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Therapeutic criteria in communicating childhood hydrocephalus
A Rodríguez-Nuñez1, M Somoza-Martín, C Gómez-Lado
1Department of Pediatrics, Neuropediatric Service, University Hospital , Santiago de Compostela, Spain.
Insights
Transcranial Doppler (TCD) effectively monitors communicating hydrocephalus in infants. This noninvasive technique provides immediate, repeatable assessments, making it ideal for clinical practice.
Area of Science:
- Pediatric Neurology
- Neuroimaging
- Cerebrovascular Physiology
Background:
- Communicating hydrocephalus is a significant concern in infants.
- Monitoring therapeutic action requires reliable assessment methods.
- Traditional methods may have limitations in frequency or invasiveness.
Purpose of the Study:
- To evaluate the utility of middle cerebral artery blood flow velocity, measured by transcranial Doppler (TCD), for guiding therapeutic interventions in infants with communicating hydrocephalus.
- To compare TCD findings with established clinical, radiological, and biochemical markers.
Main Methods:
- Eight infants (5-18 months) with non-tumoral communicating hydrocephalus were monitored for 18-36 months.
- Cerebrospinal fluid (CSF) oxypurines and uric acid levels were analyzed.
- Measurements included Evans' index, cranial circumference growth rate, and TCD velocity.
Main Results:
- Clinical, radiological, biochemical, and hemodynamic criteria demonstrated similar roles in monitoring infantile hydrocephalus.
- Transcranial Doppler (TCD) measurements were found to be comparable to other monitoring parameters.
Conclusions:
- Transcranial Doppler (TCD) offers a noninvasive method for monitoring infantile hydrocephalus.
- The ability to repeat TCD examinations as needed makes it a highly suitable technique for clinical practice.
Aim:
The aim of this study was to evaluate the usefulness of cerebral blood flow velocity in the middle cerebral artery measured by transcranial Doppler as criteria to therapeutic action in communicating hydrocephalic children.
Methods:
In eight non-tumoral communicating hydrocephalic infants, ranging from five to 18 months of age, monitored from 18 to 36 months (mean time of follow-up: 24.25 months), cerebrospinal fluid (CSF) oxypurines (hypoxanthine and xanthine) and uric acid levels were compared by means of the Evans' index, the mean weekly increase in cranial circumference, and the transcranial Doppler measurements.
Results:
Results indicate that clinical (mean weekly increase in head circumference), radiological (Evans' index), biochemical (oxypurines and uric acid in the CSF), and hemodynamic (transcranial Doppler) criteria have the same role in monitoring infantile hydrocephalus.
Conclusion:
In conclusion the transcranial Doppler measurement can be done noninvasively and examinations can be repeated when needed, obtaining immediate
Results:
Hence, it is the most adequate monitoring technique in clinical practice.
