[Results of transcranial Doppler examination of cerebral blood flow in children with vertigo].
BACKGROUND
Episodic recurrent vertigo in the developmental age is associated in majority of cases with disorders of the labirynth, however they can be also associated with epilepsy or migraine. Less often they are result of disorders of vertebro-basillar circulation. The important tool in the diagnosis of such disorders is Doppler examination. Transcranial Doppler (TCD) allows detection of hypoplasia or vasospasm, it helps also in evaluation of process of autoregulation and hemodynamics of circulation in the stimulation tests.


OBJECTIVE
The aim of our research was evaluation of circulation in carotid and vertebral arteries and transcranial examination of anterior, middle cerebral, vertebral arteries and basillar artery in children with vertigo of central origin. The reactivity of cerebral arteries in the stimulation tests: hyperventilation and upright test, was evaluated as well.


METHODS
20 children were included, aged 8-18 years (mean 14 year) with vertigo of central origin. Children with disorders of labirynth, epilepsy and migraine, as well as with vascular diseases were excluded. The control group of healthy volunteers consisted of 12 children aged 10-16 year (mean 13 year). The examination was conducted in the Lab of Neurosonography. The peak-systolic (S), end-diastolic (D) and mean velocities were measured in the carotid arteries using continuos wave, CW. Transcranial examination, TCD of the middle, anterior, vertebral and basillar arteries with the use of the pulse wave, PW was conducted with Nicolet/EME Companion III.


RESULTS
Dopppler examination detected in one child with vertigo a 50% asymmetry of the velocities between vertebral arteries, with confirmed with angiography asymmetry in diameters. The basic Doppler examination did not revealed significant difference between children with vertigo and controls, as well as during hyperventilation. The upright position provoked in children with vertigo decrease of PI and RI (85% of basic value). In controls however, indexes increased 107 and 103% respectively.


CONCLUSIONS
Hemodynamic changes predisposing to central vertigo in children were not detected. The stimulation in the upright test may increase the role of Doppler in the detection of hemodynamic changes. Doppler is an important tool in diagnostics of vertigo in children, allowing detection of congenital malformations of vertebro-basillar system.
Gergont
Aleksandra
A
Klinika Neurologii Dzieciecej, Uniwersytetu Jagiellońskiego, Collegium Medicum, Kraków.
Wesołowska
Ewa
E
Zajac
Anna
A
Nowak
Agnieszka
A
D000293:Adolescent; D001921:Brain / Q000098:blood supply*; D002536:Cerebral Arteries / Q000000981:diagnostic imaging; D002560:Cerebrovascular Circulation; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012016:Reference Values; D018615:Ultrasonography, Doppler, Color; D017585:Ultrasonography, Doppler, Transcranial; D014717:Vertigo / Q000000981:diagnostic imaging* / Q000503:physiopathology*