Document Detail


Transcranial Doppler ultrasonography for the evaluation of shunt malfunction in pediatric patients.
MedLine Citation:
PMID:  2054804     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Previous studies have demonstrated a high correlation between hydrocephalus and the resistive index (RI), as determined by transcranial Doppler ultrasonography. Measurements of RI, calculated by dividing the difference between the peak systolic velocity and the end-diastolic velocity by the peak systolic velocity, were attempted in 55 pediatric patients during evaluations for ventriculoperitoneal shunt malfunctions; values were obtained in 52. Indications of shunt malfunction included both clinical and radiographic evidence of increased intracranial pressure. Eleven patients, determined to have functional shunts both by clinical criteria and subsequent outcome, had RIs of 47 +/- 5 (average +/- 1 standard deviation). Shunt malfunctions were confirmed in 41 patients. Prior to shunt revisions, these 41 patients had RIs of 71 +/- 10%; following revision, the RIs fell to 53 +/- 12%. Nine patients had had pre-malfunction RIs of 48 +/- 11% obtained during routine follow-ups; when they subsequently had shunt malfunctions, their RIs had significantly increased. Four of the 41 patients with shunt malfunctions had essentially normal RIs (52 +/- 7%), but had fluid tracking along the shunt; in these, RIs were essentially unaffected by shunt revision. For comparison, 119 pediatric patients with clinically functional ventriculoperitoneal shunts had RIs of 50 +/- 9%. The data, statistically significant with a P value of less than 0.001, showed a correlation between elevated RIs and shunt malfunction; thus, transcranial Doppler ultrasonography is a practical, non-invasive technique useful in the diagnosis of ventriculoperitoneal shunt malfunction.
Authors:
W M Chadduck; H M Crabtree; J B Blankenship; J Adametz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery     Volume:  7     ISSN:  0256-7040     ISO Abbreviation:  Childs Nerv Syst     Publication Date:  1991 Feb 
Date Detail:
Created Date:  1991-08-01     Completed Date:  1991-08-01     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8503227     Medline TA:  Childs Nerv Syst     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  27-30     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock 72202.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cerebrospinal Fluid Shunts / adverse effects*
Child
Child, Preschool
Echoencephalography*
Humans
Hydrocephalus / physiopathology,  surgery,  ultrasonography*
Infant
Intracranial Pressure
Monitoring, Physiologic
Comments/Corrections
Comment In:
Childs Nerv Syst. 1992 Jun;8(4):183-4   [PMID:  1394247 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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