Abstract

Background: This article is to assess the role of transcranial Doppler (TCD) in predicting neurological outcome in traumatic brain injury (TBI) and we review its practical aspects in management of TBI.

Material and Methods: This was a prospective study conducted on 50 patients with traumatic brain injury in the Neurosurgery department of a tertiary care hospital in Rajasthan. Transcranial colour Doppler was done in all the patients to assess the cerebral perfusion. Doppler parameters like Peak systolic velocity, End diastolic velocity, Mean flow velocity and Pulsatility index in bilateral proximal middle cerebral arteries were obtained in all the cases. Patients are categorized into normal, hypoperfusion and vasospasm groups depending on the values. Prognosis was assessed by the neurological deficit and mortality.

Results: Among thirty six patients (51%) who had normal measurement on TCD, 72% patients had good outcome, 18% patients had poor neurological status and 10%patients died. Out of these eleven patients (23%) who had vasospasm, three died, six had severe neurological disability and two patients were discharged in good neurological status. Eighteen patients (26%) had hypoperfusion, of whom, 7 patients had neurological impairment and 5 patients progressed to brain death.

Conclusion: TCD is a valuable imaging tool in prognostication of patients with TBI information by providing information about the cerebral blood flow. It is an emerging modality in predicting neurological outcome in patients with TBI.

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