Transcranial Doppler Ultrasound Use in Pediatric Patients With Penetrating Traumatic Brain Injuries |
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| Institution: | 1. Duke University, School of Nursing, Durham, NC, USA;2. Duke University Health System, Durham, NC, USA;3. Division of Pediatric Critical Care, School of Medicine Department of Pediatrics, School of Nursing, Duke University, Durham, NC, USA;1. Advantage Home Health, Altoona, PA;2. Department of Nursing and Allied Health Professions, Indiana University of Pennsylvania, Indiana, PA;1. Department of Neurology, Michigan Medicine, Michigan NeuroSport, 2301 Commonwealth Boulevard, Suite 1022, Ann Arbor, MI 48105, USA;2. Department of Emergency Medicine, Children’s Emergency Services, Michigan Medicine, North Campus Research Complex, University of Michigan Injury Center, 2800 Plymouth Road, Suite G080, NCRC Building 10, Ann Arbor, MI 48105, USA;1. Department of Imaging Sciences, University of Rochester – Strong Memorial Hospital, Rochester, NY;2. University of Rochester School of Medicine, Rochester, NY |
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| Abstract: | The purpose of this article is to increase awareness of the usefulness of transcranial Doppler (TCD) ultrasound as a noninvasive neuromonitor and bedside ultrasound in pediatric patients who have experienced a penetrative traumatic brain injury (TBI) as a result of a firearm. To date, the use of TCD is not standard of care in pediatric TBI patients. TCD is a portable ultrasound that can be performed in any care environment. The use of TCD in pediatric TBI studies have demonstrated abnormalities in cerebral blood flow velocity, autoregulation, and embolic events; all of which have been associated with poor neurocognitive and functional outcomes. A penetrating brain injury as a result of a firearm is associated with ongoing vascular injury and thereby an increased risk for poor neurologic sequelae. We discuss two exemplars of TCD use in children who experienced a firearm-related penetrating TBI and their TCD findings. Both exemplars identified the unique insights provided by TCD that were unappreciated by clinical observation. This article provides early evidence for the use of TCD as a neuromonitor in pediatric penetrating TBI. |
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| Keywords: | Firearm Penetrating Traumatic brain injury Transcranial Doppler Ultrasound |
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