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1153671 JVUXXX10.1177/15443167231153671Journal for Vascular UltrasoundKleitsch et al research-article2023 Images in Vascular Ultrasound Journal for Vascular Ultrasound 1 –2 © 2023, Society for Vascular Ultrasound Changes on Continuous Transcranial Doppler Article reuse guidelines: sagepub.com/journals-permissions During Treatment for Elevated Intracranial https://doi.org/10.1177/15443167231153671 DOI: 10.1177/15443167231153671 journals.sagepub.com/home/jvu Pressure 1,2 3 Julianne Kleitsch, BA , Kaitlin J. Reilly-Kit, MD , and Alexandra S. Reynolds, MD Panel 1. Mean velocity (MV) and pulsatility index (PI) of the right MCA at a depth of 52mm were monitored using continuous transcranial Doppler. (A) Initial waveforms with high PI concerning for elevated intracranial pressure. (B) Treatment with hypertonic saline is started causing systemic hypotension with worsening MV and PI. (C) Hypotension is treated with resultant increase in MV and decrease PI. (D) Final post-treatment waveform has normalized with improved MV and PI. A 53-year-old man with alcohol-related cirrhosis presented suggested an intracranial vasodilatory response to systemic with acute peritonitis and esophageal variceal hemorrhage and hypotension that contributed to elevated intracranial pressure developed septic and hemorrhagic shock and acute-on-chronic and resultant higher resistance to flow. When the systemic liver failure with ammonia of 497 μmol/L. He developed hypotension resolved (Panels 1C and 2, Arrow 3), MV increased severe cerebral edema
Journal for Vascular Ultrasound – SAGE
Published: Sep 1, 2023
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