[Transcranial Doppler ultrasound monitoring of patients with viral infections of the central nervous system].
Serial (days 1, 3, 5, 8, 14, 21 after admission) transcranial Doppler ultrasound measurements of the mean blood velocity (Vmean) and the pulsatility index (PI) in the middle, anterior and posterior cerebral arteries (MCA, ACA, PCA) and the basilar artery were performed in 35 consecutive patients (male, 20, female, 15, mean age: 37 +/- 19 years) with acute meningitis or meningoencephalitis thought to have arisen from viral infections. The Glasgow Coma Scale (GCS) and the TCD findings on days 1-8 were compared with the Glasgow Outcome Scale on day 21 (GOS, short-term outcome). Compared with the reference values recorded in 69 healthy volunteers, Vmean was significantly elevated in the MCA, ACA and PCA on days 1-3, and on day 5 in the MCA (P< 0.01-0.05). The PI was significantly increased on days 1-8 in all intracranial arteries (P < 0.001-0.05). With respect to the outcome, patients with a poor outcome (GOS score 1-3) were found to have had significantly more markedly elevated PI in all vessels on days 3-8 (P < 0.05) than the patients with a good outcome (GOS score 4 and 5). The linear regression coefficient for the relationship between the PI on days 3-8 and the GOS ranged from r = 0.35 to 0.48 (P < 0.01) in all vessels. However, the coefficient (r) between the GCS score on days 3-8 and GOS was more marked (day 3: r = 0.7545, P< 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
Müller
M
M
Neurologische Klinik, Universitätskliniken des Saarlandes, Homburg/Saar.
Merkelbach
S
S
Hasert
K
K
Schimrigk
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity / Q000502:physiology; D001921:Brain / Q000098:blood supply*; D001925:Brain Damage, Chronic / Q000000981:diagnostic imaging; D018792:Encephalitis, Viral / Q000000981:diagnostic imaging*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008587:Meningitis, Viral / Q000000981:diagnostic imaging*; D008875:Middle Aged; D011379:Prognosis; D011673:Pulsatile Flow / Q000502:physiology; D017585:Ultrasonography, Doppler, Transcranial