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Intracranial arterial duplex Doppler waveform analysis in infants.

J C Anderson1, J R Mawk

  • 1Department of Radiology, University of Nebraska Medical Center, Omaha 68105-1065.

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|June 1, 1988
PubMed
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Duplex sonography revealed increased arterial pulsatility in the Circle of Willis for pediatric patients with intracranial hemorrhage and hypoxic-ischemic encephalopathy. This finding aids in diagnosing various pediatric brain conditions using Doppler ultrasound.

Area of Science:

  • Pediatric Neurology
  • Neuroimaging
  • Cerebrovascular Physiology

Background:

  • Duplex sonography is a non-invasive neuroimaging technique.
  • Assessing cerebral blood flow dynamics is crucial in pediatric neurological conditions.
  • Pulsatility of arterial waveforms can indicate cerebrovascular changes.

Purpose of the Study:

  • To evaluate the utility of Doppler arterial waveforms from the Circle of Willis in differentiating pediatric brain pathologies.
  • To investigate increased pulsatility as a potential biomarker in conditions like intracranial hemorrhage and hypoxic-ischemic encephalopathy.

Main Methods:

  • Duplex sonography of the brain was performed on 130 pediatric patients.
  • Doppler arterial waveforms from the Circle of Willis were analyzed for pulsatility.

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  • Patients were categorized into groups: normal, intracranial hemorrhage, hypoxic-ischemic encephalopathy, hydrocephalus with shunt, and ventriculomegaly without shunt.

    • Main Results:

    • Increased pulsatility was observed in 82% of intracranial hemorrhage cases and 53% of hypoxic-ischemic encephalopathy cases.
    • Lower rates of increased pulsatility were found in hydrocephalus (31%) and ventriculomegaly (36%) groups.
    • Mean pulsatility was significantly increased (p<0.05) across most pathological groups, excluding ventriculomegaly without complications.

    Conclusions:

    • Doppler sonography of the Circle of Willis demonstrates altered arterial pulsatility in pediatric intracranial hemorrhage and hypoxic-ischemic encephalopathy.
    • Increased pulsatility in Doppler waveforms may serve as a valuable indicator in diagnosing specific pediatric neurological conditions.
    • The diagnostic efficiency of different pulsatility indices was comparable.