Role of Transcranial Doppler and Pressure Provocation in Evaluation of Cerebral Compliance in Children with Hydrocephalus

摘要

Aim: To evaluate the role of transcranial Doppler sonography and Resistive Index (RI) of Anterior Cerebral artery without and with pressure provocation as a marker of altered cerebral compliance in hydrocephalic children. Materials and Methods: Transcranial doppler study of 30 hydrocephalic children with elevated intracranial pressure and 30 controls with normal brain scan was done and resistive index of anterior cerebral artery was measured both with pressure provocation (applied by uniform pressure with transducer on anterior fontanelle for less than 5 seconds) and without pressure provocation. Results: The difference of resistive index and pressure provocation test values between the study and control group was found to be statistically significant (p<0.001). The application of Pressure Provocation Test markedly improved the specificity of RI by eliminating the false positives. Conclusion: Resistive index using transcranial Doppler sonography particularly with pressure provocation can serve as a useful and specific marker of altered cerebral compliance thus evaluating the necessity and effectiveness of CSF drainage procedures.