Pulsed Doppler sonographic measurement of normal values for the flow velocities in the intracranial arteries of healthy newborns

Abstract

121 healthy premature born infants and full term newborns (corrected gestational age 29 to 45 weeks, weight at investigation 1070 to 3750 g) were investigated by pulsed Doppler sonography with a 5 MHz transducer. In all infants pulsed Doppler recordings were obtained from the internal carotid arteries (ICA), the basilar artery (BA) and both anterior cerebral arteries (ACA). From the flow profile the maximal systolic velocity (Vs), the endsystolic velocity (Ves) and the enddiastolic velocity (Ved), the time average velocity (TAV) and the time average maximal velocity (TAMX) as well as the resistance-index (RI) and the pulsatility-index (PI) were measured. For all parameters the relationship to the gestational age was analysed and normal values were established. There was a linear increase of all flow velocities with increasing gestational age. Vs in the ICA was about 20% higher than in the ACA and BA whereas Ves and Ved were not significantly different in the three arteries. The TAV in the ICA was 9% higher than in the ACA and 15% higher than in the BA. The TAMX in the ICA was 10% higher than in the ACA and 14% higher than in the BA. In contrast to the increase of the flow velocities neither the RI nor the PI showed a significant age dependency. For the RI in the ICA 0.77 +/- 0.08, in the ACA 0.73 +/- 0.08 and in the BA 0.72 +/- 0.09 were measured. The PI in the ICA was 3.0 +/- 0.08, in the ACA 2.7 +/- 0.09 and in the BA 2.7 +/- 0.7.(ABSTRACT TRUNCATED AT 250 WORDS)

Increased cerebral blood flow velocities in newborn infants of smoking mothers

“…However, as we do not know of data reporting an influence of prenatal smoke exposure on CO2 tensions, we did not consider it acceptable to determine arterial blood gases in apparently healthy infants before we knew whether or not there would be any differences in CBFVs at all. The CBFVs in our control infants were in the same range as those observed by others [7]. We tried to confirm prenatal exposure to tobacco smoke in the infants of smoking mothers by determination of their urine cotinine excretion.…”

“…In our study, according to the lower birth weight and gestational age of babies born to smoking mothers compared to control infants, lower CBFVs were to be expected in the former group [7]. However, significantly higher CBFVs were found in smokers' babies.…”

“…All Doppler examinations were carried out by the same investigator (H. A-K.). CBFVs were examined in the internal carotid artery immediately beneath the lateral edge of the sella turcica, in the anterior cerebral artery directly anterior to the third ventricle beneath the lower edge of the corpus callosum, and in the basilar artery between ports and the skull base [7]. Doppler frequencies were recorded when the sharpest characteristic visual and highest audible signals were obtained [16].…”

Ultrasound Diagnosis of Congenital Brain Anomalies

“…Knowledge of normal values of cerebral blood flow velocities and Doppler indices in neonates different gestation age is important for the monitoring maturational processes and growth of the immature brain and also useful for differential diagnosis of congenital and acquired CNS anomalies in both preterm and full-term neonates (Chavhan et al, 2008;). Normal neonatal values and postnatal changes of cerebral blood flow velocities have been reported by several examiners (Deeg & Rupprecht 1989;Romagnol et al, 2006;Vasiljevic et al, 2010). Table 2.…”

Transcranial Doppler ultrasonography to evaluate need for cerebrospinal fluid drainage in hydrocephalic children.

“…1-5 TCD ultrasonography is an accepted noninvasive method to quantify perfusion of intracranial arteries in adults 6,7 and children. [8][9][10][11][12][13][14][15][16][17] The peak S and end D flow velocities are measured, and the RI is calculated as (S -D)/S. Several authors have described the use of RI to study the relationship between cerebral perfusion pressure and ICP, 1,15-18 to investigate ICP-volume relationships (compliance [19][20][21][22] ), and to examine the effects of treatments aimed at decreasing ICP and improving brain perfusion in infants with the previously mentioned clinical conditions.…”