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Monitoring of cerebrospinal fluid flow by intraoperative ultrasound in patients with Chiari I malformation.
MedLine Citation:
PMID:  21075511     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the feasibility of intraoperative ultrasound (IOUS) for monitoring cerebrospinal fluid (CSF) flow in patients with Chiari I malformation. METHODS: Twenty patients with Chiari I were scanned by IOUS with color Doppler flow imaging (CDFI). CSF flow status and flow velocity were monitored at different times during the surgery. RESULTS: CSF flow was detected in all 20 cases by IOUS-CDFI in real time. CSF flow was extremely slow or even ceased following bony decompression (craniectomy+laminectomy) in 19 patients; however, bi-directional flow was observed in the systolic phase and cranially directed flow in the diastolic phase. The maximum flow rate ranged from 4 to 13cm/s after duraplasty, and this varied with respiratory rhythm. Only 1 patient showed typical CSF flow after craniectomy, suggesting sufficient decompression, and without further duraplasty. All surgeries were terminated when bi-directional CSF flow was observed using IOUS-CDFI. With the exception of 1 patient, all the patients' symptoms were significantly relieved. CONCLUSION: IOUS-CDFI can monitor CSF flow during posterior fossa decompression, provide information about the re-circulation of CSF flow, and objectively evaluate the efficacy of surgery.
Authors:
Li-Gang Cui; Ling Jiang; Hua-Bin Zhang; Bin Liu; Jin-Rui Wang; Jian-Wen Jia; Wen Chen
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2010-11-12
Journal Detail:
Title:  Clinical neurology and neurosurgery     Volume:  -     ISSN:  1872-6968     ISO Abbreviation:  Clin Neurol Neurosurg     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7502039     Medline TA:  Clin Neurol Neurosurg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2010 Elsevier B.V. All rights reserved.
Affiliation:
Department of Diagnostic Ultrasound, Peking University Third Hospital, Beijing 100191, China.
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