Abstract
Introduction : Traumatic brain injury (TBI) is reported to cause cerebral circulation disturbance. Ischemia is one of the major risk factors contributing to death and disability. The purpose of this study was to evaluate cerebral circulation in different types of severe TBI. Methods : Ninety patients with severe TBI were divided into five groups, the subdural hematoma group, the epidural hematoma group, the contusion/intracerebral hematoma group, the diffuse axonal injury group, and the diffuse brain swelling group. In these patients, we simultaneously performed Xe-CT and perfusion CT to evaluate the cerebral circulation on post-injury days 1-3. We measured CBF using Xe-CT and mean transit time using perfusion CT, and calculated the cerebral blood volume. Results : The patients who had focal TBI exhibited more significant cerebral circulation disturbances than those that had diffuse TBI. Analysis of variance demonstrated significant differences in CBF and MTT. The CBF values of patients with SDH were the lowest of the 5 groups and the MTT values of patients with SDH were the highest. Conclusion : We demonstrated that there were differences in cerebral circulation among different intracranial pathological conditions. All possible treatment measures, including hypothermia therapy, should be performed based on pathological conditions.
