Doppler Sonographic Screening of the Flow in the Basilar Artery during Head Rotation Reduces the Risk for Sudden Infant Death

Deeg, Karl‐Heinz; Reisig, A.

doi:10.1055/s-0029-1245144

Cited by 5 publications

(4 citation statements)

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“…The reason for development of brain stem hypoperfusion, resulting in desaturation or bradycardia, could not be determined in our study. Several studies have suggested that position‐dependent hypoperfusion of the brain stem caused by abnormal blood flow of the basilar‐vertebral system may be a risk factor for sudden infant death 8 , 9 . In our study, diastolic blood flow in the basilar and vertebral arteries and systolic blood flow in the vertebral arteries were lower in premature than term neonates.…”

Section: Discussionsupporting

confidence: 47%

“…Low blood flow and volume in the blood supply of the brain stem may cause malfunction of the brain stem, leading to central apnea or sudden infant death 5 , 6 . Prospective sonographic studies of healthy neonates examined position‐dependent blood flow in the basilar artery to evaluate hypoperfusion of the brain stem as a risk factor for sudden infant death 7 , 8 . A further study with 3259 neonates defined standard velocity values in the vertebral arteries of healthy term neonates 9 .…”

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confidence: 99%

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Doppler Sonography of Blood Flow Velocity in the Vertebral Arteries of Preterm and Term Neonates

Windschall

Hoekstra

Haase

2016

J of Ultrasound Medicine

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Section: Discussionsupporting

confidence: 47%

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confidence: 99%

Doppler Sonography of Blood Flow Velocity in the Vertebral Arteries of Preterm and Term Neonates

Windschall

Hoekstra

Haase

2016

J of Ultrasound Medicine

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“…The cervical position-induced changes in the blood flow of vertebral arteries are associated with the disturbances in the blood supply of the brainstem, and several studies have assessed its role in SIDS 9,10) . Based on their results, the authors suggest avoidance of risky rotated positions either supine or prone 11) , emphasising that the lateral position is urgently recommended as the sleeping position in infants 12) . This is because in some infants, the rotated head positions during sleep (especially rotation in prone) can cause position-dependent circulatory disturbance in the vertebrobasilar circuit.…”

Section: Resultsmentioning

confidence: 99%

An epidemic of new-born photography poses: the potential dangers of passive end range positioning during induced sleep in 0–14-day-old neonates: a scoping review

Nagy

Finta

2020

J Phys Ther Sci

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[Purpose] In the photography of new-borns, there is an epidemic trend in the posing of 0–14-day-old neonates that induces ethical and competence issues. The aim of this study is to map the key concepts underpinning the contraindications of this type of passive positioning of the new-borns. [Methods] During the search for literature, the following keywords were used in the PubMed database: neonates; new-born; neck position; hyperextension; rotation; atlanto-occipital joint; sudden infant death; prone sleeping position; white noise; and pain perception. [Results] The white noise applied has been described as a pain perception modulator and an alternative pain reducing method in new-born care. There is evidence warning of the potential danger of passively produced cervical spine positions, considering the primary unstable atlanto-occipital joint during early infancy, the possible compression on vertebral arteries, and the intradural diameter decreasing the effect of extension. These factors may have an impact on healthy motor and cognitive development. [Conclusion] This perspective suggests that a wider debate should be called for concerning the role of medical professions to control this very dangerous practice, and that future cohort studies are necessary to monitor and follow up on the potential negative effects of this current trend.

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“…The aim is to investigate positional hypoperfusion of the brain stem, which is considered a risk factor for sudden infant death. 1 The neonate was the second child of a 30-year old white woman. Pregnancy and birth were uneventful.…”

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confidence: 99%

Pulseless and Alive

et al. 2012

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A cerebral ultrasound study on a neonate revealed abnormal blood flow in all intracranial arteries (Figure 1). The boy was scanned at 5 days of age as part of a Doppler ultrasound research program conducted at our department. Almost all neonates delivered at our hospital undergo imaging of the blood flow in the basilar artery. Perfusion is visualized when the head is turned to the left and right in both the prone and supine position. The aim is to investigate positional hypoperfusion of the brain stem, which is considered a risk factor for sudden infant death. 1 The neonate was the second child of a 30-year old white woman. Pregnancy and birth were uneventful. He did not display any signs or symptoms consistent with a congenital abnormality or syndrome. Doppler ultrasound revealed an abnormal cerebral perfusion pattern with low flow velocities and a flattened, veinlike flow profile in all major intracranial arteries (anterior cerebral artery, both internal carotid arteries, basilar and both vertebral arteries) (Figure 1), whereas all abdominal arteries (celiac trunk and renal arteries) showed normal pulsatile flow. Echocardiography demonstrated normal anatomy of the heart. However, the origin of the great neck vessels at the aortic arch could not be identified, ie, absence of the right innominate artery, left common carotid artery, and left subclavian artery. MRI of the head showed normal morphology and vascular anatomy of the brain. The boy showed neither abnormal neurology nor signs suggestive of a circulatory disorder of the upper limb or brain. In the absence of any rational surgical option, it was decided to continue monitoring cerebral blood flow by Doppler sonography. Follow-up studies brought unchanged findings and unremarkable infantile neurological development.To further assess vascular anatomy and possible therapeutic options, MRI angiography was performed when the boy was at the age of 2 years (Figures 2 through 4 and online-only Data Supplement Movie I). It confirmed the absence of all branches of the aortic arch. The right innominate artery, right common carotid artery, right subclavian artery, parts of the right axillary artery, parts of the right vertebral artery, and the left subclavian artery were either absent or hypoplastic. The left subclavian artery was not connected to the aortic arch. arteries, left internal mammary artery, left subclavian artery, and left vertebral artery. Both internal mammary arteries were also supplied through anastomoses with the celiac trunk via prominent phrenic arteries. Similarly, the right arm was supplied via connections between intercostal arteries and the right internal mammary and axillary artery. Because the right subclavian and common carotid arteries were absent, the filling of the right vertebral artery and right internal and external carotid artery was presumed to occur via anastomoses to thyroid, spinal, and muscle arteries of the neck. The venous system, and the intracranial vascular anatomy, as well, appeared normal. Given that the extracranial part...

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Doppler Sonographic Screening of the Flow in the Basilar Artery during Head Rotation Reduces the Risk for Sudden Infant Death

Abstract: Hypoperfusion of the brain stem may be a significant risk factor of SIDS.

Cited by 5 publications

References 14 publications

Doppler Sonography of Blood Flow Velocity in the Vertebral Arteries of Preterm and Term Neonates

Doppler Sonography of Blood Flow Velocity in the Vertebral Arteries of Preterm and Term Neonates

An epidemic of new-born photography poses: the potential dangers of passive end range positioning during induced sleep in 0–14-day-old neonates: a scoping review

Pulseless and Alive

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