gms | German Medical Science

68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
7. Joint Meeting mit der Britischen Gesellschaft für Neurochirurgie (SBNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

14. - 17. Mai 2017, Magdeburg

Artikel

Artikel empfehlen

Intraoperative ICG-based cortical perfusion measurement in patients suffering from severe traumatic brain injury

Meeting Abstract

Suche in Medline nach

  • Marcel Alexander Kamp - Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Duesseldorf, Deutschland
  • Athanasios K. Petridis - Heinrich Heine University Duesseldorf, Department of Neurosurgery, Duesseldorf, Deutschland
  • Jan Frederick Cornelius - Neurochirurgische Klinik, Universitätsklinikum Düsseldorf, Heinrich Heine Universität, Duesseldorf, Deutschland
  • Bernd Turowski - Uniklinik Düsseldorf, Radiologie, Neuroradiologie, Düsseldorf, Deutschland
  • Hans-Jakob Steiger - Universitätsklinikum Düsseldorf, Neurochirurgische Klinik, Düsseldorf, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMO.11.07

doi: 10.3205/17dgnc062, urn:nbn:de:0183-17dgnc0620

Veröffentlicht: 9. Juni 2017

© 2017 Kamp et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: The pathophysiology of traumatic brain injury (TBI) largely involves the brains vascular structural integrity. We analyzed the value of an intraoperative cortical ICG-angiography in patients with TBI who underwent decompressive craniectomy to treat acute subdural hematoma.

Methods: ICG-derived fluorescence curves of cortex and cerebral vessels were recorded using a software integrated into a surgical microscope in 10 patients. The maximum intensity, rise time (RT), time to peak (TTP) and residual fluorescence intensity (FI) were estimated from cortical arteries, the parenchyma and veins. ICG-derived fluorescence parameters were correlated with the short-term outcome 3 months after discharge.

Results: Each five patients had a favorable and five an unfavorable outcome. Patients with a favorable outcome showed a significant longer RT in the arteries and a trend towards a significant longer RT in the veins. Overall mean residual FI was 47.5 ± 6.8 % for the arteries, 45.0 ± 7% for the parenchyma and 57.6 ± 6% for the veins: The residual FI of the parenchyma and the veins was significantly higher in patients with an unfavorable clinical outcome. Patients with an unfavorable clinical outcome showed an altered shape of the ICG-derived fluorescence curve, a shorter increase of the ICG-derived fluorescence intensity in the cortical arteries and a significant higher residual fluorescence intensity. These observations are likely a correlate of an increased ICP, a capillary leak and a venous congestion.

Conclusion: Intraoperative quantification of the ICG-derived fluorescence might help to appreciate the clinical outcome in patients with severe TBI.