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Review
. 2008 Apr;38(4):225-34.
doi: 10.1016/j.pediatrneurol.2007.09.012.

Cerebral blood flow and autoregulation after pediatric traumatic brain injury

Yuthana Udomphorn  1 , William M Armstead, Monica S Vavilala
Affiliations
Review

Cerebral blood flow and autoregulation after pediatric traumatic brain injury

Yuthana Udomphorn et al. Pediatr Neurol. 2008 Apr.

Abstract

Traumatic brain injury is a global health concern and is the leading cause of traumatic morbidity and mortality in children. Despite a lower overall mortality than in adult traumatic brain injury, the cost to society from the sequelae of pediatric traumatic brain injury is very high. Predictors of poor outcome after traumatic brain injury include altered systemic and cerebral physiology, including altered cerebral hemodynamics. Cerebral autoregulation is often impaired after traumatic brain injury and may adversely impact the outcome. Although altered cerebrovascular hemodynamics early after traumatic brain injury may contribute to disability in children, there is little information regarding changes in cerebral blood flow and cerebral autoregulation after pediatric traumatic brain injury. This review addresses normal pediatric cerebral physiology and cerebrovascular pathophysiology after pediatric traumatic brain injury.

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Figures

Figure 1
Figure 1
Age-related changes in mean flow velocity of middle cerebral artery (VMCA) in both genders, cerebral blood flow (CBF), cerebral metabolic rate of glucose (CMRglu) [14,22,26,38,39]. (Adult values: VMCA ∼ 50 cm/sec [15,16], CBF 50 ml/100g/min [13], CMRglu 19-33 μmol/100g/min) [26])
Figure 2
Figure 2
Intact (2a) and impaired (2b) cerebral autoregulation by transcranial Doppler ultrasonography from 2 children with traumatic brain injury. Vmca scales are different in Figures 2a and 2b. MABP = mean arterial blood pressure. Lt = left; Rt = right; Vmca = middle cerebral artery flow velocity [110].
Figure 2
Figure 2
Intact (2a) and impaired (2b) cerebral autoregulation by transcranial Doppler ultrasonography from 2 children with traumatic brain injury. Vmca scales are different in Figures 2a and 2b. MABP = mean arterial blood pressure. Lt = left; Rt = right; Vmca = middle cerebral artery flow velocity [110].
See this image and copyright information in PMC

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