抄録
By color Doppler ultrasonography, blood flow velocity in the anterior cerebral artery (ACA), basilar artery (BA) and internal cerebral vein (ICV) was measured serially in neonates with intracranial hematoma. In a neonate with a supratentorial subdural hematoma exceeding 16% of cranial volume (patient 1), preoperative Doppler study showed a decreased mean peak flow velocity (ACA: 7 cm/s and BA: 23 cm/s) and an endodiastolic retrograde flow pattern both in ACA and BA, and no blood flow in ICV. Postoperative studies revealed transient hyperemia with a high endodiastolic peak flow velocity in ACA and BA and a continuous flowpattern in ICV. In neonates with intracerebral hematoma with a 7.9% (patient 2) and 8.6% (patient 3) cranial volume, preoperative Doppler studies showed the mean peak flow velocity in ACA and BA respectively to be 35 and 63 cm/s in patient 2 and 28 and 32 cm/s in patient 3, while the resistance index in ACA and BA respectively was 0.80 and 0.80 in patient 2 and 0.72 and 0.80 in patient 3. Postoperative studies 3 days after surgery showed increased mean peak flow velocities and a decreased resistance index both in ACA and BA. Continuous flow pattern in ICV was detected before and after surgery in both patients. Functional outcome was satisfactory in all patients.
Perioperative hemodynamic changes in infants with intracranial mass lesions can be reflected in changes in blood flow velocities in basal cerebral vessels. Evaluation of cerebral hemodynamic changes by color Doppler ultrasonography provides valuable information for the selection of treatment modalities and postoperative management.
