The ratio of flow velocities in the middle cerebral and internal carotid arteries for the prediction of cerebral palsy in term neonates.
OBJECTIVE
This study evaluated whether the ratio of the mean flow velocities in the middle cerebral artery (MCA) and the internal carotid artery (ICA) of neonates in the first days of life can be used to identify future neurodevelopmental disabilities.


METHODS
We observed 127 term neonates without congenital malformations, chromosomal aberrations, intracranial hemorrhage, or early onset sepsis. The mean cerebral blood flow velocities were measured in the right and left ICAs and in the right and left MCAs with a Doppler flowmeter once from day 1 to day 3. The Vm ratio was defined as the mean velocity in the right and left MCAs/mean velocity in the right and left ICAs. Neurologic examinations were performed at 12 months of age in the outpatient follow-up clinic to detect cerebral palsy (CP), and the subjects were divided into 4 groups according to the diagnosis of hypoxic-ischemic encephalopathy (HIE) and neurologic prognosis: HIE- and normal neurologic function, HIE- and CP, HIE+ and normal neurologic function, and HIE+ and CP.


RESULTS
The Vm ratio in infants with the HIE- diagnosis and CP was significantly lower than that in infants with the HIE- diagnosis without CP (P < .05). There was no significant difference between the Vm ratios in infants with the HIE+ diagnosis without CP and infants with the HIE+ diagnosis and CP.


CONCLUSIONS
The Vm ratio might be a useful index in estimating neurologic outcome at birth, especially in neonates without the diagnosis of HIE.
Fukuda
Sumio
S
Department of Pediatrics, Neonatology, and Congenital Disorders, Nagoya City University, Graduate School of Medical Sciences, Kawasumi, Mizuho, Nagoya, Aichi 467-8601, Japan. fukuda@med.nagoya-cu.ac.jp
Kato
Takenori
T
Kuwabara
Satomi
S
Kato
Ineko
I
Futamura
Masahide
M
Togari
Hajime
H
D001783:Blood Flow Velocity; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging*; D002547:Cerebral Palsy / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D017585:Ultrasonography, Doppler, Transcranial