[Assessment of the Doppler cerebral blood flow measurement in infants with perinatal trauma]

Abstract

Background: Birth trauma may lead in infants to developmental delay, cerebral palsy, epilepsy and complications with increasing risk of the death. Several complications are of vascular origin. The aim of the study was the assessment of the transcranial Doppler-sonographic (TCD) measurement of cerebral blood flow in infants with perinatal CNS pathology.

Material and methods: 14 infants, 9 females and 5 males, within 12 premature infants, with the CNS perinatal pathology were examined. In children during the neonatal period respiratory distress syndrome, sepsis, apnoe and seizures were also observed. Neuroimaging was performed in each neonate and TCD measurement as well, in 1-7 month of age. Pulsatility index (PI) and resistive index (RI) in anterior cerebral artery (ACA) and in middle cerebral artery (MCA) were established.

Results: In 10 children neuroradiologic examination revealed pathological changes: intraventricular hemorrhage, subdural hematoma, subarachnoid hemorrhage, porencephalic cyst of parietal lobes, agenesis of corpus callosum or lateral ventricles dilatation. In 7 children of this group blood flow changes were registered and in 3 of them (21%) the blood flow was normal. The most severe decrease of blood flow in ACA and MCA associated with decreased PI and RI were detected in a case after subdural hematoma operation, prior to death. In other 4 children with normal brain imaging but abnormal neurological examination, cerebral blood flow was disturbed. In three of them blood flow velocity in ACA was decrease with PI increase and in other one blood flow velocity in MCA was increased.

Conclusions: 1. In 79% of the infants with CNS perinatal pathology transcranial Doppler identified blood flow changes. 2. The further research is necessary for the confirmation that a significant decrease of blood flow velocities and indexes in such cases is a poor prognostic factor.