared between the two groups before and after intervention.Results:Before intervention, differences in serum levels of nerve injury indexes, neurotrophy indexes, amino acid neurotransmitters and oxidative stress indexes were not statistically significant between the two groups of patients. After intervention, serum nerve injury indexes MBP, NGB, NSE and S-100B levels as well as excitatory amino acids Glu and Asp levels of observation group were lower than those of control group;neurotrophy indexes BDNF and GDNF levels as well as inhibitory amino acids GABA and Gly levels were higher than those of control group;serum oxidative stress indexes SOD and CAT levels were higher than those of control group;MDA level was lower than that of control group.Conclusions:Rehabilitation training combined with neurotrophic therapy can effectively optimize the nerve function and reduce the systemic oxidative stress state of patients in rehabilitation period of traumatic brain injury.

外泌体与围生期炎症性脑损伤

围生期脑损伤(perinatal brain injury,PBI)是婴儿死亡和儿童残疾的主要原因。大部分患有PBI的儿童中枢神经系统损伤主要源于绒毛膜羊膜炎(chorioamnionitis,CHORIO),CHORIO影响胎盘的通透性和血流,是足月儿和早产儿脑损伤的常见独立危险因素。外泌体是直径40~160 nm的纳米级囊泡,能够携带多种生物活性物质,并完成细胞间信息交流。研究发现,不同细胞来源的外泌体具有不同的生物学功能。外泌体作为母胎交流的重要介质,通过参与免疫调节抑制炎症、促进血管和髓鞘形成以及建立胎盘防御屏障,可能介导脑损伤的修复,在脑损伤和神经发育障碍中有一定的治疗意义。本综述探讨外泌体在PBI儿童中的病理机制以及潜在的治疗作用,以期为临床PBI提供有效的治疗策略。

鼻咽癌放射治疗患者放射性脑损伤的危险因素分析及风险预测模型构建

目的探讨影响鼻咽癌放射治疗患者发生放射性脑损伤的危险因素,并构建风险预测模型。方法回顾性选取郑州大学第五附属医院2021年1月至2022年1月放射治疗后发生放射性脑损伤的40例鼻咽癌患者作为发生组,另选取同期接受放射治疗后未发生放射性脑损伤的61例鼻咽癌患者作为未发生组。收集两组患者的一般资料及临床指标,采用logistic回归性分析检验影响鼻咽癌放射治疗患者并发放射性脑损伤的危险因素,同时依据回归分析结果构建风险预测模型,绘制受试者工作特征(ROC)曲线检验风险预测模型对鼻咽癌放射治疗患者放射性脑损伤发生的预测价值。结果两组患者双侧颞叶最高照射剂量、血清胶质纤维酸性蛋白(GFAP)、血清环氧化酶-2(COX-2)及血浆纤维蛋白原(Fib)差异有统计学意义(P<0.05)。logistic回归性分析显示,高水平双侧颞叶最高照射剂量、血清GFAP、血清COX-2及血浆Fib是影响鼻咽癌放射治疗患者放射性脑损伤发生的危险因素(P<0.05)。构建风险预测模型,ROC内部验证显示曲线下面积(AUC)为0.911,AUC的95%CI为0.851~0.972,特异度0.967,敏感度0.775,约登指数0.742,(P<0.001)。结论双侧颞叶最高照射剂量、血清GFAP、血清COX-2及血浆Fib是影响鼻咽癌放射治疗患者放射性脑损伤发生的危险因素。

铁死亡在创伤性中枢神经系统损伤治疗中的研究进展

创伤性中枢神经系统损伤包括创伤性脑损伤和脊髓损伤,具有极高的致残率和死亡率,巨额的医疗费用和后遗症进一步加重了患者和家属的经济负担及心理负担。目前对创伤性中枢神经系统损伤的治疗包括手术疗法、物理疗法、药物治疗及后期康复治疗,但均不能取得理想的疗效,亟须更有效的治疗方法。铁死亡作为新近发现的程序性细胞死亡方式之一,被证实在创伤性中枢神经系统继发性损伤中发挥关键作用,但临床转化有限。本文通过总结抗中枢神经系统损伤铁死亡药物研究成果,分析铁死亡抑制剂的种类及作用结果,为临床治疗创伤性中枢神经系统损伤及药物开发提供新思路。

创伤性脑损伤与自发性蛛网膜下腔出血所致脑血管痉挛的TCD临床对比观察

目的探讨经颅多普勒超声（TCD）对创伤性脑损伤（TBI）及自发性蛛网膜下腔出血（SAH）所致脑血管痉挛（CVS）的诊断价值。方法选择381例TBI和216例SAH患者,应用CT、CTA及TCD等确定患者的临床诊断并筛选出存在CVS者,对TCD发现的CVS患者按血管痉挛程度（VmMCA值）分为轻、中、重三组。每天1次行TCD监测。比较两组CVS发生率、开始时间、严重程度及持续时间。结果 381例TBI患者中共发生CVS 210例,发生率为55.12%;CVS发生在伤后2~3 d,持续10~14 d。而216例SAH患者CVS发生151例,发生率为69.91%,发生时间在发病后3~7 d,持续14~21 d。两组CVS发生率、发病高峰及病程比较差异均有统计学意义（P〈0.01）。结论 TCD对CVS能准确进行临床诊断;创伤性脑损伤所致脑血管痉挛发生率低于自发性蛛网膜下腔出血脑血管痉挛,但发生时间早,发生程度轻,持续时间短,预后好。

TCD参数与重型颅脑损伤患者颅内压及脑灌注压的相关性研究

目的:探讨重型颅脑损伤患者经颅多普勒(transcranial doppler,TCD)参数与颅内压(intracranialpressure,ICP)及脑灌注压(cerebral perfusion pressure,CPP)的关系。方法:应用TCD检测40例重型颅脑损伤患者入院后连续7 d的大脑中动脉收缩期峰血流速度(peak systolic velocity,Vs)、舒张期末血流速度(end diastolicvelocity,Vd)、平均血流速度(mean velocity,Vm)以及搏动指数(pulsatility index,PI)、阻力指数(resistance index,RI),同时记录ICP、CPP、平均动脉压(mean arterial pressure,MAP)。结果:ICP与Vs、Vd、Vm均呈负直线回归关系,ICP与RI呈正直线回归关系,而与PI呈正指数回归关系。CPP与Vs、Vd、Vm均呈正直线回归关系,CPP与RI呈负直线回归关系,而与PI呈负指数回归关系。其中PI的相关系数最大(rICP=0.809,rCPP=-0.828,P<0.001)。在20 mmHg≤ICP≤50 mmHg4、0 mmHg≤CPP≤70 mmHg范围内,PI与ICP、CPP也呈直线相关,且相关性更好(rICP=0.864,rCPP=-0.887,P<0.001)。结论:TCD参数能够定性或半定量地判断ICP和CPP的变化,应用TCD是无创监测ICP和CPP的方向。

TCD无创监测颅脑外伤患者ICP变化的临床价值探讨

目的:通过对颅脑外伤患者的颅内压(Intracranial pressure,ICP)和经颅多普勒(Transcranial doppler ultrasonography,TCD)监测结果进行对比分析,以进一步评估TCD无创监测ICP的临床应用价值。方法:对进行手术治疗的32名脑外伤患者行持续床旁ICP监测,术后次日采用经颅多普勒超声床旁检测患侧大脑中动脉的频谱图像及各参数并记录即时的颅内压值,按颅内压进行分组,将颅内压增高的各组的TCD频谱图像和参数与颅内压正常组进行比较分析。结果:(1)频谱图像:颅内压轻度增高组的频谱图像和颅内压正常组无明显差别,在颅内压中度增高组中有D峰前切迹加深现象,颅内压重度增高组中有S2峰消失和"单尖峰"出现,舒张期血流下降明显。(2)TCD参数:随着ICP增高,Vs、Vd和Vm均逐渐下降,以Vd下降最明显,而PI和RI则逐渐升高。结论:TCD进行无创的颅内压监测有一定的临床应用价值,对颅脑外伤患者在颅内压增高明显时能有提示,但不能在颅内压增高的早期作出明确的提示,对颅内压增高的判断频谱图像优于参数。