[Cerebral Doppler ultrasound in fetal hydrocephalus].
Within a six-year period (1988-1993), we diagnosed and treated 143 cases of fetal hydrocephalus. We investigated the relationship between the degree of dilatation of the cerebral ventricles, the thickness of the pallium, and blood flow velocities in cerebral arteries. The assumption that progressive dilatation of the fetal ventricles leads to increasing resistance of the cerebral blood flow and disrupted cerebral perfusion was confirmed. Applying the postnatal pediatric principle of indication for shunt implantation based on Doppler sonographic diagnosis, delivery was instituted immediately in cases with pathologically increased pulsatility indices (PI). In all cases, this indication and the need for immediate shunt implantation were confirmed by postnatal pediatric ultrasonography. Cerebral Doppler velocimetry enables timely identification of fetuses at risk for pressure- or ischemia-induced cerebral tissue damage. The timing of delivery and subsequent neurosurgical therapy can thus be optimized.
Voigt
H J
HJ
Frauenklinik, Universität Erlangen-Nürnberg.
Deeg
K H
KH
Rupprecht
T
T
D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D001921:Brain / Q000098:blood supply; D001925:Brain Damage, Chronic / Q000000981:diagnostic imaging / Q000196:embryology; D002552:Cerebral Ventricles / Q000000981:diagnostic imaging / Q000196:embryology; D002557:Cerebrospinal Fluid Shunts; D005260:Female; D005865:Gestational Age; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging* / Q000196:embryology; D007231:Infant, Newborn; D011247:Pregnancy; D011673:Pulsatile Flow / Q000502:physiology; D017585:Ultrasonography, Doppler, Transcranial; D016216:Ultrasonography, Prenatal; D014655:Vascular Resistance / Q000502:physiology
Zerebrale Dopplersonographie beim fetalen Hydrocephalus.