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An alternative ultrasonographic approach to assess basilar artery flow.
MedLine Citation:
PMID:  21346650     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: Assessment of basilar artery blood flow is of interest in many neurosurgical situations. Using ultrasonography, the standard posterior approach is difficult in neurointensive care. OBJECTIVE:: To evaluate the accuracy of an alternative submandibular approach for the assessment of blood flow in the basilar artery. METHOD:: Fifty adult trauma patients without cervical spine injury were included in a prospective, comparative study. Doppler color-coded sonography of the basilar artery was performed using a 2 MHz pulsed probe. Blood flow velocities and pulsatility indexes obtained from the new submandibular approach and the standard suboccipital approach were compared. RESULTS:: There were no significant differences in systolic, mean, and end-diastolic velocities between both approaches. Strong relationships were found between suboccipital and submandibular approaches for systolic, mean, end-diastolic velocities and pulsatility indexes (r respectively equal to 0.94, 0.95, 0.95 and 0.91; p<0.0001 for all). The mean bias between suboccipital and submandibular approaches was 1.1 cm/sec for systolic velocity, 0.4 cm/sec for mean velocity, -1.2 cm/sec for end-diastolic velocity and 0.0 for pulsatility index. CONCLUSION:: This alternative submandibular approach appears to be accurate in measuring blood flow velocity and pulsatility index in the basilar artery. The main advantage of this approach is to facilitate monitoring of brain stem perfusion by avoiding neck flexion. This can be very helpful in intensive care settings.
Authors:
Thomas Geeraerts; Wissam Thome; Sébastien Tanaka; Pierre Etienne Leblanc; Jacques Duranteau; Bernard Vigué
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-22
Journal Detail:
Title:  Neurosurgery     Volume:  -     ISSN:  1524-4040     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
AP-HP, Univ Paris-Sud, Hôpital de Bicêtre, Département d'Anesthésie-Réanimation, F-94275 Le Kremlin-Bicêtre, France.
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