Evaluation of Cerebral Hemodynamics in Cirrhotic Patients by Transcranial Doppler Ultrasonography and its Relation to Hepatic Encephalopathy

Abstract

The study aimed at Aim evaluation the cerebral hemodynamics in cirrhotic patients by transcranial Doppler ultrasonography and its relation to hepatic encephalopathy. This study is a prospective study , 50 subjects attended El Hussein university hospital, inpatient and outpatient clinic are classified into three groups, group I(10 subjects as a healthy control),group II (20 subjects with liver cirrhosis without hepatic encephalopathy) and group III(20 subjects with liver cirrhosis with hepatic encephalopathy). All patients included in the study underwent a full history taking,complete physical examination, liver functions tests,blood ammonia level,C.B.C,blood urea and serum creatinine and pelvi-abdominal ultarasonography. Transcranial Doppler done for all patients participated in the study using a 2 MHz transducer. The results showed that as regard Trans cranial Doppler ultrasound parameters, we found a statistical significant difference between the three groups as regard Pulsatility Index (P ˂ 0.001), Breath-Holding Index (P ˂ 0.001) ) , Maximum Flow Velocity(P ˂ 0.001) and Mean (P ˂ 0.001), whereas Pulsatility Index, , Maximum Flow Velocity and Mean are higher in patient with Hepatic Encephalopathy, but Breath-holding index is low, there is no statistical significant difference (P > 0.05) between them as regard Minimum Flow Velocity. Conclusion: Transcranial doppler ultrasonography is easy, rapidly done not invasive method for evaluation of cerebral hemodynamic in cirrhotic patient and predection of hepatic encephalopathy.
Keywords: Transcranial doppler, Hepatic encephalopathy, Cirrhosis.