[Detection of reduced flow velocities in the anterior cerebral artery in premature and newborn infants and in older infants with cerebral hemorrhages using pulsed Doppler sonography].
34 infants with intracerebral haemorrhage (intraventricular haemorrhage 26; subdural haemorrhage 2; epidural haemorrhage 2; subarachnoidal haemorrhage 4) were investigated by pulsed Doppler-sonography. Absolute flow velocities were measured in the anterior cerebral arteries in infants with intracranial haemorrhage and compared with the flow velocities of a healthy control group of identical gestational age, actual age and weight. All flow velocities were significantly reduced in premature and full-term infants with intracranial haemorrhage, whereas the pulsatility-index was significantly increased. 10 infants with severe intracranial haemorrhage developed a shunt-depending posthaemorrhagic hydrocephalus. These children showed a significant reduction of all flow velocities in the anterior cerebral arteries in comparison to the healthy control group. The diastolic forward flow was more reduced than the maximal systolic velocity resulting in a significant increase of the pulsatility index. In rapidly progressive hydrocephalus, often no diastolic flow or even a retrograde diastolic flow could be found. After shunt-implantation normalisation of the flow velocities could be observed. Reduced flow velocities could be observed. Reduced flow velocities in the anterior cerebral arteries in infants with subdural, epidural and subarachnoidal haemorrhage were associated with a bad outcome: 1 infant died, 1 infant developed severe leucomalacia, and 1 infant showed atrophy of one cerebral hemisphere. Normal flow velocities in the intracranial arteries in subdural, epidural and subarachnoidal were associated with a favourable prognosis. Absent or even retrograde diastolic flow indicates a dramatic decrease of cerebral perfusion. The longer the pathologic flow patterns were demonstrable the worse was prognosis.
Kinderklinik mit Poliklinik, Universität Erlangen-Nürnberg.
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KH
Deeg
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Rupprecht
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Segerer
D001783:Blood Flow Velocity; D002545:Brain Ischemia / Q000503:physiopathology*; D002536:Cerebral Arteries / Q000503:physiopathology; D002543:Cerebral Hemorrhage / Q000503:physiopathology*; D002560:Cerebrovascular Circulation; D004453:Echoencephalography; D006407:Hematoma, Epidural, Cranial / Q000503:physiopathology; D006408:Hematoma, Subdural / Q000503:physiopathology; D006801:Humans; D006849:Hydrocephalus / Q000503:physiopathology; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000503:physiopathology*; D011379:Prognosis; D013345:Subarachnoid Hemorrhage / Q000503:physiopathology
Nachweis erniedrigter Flussgeschwindigkeiten in der Arteria cerebri anterior bei Früh- und Neugeborenen sowie älteren Säuglingen mit Hirnblutungen mit Hilfe der gepulsten Dopplersonographie.