Intracranial compliance in infants: evaluation with Doppler US

Area of Science:

• Neonatal neurology
• Pediatric neuroimaging
• Cranial compliance assessment

Background:

• Assessing cranial compliance in infants is crucial for managing neurological conditions.
• Current methods for evaluating intracranial volume and compliance can be limited.

Purpose of the Study:

• To evaluate the efficacy of graded fontanelle compression during Doppler ultrasound (US) for identifying and monitoring infants with altered cranial compliance.
• To compare the diagnostic utility of this technique against existing methods.

Main Methods:

• An ophthalmodynamometer applied graded pressure to the anterior fontanelle during middle cerebral artery Doppler US.
• Resistive index (RI) and time-averaged mean velocities (TAV) were measured at varying pressures in healthy term/premature infants and those with suspected abnormal cranial compliance.
• Sixty examinations were conducted across 43 infants.

Main Results:

• Baseline RI was significantly lower in healthy term infants compared to healthy premature infants and those with abnormal compliance.
• RI and TAV showed significant changes with compression in infants with abnormal cranial compliance, but not in healthy infants.
• Values for healthy premature infants and those with abnormal compliance were initially indistinguishable.

Conclusions:

• Graded fontanelle compression during Doppler US is a promising method for evaluating infant cranial compliance.
• This technique may offer advantages over isolated middle cerebral artery RI measurements for assessing altered cranial compliance in neonates.