Cerebrospinal fluid dynamics in infants evaluated with echographic color-coded flow imaging

Abstract

Purpose: To use color Doppler flow ultrasonography (US) for investigation of rapid regional motion of cerebrospinal fluid (CSF) in infants with subarachnoid hemorrhage or meningitis.

Materials and methods: Sixty-four transfontanellar and transcranial color Doppler US scans of the cerebral aqueduct, ventricles, and basal cerebral and spinal subarachnoid spaces were obtained in 19 infants (12 male and seven female infants, aged 1-81 days). Abdominal palpation or periods of straining or crying were used to increase velocity of CSF motion.

Results: In all 19 infants, rapid to-and-fro color CSF flow was observed in the aqueduct. Color-coded CSF flow signals were seen in the aqueduct in 19 infants, in the third (n = 17 with jetlike flow) and fourth (n = 7 with jets) ventricles in 17, at the foramen of Magendie in 11 (n = 4 with jets), and in the spinal compartment in 14.

Conclusion: In the presence of scattering particles or cells, regional CSF flow can be investigated with transfontanellar, transcranial, and spinal color flow imaging. Results of regional echographic CSF flow investigation can indicate recent subarachnoid hemorrhage or exclude obstruction. Jetlike CSF flow might stimulate new concepts of rapid CSF dynamics.