The role of trans cranial duplex and Jugular Venous Oxygen Saturation Monitoring as a Predictive Value in Cases of Deep Seated Brain Lesion After Head Trauma

Abstract

Background: Head injuries (HI) are major threat to public health. Initial management should involve careful evaluation and neurological assessment. Aim: To evaluate the predictive value of trans cranial duplex and jugular venous oxygen saturation in patients of Deep Seated Brain Lesion After Head Trauma.Methods: A prospective study on 60 patients of deep seated brain lesion after head trauma was conducted at neurosurgical department and intensive care unit in Zagazig University Hospital. Trans cranial duplex and Jugular Venous Oxygen Saturation Monitoring were assessed in all patients.Results: The best cutoff of TCD (PI) at week 2 that can predict unfavorable outcome among patients is ≥0.95 cm with area under curve 0.838 with 73.1% sensitivity and 60% specificity. The best cutoff of TCD (MFV) at week 2 that can predict unfavorable outcome among patients is ≤39.5 cm/sec with area under curve 0.831 with 84.6% sensitivity and 60% specificity. The best cutoff of baseline SjVO2 that can predict unfavorable outcome among patients is ≥73.5% with area under curve 0.908 with 80.8% sensitivity and 60% specificity.Conclusion: There is statistically significant relation between outcome and SjVO2 at ER admission, and at each point of follow up period till end of second week where all those with favorable outcome were discharged (higher levels significantly associated with unfavorable outcome). There is statistically significant relation between outcome and TCD (MFV) and TCD (PI) at ER admission, first and third week (lower TCD (MFV) and higher TCD (PI) were significantly associated with unfavorable outcome).