Research Article
Volume 6 Issue 5 - 2020
Transcranial Doppler (TCD) Interest for Early Care in Post-Traumatic Intra-Parenchymal Hematomas Not Accessible to Surgery
Ramarolahy Rija1, Razafindraibe Faneva Angelo Parfait2*, Razanamarovola Onihitoerantsoa Felatiana1, Rakotoarison Ratsaraharimanana Catherine Nicole2 and Rajaonera Andriambelo Tovohery1
1Surgical Intensive Care of the Joseph Ravoahangy Andrianavalona University Hospital, Antananarivo, Madagascar
2Surgical Emergency Unit of the Joseph Ravoahangy Andrianavalona University Hospital, Antananarivo, Madagascar
*Corresponding Author: Razafindraibe Faneva Angelo Parfait, Surgical Emergency Unit of the Joseph Ravoahangy Andrianavalona University Hospital, Antananarivo, Madagascar.
Received: March 14, 2020; Published: April 29, 2020


Introduction: The transcranial Doppler (TCD) is an integral part of the initial care of the head trauma patient. The study objective was to assess the interest of TCD for the early care in post-traumatic intra-parenchymal hematomas not accessible to surgery

Methods: It is a prospective cohort study on the early care of post-traumatic intra-parenchymal hematomas observed at the Surgical intensive care of the Joseph Ravoahangy Andrianavalona University Hospital, Antananarivo, Madagascar over a period of one year, from January 2019 to December 2019. All patients with and without TCD were followed during the first 5 days of hospitalization. Neurological progression and patient condition were the primary outcome.

Results: 47 patients were retained. Among them, 16 patients or 34.04% had benefited from a TCD. The patients average age was 54.10 +/- 12.05 years with a sex ratio 1.76 (30/17). At admission, all patients were comatose. Anisocoria was observed in 21 patients or 44.68% of the cases. The majority of the patients had high blood pressure at admission (70.21%). Regarding biological assessments, hyponatremia was the most observed (34.03%). The worsening of the neurological state was tripled in patients who did not benefit from TCD (RR: 3.22 [1.43 - 7.27], p = 0.003,). In contrary, there was no significant difference in early mortality (first 5 days) for the 2 groups (RR: 0.95 [0.47 - 1.91], p = 0.57).

Conclusion: The transcranial Doppler is an important tool for the care of brain injury in the acute phase.

Keywords: Transcranial Doppler; Brain Monitoring; Pulsatility Index; Management


  1. DM Stein., et al. “Brief episodes of intracranial hypertension and cerebral hypoperfusion are associated with poor functional outcome after severe traumatic brain injury”. The Journal of Trauma: Injury, Infection, and Critical Care2 (2011): 364-374.
  2. M Balestreri., et al. “Impact of intracranial pressure and cerebral perfusion pressure on severe disability and mortality after head injury”. Neurocritical Care 1 (2006): 8-13.
  3. Vergouwen., et al. “Cerebral infarction after subarachnoid hemorrhage contributes to poor outcome by vasospasm-dependent and -independent effects”. Stroke 42.4 (2011): 924-929.
  4. P Bouzat., et al. “Transcranial doppler to screen on admission patients with mild to moderate traumatic brain injury”. Neurosurgery 6 (2011): 1603-1610.
  5. Chan KH., et al. “Intracranial blood flow velocity after head injury: relationship to severity of injury, time, neurological status and outcome”. Journal of Neurology, Neurosurgery, and Psychiatry 9 (1992): 787-791.
  6. Quire JC., et al. “Early changes in middle cerebral artery blood flow velocity after head injury”. Journal of Neurosurgery 4 (1998): 526-532.
  7. Trabold F., et al. “The prognostic value of transcranial Doppler studies in children with moderate and severe head injury”. Intensive Care Medicine 1 (2004): 108-112.
  8. Jaffres P., et al. “Transcranial Doppler to detect on admission patients at risk for neurological deterioration following mild and moderate brain trauma”. Intensive Care Medicine 6 (2005): 785-790.
  9. Ract C., et al. “Early Transcranial Doppler in patients with severe brain trauma”. Intensive Care Medicine 33 (2007): 645-651.
  10. Servadei F., et al. “The value of the ‘‘worst’’ computed tomographic scan in clinical studies of moderate and severe head injury”. European Brain Injury Consortium. Neurosurgery1 (2000): 70-75.
Citation: Razafindraibe Faneva Angelo Parfait., et al. “Transcranial Doppler (TCD) Interest for Early Care in Post-Traumatic Intra- Parenchymal Hematomas Not Accessible to Surgery”. EC Anaesthesia 6.5 (2020): 08-12.

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