Objective: To investigate the value of transcranial Doppler (TCD) ultrasonography in evaluating the outcome of severe traumatic brain injury and to correlate the TCD values with intracranial pressure (ICP) and cerebra...Objective: To investigate the value of transcranial Doppler (TCD) ultrasonography in evaluating the outcome of severe traumatic brain injury and to correlate the TCD values with intracranial pressure (ICP) and cerebral perfusion pressure (CPP) monitoring. Methods: A prospective study was conducted to evaluate the contribution of TCD ultrasonography to neurological outcome in a series of 96 severe traumatic brain injury patients. The quantitative variables of TCD ultrasonography included the mean blood flow velocity of the middle cerebral artery (MCA) and pulsatility index within the first 24 hours of admission. The ICP and CPP values were also recorded. Outcome in 6 months postinjury was evaluated using the Glasgow Outcome Scale (GOS 4 5 was considered as "good" and GOS 1 3 as "poor"). Results: The mean blood flow velocity of the MCA was larger than 40 cm/s in 30 (51%) patients with good outcome whereas it was less than 40 cm/s in 27 (73%) patients with poor outcome (P< 0.025 ). The mean PI in cases of good outcome (34 patients, 57%) was lower than 1.5 whereas in poor outcome (30 patients, 83%) was higher than 1.5 (P< 0.001 ). The correlations of ICP and CPP to pulsatility index were statistically significant (P< 0.01 ). Conclusions: TCD ultrasonography is valid in predicting the patients outcome of 6 months and correlates significantly with ICP and CPP values when it is performed in the first 24 hours of severe traumatic brain injury.展开更多
Objective： To investigate the expres- sion of Caspase-3 and Hsp70 in rabbits after severe trau- matic brain injury （TBI） and to explore the feasibility of its application in estimation of injury time in forensic me...Objective： To investigate the expres- sion of Caspase-3 and Hsp70 in rabbits after severe trau- matic brain injury （TBI） and to explore the feasibility of its application in estimation of injury time in forensic medicine. Methods： Arabbit model of heavy TBI was developed by high velocity impact on the parietal bone with an iron stick. Totally 8 healthy adult New Zealand white rabbits were randomly divided into control group （n=2） and injury group （n=6）. Four hours after injury, tissue specimens from the parietal lobe, temporal lobe, occipital lobe, cerebellum and brainstem were harvested to detect the expression of Hsp70 and Caspase-3 by immunohistochemistry. Besides, the gray values of cells positive for HspT0 and Caspase-3 were analyzed with an image analyzer. Results： Immunohistochemistry staining demonstrated a low level of Caspase-3 and Hsp70 expression in normal control group. While in injury group, both the Caspase-3 and Hsp70 expression was significantly elevated （P〈0.05）. Positive cells gathered around the lesion focus. Occipital lobe and cerebellum had fewer positive cells while temporal and brainstem had the fewest. Conclusion： The expression of Caspase-3 and HspT0 at an early stage following severe TBI is characteristic and can be applied to estimate the time of injury.展开更多
文摘Objective: To investigate the value of transcranial Doppler (TCD) ultrasonography in evaluating the outcome of severe traumatic brain injury and to correlate the TCD values with intracranial pressure (ICP) and cerebral perfusion pressure (CPP) monitoring. Methods: A prospective study was conducted to evaluate the contribution of TCD ultrasonography to neurological outcome in a series of 96 severe traumatic brain injury patients. The quantitative variables of TCD ultrasonography included the mean blood flow velocity of the middle cerebral artery (MCA) and pulsatility index within the first 24 hours of admission. The ICP and CPP values were also recorded. Outcome in 6 months postinjury was evaluated using the Glasgow Outcome Scale (GOS 4 5 was considered as "good" and GOS 1 3 as "poor"). Results: The mean blood flow velocity of the MCA was larger than 40 cm/s in 30 (51%) patients with good outcome whereas it was less than 40 cm/s in 27 (73%) patients with poor outcome (P< 0.025 ). The mean PI in cases of good outcome (34 patients, 57%) was lower than 1.5 whereas in poor outcome (30 patients, 83%) was higher than 1.5 (P< 0.001 ). The correlations of ICP and CPP to pulsatility index were statistically significant (P< 0.01 ). Conclusions: TCD ultrasonography is valid in predicting the patients outcome of 6 months and correlates significantly with ICP and CPP values when it is performed in the first 24 hours of severe traumatic brain injury.
基金The paper was supported by the National Natural Science Foundation of China，the Natural Science Foundation of Chongqing of China，the Key Projects Foundation of the Ministry of Public Security
文摘Objective： To investigate the expres- sion of Caspase-3 and Hsp70 in rabbits after severe trau- matic brain injury （TBI） and to explore the feasibility of its application in estimation of injury time in forensic medicine. Methods： Arabbit model of heavy TBI was developed by high velocity impact on the parietal bone with an iron stick. Totally 8 healthy adult New Zealand white rabbits were randomly divided into control group （n=2） and injury group （n=6）. Four hours after injury, tissue specimens from the parietal lobe, temporal lobe, occipital lobe, cerebellum and brainstem were harvested to detect the expression of Hsp70 and Caspase-3 by immunohistochemistry. Besides, the gray values of cells positive for HspT0 and Caspase-3 were analyzed with an image analyzer. Results： Immunohistochemistry staining demonstrated a low level of Caspase-3 and Hsp70 expression in normal control group. While in injury group, both the Caspase-3 and Hsp70 expression was significantly elevated （P〈0.05）. Positive cells gathered around the lesion focus. Occipital lobe and cerebellum had fewer positive cells while temporal and brainstem had the fewest. Conclusion： The expression of Caspase-3 and HspT0 at an early stage following severe TBI is characteristic and can be applied to estimate the time of injury.
