title: Transcranial Doppler in the evaluation of infants treated with retrograde ventriculosinus shunt.
abstract: BACKGROUND
  Hydrocephalus is a prevalent condition among infants. Retrograde ventriculosinus shunt (RVSS) proposes a feasible option to treat hydrocephalus according to the principles presented by El-Shafei. In this essay, we analyze nuances and application of transcranial Doppler (TCD) in patients submitted to RVSS.
  
  
  METHODS
  We consecutively enrolled patients diagnosed with hydrocephalus after surgical repair of myelomeningocele from January 2010 to January 2012, users of Hospital das Clinicas, University of Sao Paulo. They were treated with RVSS. Patients enrolled to the study were consecutively evaluated in an outpatient basis with TCD in preoperative, immediate postoperative period, and late postoperative period (1 year).
  
  
  RESULTS
  Except for patient 3, there was an increase in mean flow velocity, decreased pulsatility index, and decreased resistance index in all vessels analyzed.
  
  
  CONCLUSIONS
  In our sample, transcranial Doppler could be used as a diagnostic and follow-up tool to evaluate hemodynamics and hydrodynamics in the preoperative and postoperative phases of RVSS. It was technically feasible in all patients, had close relation with other clinical and image parameters, and was sensitive to identify system malfunction.
authors.affiliation: Division of Functional Neurosurgery of the Institute of Psychiatry, Hospital das Clínicas, Universidade de São Paulo, Rua Loefgren 700, apto 103, Vila Mariana, São Paulo, São Paulo, 04040-000, Brazil. mafernoliv@yahoo.com.br.
authors.forename: Matheus Fernandes
authors.initials: MF
authors.lastname: de Oliveira
authors.affiliation: Division of Functional Neurosurgery of the Institute of Psychiatry, Hospital das Clínicas, Universidade de São Paulo, Rua Loefgren 700, apto 103, Vila Mariana, São Paulo, São Paulo, 04040-000, Brazil.|Division of Neurological Surgery, Hospital das Clinicas, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
authors.forename: Manoel Jacobsen
authors.initials: MJ
authors.lastname: Teixeira
authors.affiliation: Division of Neurological Surgery, Hospital das Clinicas, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: de Lima Oliveira
authors.affiliation: Division of Neurological Surgery, Hospital das Clinicas, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
authors.forename: Edson Bor
authors.initials: EB
authors.lastname: Seng-Shu
authors.affiliation: Division of Neurological Surgery, Hospital das Clinicas, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
authors.forename: Karen Andrade
authors.initials: KA
authors.lastname: Norremose
authors.affiliation: Division of Functional Neurosurgery of the Institute of Psychiatry, Hospital das Clínicas, Universidade de São Paulo, Rua Loefgren 700, apto 103, Vila Mariana, São Paulo, São Paulo, 04040-000, Brazil.|Division of Neurological Surgery, Hospital das Clinicas, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
authors.forename: Fernando Campos
authors.initials: FC
authors.lastname: Gomes Pinto
mesh_terms: D002557:Cerebrospinal Fluid Shunts; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D007223:Infant; D008297:Male; D008591:Meningomyelocele / Q000601:surgery; D019635:Neurosurgical Procedures / Q000009:adverse effects; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*
keywords: Hydrocephalus; Myelomeningocele; Neurosurgery; Shunt; Transcranial Doppler