Midline shift in patients with closed traumatic brain injury may be driven by cerebral perfusion pressure not intracranial pressure

Description

In traumatic brain injury (TBI), swelling may disturb the potentially uniform pressure distribution in the brain, producing sustained intercompartmental pressure gradients which may associate with midline shift. The presence of pressure gradients is often neglected since bilateral invasive intracranial pressure (ICP) monitoring is not usually considered because of risks and high costs. We evaluated the presence of interhemispheric pressure gradients using bilateral transcranial Doppler (TCD) as means for noninvasive ICP (nICP) monitoring in TBI patients presenting midline shift.

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