Document Detail

New transcranial Doppler index in infants with hydrocephalus: transsystolic time in clinical practice.
MedLine Citation:
PMID:  19632761     Owner:  NLM     Status:  In-Process    
Raised intracranial pressure (ICP) in infants with hydrocephalus may cause (ir)reversible damage to the brain parenchyma but can be present without clinical signs and/or symptoms. Therefore, new, favorably noninvasive, detection methods are needed to distinguish between compensated hydrocephalus with normal intracranial pressure and slowly progressive hydrocephalus with increased intracranial pressure. Because early ischemic changes in the brain parenchyma are associated with increased intracranial pressure, transcranial Doppler (TCD) indices may be useful to detect increased intracranial pressure in infants with hydrocephalus. Twenty-four infants with hydrocephalus underwent noninvasive ICP measurement, magnetic resonance imaging and TCD before and after cerebrospinal fluid (CSF) diversion. The TCD indices were paired to the anterior fontanelle pressure findings and compared for correlation. After CSF diversion, ICP decreased significantly from 21.8 cm H(2)O to 7.7 cm H(2)O (p<0.005). The transsystolic time (TST) as measured with TCD increased significantly from 176 to 221 ms (p<0.005), whereas the pulsatility index (PI) decreased significantly from 1.3 to 1.0 (p<0.05). The resistance index (RI) decreased significantly from 0.73 to 0.63 (p<0.05). Mean bloodflow velocity through the middle cerebral artery increased significantly from 55.5 to 75.8 cm/s (p<0.005). TST has a strong correlation with the ICP (p<0.005). Measuring TST with TCD can be helpful in the decision-making process about whether to perform CSF diversion in infants with hydrocephalus. Because TST is related solely to the relative changes in the flow velocity caused by intracranial physical properties, it has a closer relation to ICP than the PI and the RI.
Paul H Leliefeld; Rob H J M Gooskens; Rob J M Peters; Cees A F Tulleken; L Jaap Kappelle; K Sen Han; Luca Regli; Patrick W Hanlo
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-07-26
Journal Detail:
Title:  Ultrasound in medicine & biology     Volume:  35     ISSN:  1879-291X     ISO Abbreviation:  Ultrasound Med Biol     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0410553     Medline TA:  Ultrasound Med Biol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1601-6     Citation Subset:  IM    
Department of Neurosurgery, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands.
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