World Neurosurg. 2023 Sep 9:S1878-8750(23)01288-3. doi: 10.1016/j.wneu.2023.09.020. Online ahead of print.
The topic of current research is the development of a new approach to the diagnosis and treatment tactics of severe brain injury, considering its main pathophysiological mechanism – intracranial hypertension syndrome. Transcranial doppler imaging is a perspective method, which allows quick and noninvasive assessment of the intracerebral blood flow dynamics right at the patient’s bedside. Due to the operator-dependent nature of this method, clinical interpretation can often be contradictory. As a result, no clear criteria for therapy correction have yet been formulated based on this neuroimaging method. This predefines the goal of the study – to identify Doppler patterns of unfavorable craniocerebral injury conditions to form a consistent algorithm of treatment measures on their basis, which will reduce secondary brain damage in patients with severe craniocerebral trauma. Analysis of the therapy performed allowed authors to specify the options for the hyperosmolar solutions for the correction of IIH syndrome and demonstrated no statistically significant difference in effectiveness between mannitol and hypertonic saline solutions.