Transcranial Doppler-guided cerebral blood flow augmentation resulting in near complete resolution of cerebral infarct: A case report of intractable intracranial hypertension

Abstract

Intractable intracranial hypertension is a nerve wrecking clinical challenge which is associated with high morbidity and mortality. Barbiturate coma therapy (BCT) is one of the recommended options for such a challenge but is associated with its own set of complications. Multimodality monitoring is a new advent in neurocritical care and provides a new vision to judiciously cater to such challenges. We hereby report a case of successfully treating intractable intracranial hypertension after maximal possible surgical decompression and evidence of well-formed cerebral ischaemic zones with intracranial multimodality monitoring guided BCT. The positive outcome was to the extent of almost complete reversal of cerebral ischaemic zones and return to normal life schedule.

Keywords

• barbiturate coma therapy
• cerebral ischaemia
• intractable intracranial hypertension
• multimodality monitoring
• transcranial doppler
• traumatic brain injury