Role of cerebral hemodynamic parameters by transcranial Doppler in diagnosis and treatment of intracranial tuberculosis

Objective To study the transcranial Doppler (TCD) -derived cerebral hemodynamic parameters in patients with intracranial tuberculosis, explore the characteristics of cerebral blood flow dynamics and its correlation with intracranial pressure (ICP), and evaluate the role of TCD in the diagnosis and treatment of intracranial tuberculosis. Methods The TCD were performed beside beds one day before the lumbar puncture for pressure testing in 52 patients with intracranial tuberculosis in our hospital between March, 2016 and September, 2016. The spectral atlas systolic peak velocity (Vs), mean velocity (Vm) and end of diastolic velocity (Vd), pulsatility index (PI), and resistance index (RI) of the basilar artery (BA), vertebral artery (VA), anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA) of both sides were determined. The results and ICP were analyzed statistically. Results Compared with control group, the blood flow velocity of anterior cerebral artery (ACA) and middle cerebral artery (MCA) by TCD in patients with intracranial tuberculosis decreased, the blood flow velocity of basilar artery (BA), vertebral artery (VA) and posterior cerebral artery (PCA) were significant decreased, while the pulsatility index (PI) increased. The result of correlation analysis was positive between PI and ICP. Conclusion All internal carotid artery and vertebral basilar artery system were involved in the abnormal changes caused by intracranial tuberculosis. The blood flow velocity of anterior cerebral artery (ACA) and middle cerebral artery (MCA) is faster relatively, which is associated with increased intracranial pressure and PI, and the faster the flow velocity, could demonstrate the more serious the condition, and the worse prognosis. The blood flow velocity of basilar artery and vertebral artery slows down may associate with TB exudate of base of Skull.