The Use of Transcranial Doppler Pulsatility Index to Guide Intracranial Pressure Monitoring in Intoxicated Traumatic Brain Injury Patients

Introduction: Management of intracranial pressure (ICP) represents a cornerstone in the care of traumatic brain injury (TBI) patients. On occasions, intoxicated TBI represent a clinical challenge since their initial imaging is not significantly correlating with elevated ICP yet their neurological exam concerns toward that possibility. Materials and Methods: We present an initial series of intoxicated TBI patients in which the trans-cranial Doppler (TCD) were conducted to noninvasively judge the ICP and correlate those with the clinical findings. Results: A total of four patients is reported in this series. About 50% of the patients had evidence of elevated ICP based on TCD parameters confirmed by ICP monitors. Conclusion: From our series, TCD screening examinations were helpful in expediting an objective guided decision for intracranial pressure monitoring.