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Cerebral pulsatility index by transcranial Doppler sonography predicts the prognosis of patients with fulminant hepatic failure

  • Manri Kawakami
    Affiliations
    Second Department of Internal Medicine, Faculty of Medicine, Tottori University School of Medicine, Nishimachi 36-1, Yonago 683-8504, Japan
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  • Masahiko Koda
    Correspondence
    Corresponding author. Second Department of Internal Medicine, Faculty of Medicine, Tottori University, Nishimachi 36-1, Yonago 683-8504, Tottori, Japan. Tel.: +81 859 38 6527; fax: +81 859 38 6529.
    Affiliations
    Second Department of Internal Medicine, Faculty of Medicine, Tottori University School of Medicine, Nishimachi 36-1, Yonago 683-8504, Japan
    Search for articles by this author
  • Yoshikazu Murawaki
    Affiliations
    Second Department of Internal Medicine, Faculty of Medicine, Tottori University School of Medicine, Nishimachi 36-1, Yonago 683-8504, Japan
    Search for articles by this author
Published:November 13, 2009DOI:https://doi.org/10.1016/j.clinimag.2009.09.006

      Abstract

      Aim

      Cerebral hemodynamic derangement is well known in patients with fulminant hepatic failure. The advent of transcranial Doppler sonography (TCD) enabled noninvasive observation of cerebral hemodynamics. To evaluate its clinical usefulness, we examined longitudinal cerebral hemodynamic parameters in patients with fulminant hepatic failure and severe acute hepatitis.

      Methods

      The six subjects were four patients with fulminant hepatic failure, one with severe acute hepatitis and one with severe acute exacerbation on chronic hepatitis. The pulsatility indices of the right middle cerebral artery were used as parameters of cerebral hemodynamics.

      Results

      The pulsatility indices of the two patients with a deteriorating course had elevated to >1.00, whereas those of the two patients undergoing recovery were within normal limits, as well as of the patients with acute hepatitis or acute exacerbation on chronic hepatitis.

      Conclusion

      Cerebral pulsatility measured by TCD may be a real-time and useful tool to assess and monitor patients with fulminant hepatic failure.

      Keywords

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