title: The assessment of intracranial dynamics by transcranial Doppler sonography in perioperative period in paediatric hydrocephalus.
abstract: OBJECTIVE
  To evaluate Doppler parameters of anterior cerebral artery (ACA) and relationship to morphological parameters of cerebral ventricles and periventricular brain tissue in paediatric hydrocephalus before and after drainage procedure.
  
  
  METHODS
  Forty newborns with hydrocephalus were evaluated before and after the drainage procedure. The morphological parameters of brain (ventricular index, width of ventricles, haemorrhagic lesions, asymmetric ventricular dilatation and dynamics of ventricles) were measured by transcranial ultrasonography. The haemodynamic parameters of ACA (peak systolic blood flow velocity, end-diastolic blood flow velocity and resistance index/RI/) were evaluated by Doppler ultrasonography. The correlation between morphological and haemodynamic parameters was analysed.
  
  
  RESULTS
  We found significant decrease of ventricular dilatation, which was accompanied with significant decrease of basal and compressive RI-ACA after drainage procedure. The correlation between basal RI-ACA, compressive RI-ACA and the dynamics of ventricular dilatation was not significant before and after drainage operation, as well. The significant correlation between preoperative basal RI-ACA, postoperative compressive RI-ACA and asymmetry of cerebral ventricles was confirmed. Statistical analysis showed significant correlation between basal RI-ACA, compressive RI-ACA and haemorrhagic lesions after drainage operation.
  
  
  CONCLUSIONS
  The results of our study showed the alteration of Doppler parameters of cerebral circulation in newborns with hydrocephalus before the drainage procedure. The successful drainage operation leads to the improvement of haemodynamic parameters of cerebral circulation. However, the statistical analysis showed the influence of some intracranial factors-the asymmetry of dilatation of lateral cerebral ventricles and periventricular haemorrhagic lesions on the Doppler parameters of cerebral circulation.
authors.affiliation: Department of Neurosurgery, Jessenius Faculty of Medicine, Comenius University, Kollarova 2, Martin 03601, Slovak Republic. kolarovszki@jfmed.uniba.sk
authors.forename: Branislav
authors.initials: B
authors.lastname: Kolarovszki
authors.forename: Pavol
authors.initials: P
authors.lastname: Zubor
authors.forename: Hana
authors.initials: H
authors.lastname: Kolarovszka
authors.forename: Martin
authors.initials: M
authors.lastname: Benco
authors.forename: Romana
authors.initials: R
authors.lastname: Richterova
authors.forename: Katarina
authors.initials: K
authors.lastname: Matasova
mesh_terms: D020771:Anterior Cerebral Artery / Q000000981:diagnostic imaging*; D002552:Cerebral Ventricles / Q000000981:diagnostic imaging*; D002557:Cerebrospinal Fluid Shunts; D004322:Drainage / Q000379:methods; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging / Q000601:surgery*; D007231:Infant, Newborn; D008297:Male; D011182:Postoperative Care; D011300:Preoperative Care; D011446:Prospective Studies; D016896:Treatment Outcome; D017585:Ultrasonography, Doppler, Transcranial