Transcranial Doppler in infantile cerebrospinal fluid disorders: clinical validity

The present study was designed to investigate a possible relationship between transcranial Doppler sonography (TCD) parameters with infantile hydrocephalus and other types of cerebrospinal fluid (CSF) abnonnalities, i.e. arrested hydrocephalus and essential ventriculomegaly. TCD parameters in the major arteries of the circle of Willis were studied in hydrocephalic children (n = 12) before and after insertion of a ventricular shunt device. It was correlated with TCD parameters of children with CSF disorders (n = 13), in whom no surgery was performed. Also, TCD parameters were assessed in control cases (n = 10). Mean values for medial cerebral artery (MCA) flow velocities were higher in the essential ventriculomegaly (75.38 +/- 4.1) and in the control group (73.93 +/- 3.4) compared with hydrocephalic children (64.13 +/- 5.3). All hydrocephalic children had a higher mean MCA pulsatility index (RI) (1.08 +/- 0.13) and resistance index (RI) (0.64 +/- 0.17) values than the essential ventriculomegaly group (PI: 1.03 +/- 0.48; RI: 0.63 +/- 0.13) and the control group (PI: 0.84 +/- 0.32; RI: 0.57 +/- 0.23). Analysis of all TCD parameters disclosed its usefulness only after a particular and thorough evaluation of the TCD results with special emphasis in the clinical correlation of every case.