Turkish Neurosurgery 2011 , Vol 21 , Num 2
Correlation of Pulsatility Index with Intracranial Pressure in Traumatic Brain Injury
Melek GURA1, Ilhan ELMACI2, Ramazan SARI3, Nilufer COSKUN1
1Goztepe Training Hospital, Department of Anesthesiology and Reanimation, Istanbul, Turkey
2Acibadem University, Faculty of Medicine, Department of Neurosurgery, Istanbul, Turkey
3Goztepe Training Hospital, Department of Neurosurgery, Istanbul, Turkey
DOI : 10.5137/1019-5149.JTN.3574-10.1 AIM: In traumatic brain injury (TBI) patients, it is desired to monitor the intracranial pressure (ICP) to assess the cerebral haemodynamics and guide the therapy. The study was designed to see if the pulsatility index (PI) measured by transcranial Doppler ultrasonography (TCD) predicts information about ICP values.

MATERIAL and METHODS: In 52 TBI patients with Glasgow Coma Scale (GCS) score < 9, invasive intracranial monitoring and TCD ultrasonography for PI were performed through five days. ICP, cerebral perfusion pressure (CPP), PI values were recorded and calculated. The correlation and regression analysis between ICP, PI and CPP were investigated in the whole group and in patients with a Glasgow Outcome Score (GOS) of 3-5.

RESULTS: The decline in ICP and PI values was significant through five days. The correlation between ICP and PI was strongly significant (p < 0.0001) on days 1, 3 and 5. In patients with a GOS of 3-5, correlation of ICP and PI was also observed. The only significant correlation observed between CPP and PI was on day 5.

CONCLUSION: The strong correlation observed between ICP and PI through the management period of TBI patients can lead us to use TCD ultrasonography-derived PI as a guide if invasive monitoring is not available. Keywords : Intracranial pressure, Pulsatility index, Transcranial doppler ultrasonography, Traumatic brain injury

Corresponding author : Melek Gura, melekgura@gmail.com