*7.3.1.2 Hyperemia phase*

Cerebral hemodynamic patterns indicative of hyperemia can be detected by TCD in about 30% of patients during the first two weeks after severe TBI. The occurrence of this pattern is associated with worsening brain swelling and increased intracranial pressure. TCD can identify patients with posttraumatic brain hyperemia prior to the development of brain swelling, which allows the establishment of therapies aimed at minimizing neural tissue lesions secondary to ICH, such as the determination of the best mean arterial blood pressure range or the determination of the best PCO2 for a patient on mechanical ventilation. Persistence of hyperemia status may be associated with poor neurological prognosis [64].
