Value of transcranial Doppler indices in predicting raised ICP in infantile hydrocephalus

Autor: C. A. F. Tulleken, A.C. Van Huffelen, Patrick W. Hanlo, R. J. A. Peters, J. A. J. Faber, Rob H. J. M. Gooskens, I. J. M. Nijhuis, Jacobus Willemse
Rok vydání: 1995
Předmět:
medicine.medical_specialty
Adolescent
Intracranial Pressure
Ultrasonography
Doppler
Transcranial
Hemodynamics
Central nervous system disease
Postoperative Complications
Predictive Value of Tests
Recurrence
Reference Values
Internal medicine
medicine
Humans
Child
Monitoring
Physiologic
Intracranial pressure
integumentary system
business.industry
musculoskeletal
neural
and ocular physiology
Infant
Newborn
Brain
Infant
General Medicine
medicine.disease
Cerebrospinal Fluid Shunts
humanities
nervous system diseases
Transcranial Doppler
Hydrocephalus
Surgery
Treatment Outcome
medicine.anatomical_structure
Child
Preschool
Predictive value of tests
Pediatrics
Perinatology and Child Health
Vascular resistance
Cardiology
Vascular Resistance
Neurology (clinical)
business
Blood Flow Velocity
Shunt (electrical)
Zdroj: Child's Nervous System. 11:595-603
ISSN: 1433-0350
0256-7040
DOI: 10.1007/bf00300999
Popis: Cerebral hemodynamic changes in infants with progressive hydrocephalus have been studied with the transcranial Doppler (TCD) technique. Several authors have referred to the correlation between the hemodynamic changes and increased intracranial pressure (ICP). Despite conflicting conclusions on the value of pulsatility index (PI) and resistance index (RI) measurements for monitoring infantile hydrocephalus, these pulsatility indices are the most commonly used for this purpose. Although clinical signs of raised ICP are highly variable and unreliable in infants, assumptions have been made in most of the studies about the presence of elevated ICP on the basis of the patient's clinical state. Few studies have reported on actual ICP values, however, and a direct relationship between ICP and TCD changes has never been adequately demonstrated. In the present study, this relationship was investigated in long-term simultaneous TCD/ICP measurements, in an attempt to develop a noninvasive method of monitoring the effect of ICP on intracranial hemodynamics. Two groups of data sets were established. Group I consisted of pre- and postoperative (shunt implantation) TCD/ICP measurements. Group II were long-term simultaneous TCD/ICP recordings showing significant ICP variations. In most of the postoperative measurements there was a decrease in the average PI and RI values. The correlation between PI or RI and ICP in the long-term simultaneous recordings, however, was generally poor. The risk of obtaining false positive or false negative PI or RI values in short-term measurements was also demonstrated. It can be concluded from our results, besides the wide range of reference values for the Doppler indices and extracranial influences upon them, that the present Doppler indices are inadequate for monitoring the complex intracranial dynamic responses in patients with raised ICP.
Databáze: OpenAIRE
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