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Medicina Intensiva
versão impressa ISSN 0210-5691
Resumo
PEREZ-BARCENA, Jon et al. Study of a brain microcirculation in cranioencephalic trauma using the Side Stream Field (SDF) system. Med. Intensiva [online]. 2009, vol.33, n.5, pp.256-259. ISSN 0210-5691.
Posttraumatic tissular hypoxia can be due to multiple causes, including microcirculation disturbances, which can be studied with the SDF (Side Stream Dark Field) system. This system is based on a small hand-held microscope that eliminates directly reflected green polarised light from an organ surface using an orthogonal analyser. It offers clear images of red and white blood cells flow through microcirculation. Specific software is later used to determine the lenght and density of microvessels. We present a case of a TBI patient who required surgical evacuation of a brain contusion. Images of the microcirculatory bed were recorded with the SDF microscope and compared with a normal pattern obtained from another patient who was operated on for an unruptured cerebral aneurysm. Both imaging and quantitative analyses showed significant differences in the cerebral microcirculatory status in these patients. Total length and density of vessels were markedly reduced in the TBI patient. SDF imaging allows direct and non-invasive in vivo observation of cerebral microcirculation, and may allow us to deepen our knowledge of the pathophysiology of posttraumatic brain ischemia.
Palavras-chave : Traumatic brain injury; Ischemia; Microcirculation.