Transcranial colour dupplex sonography in pre and post shunt assessment of hydrocephalus

ABSTRACT

The submitted study was concerned with the role of transcranial Doppler [TCD] in diagnosis and postoperative follow up of hydrocephalus. TCD was performed in 40 hydrocephalic infants [mean age = 6.95 month], as well as 40 control subjects [mean age = 4.4 month]. Patients clinically suspected of being hydrocephalic were examined transcranially in B-mode to estimate ventricular size, configuration and cerebral parenchyma, while the coloured Doppler examination focused on the velocity rates and resistive index [RI]. Patients with hydrocephalus proved to have larger ventricular systems and higher RI in comparison to their normal counterparts. The hydrocephalic patients were shunted and post-shunt TCD was performed [after an average interval of 28 days], reassessing the pre-shunt parameters and locating the position of the placed shunt. The patients with well-functioning shunts show significant decrease in the RI almost back to normal. As regards ventricular size, a less significant change was doccumented. In infected infants the RI remained high or even increased and the CSF echopattern was turbid, with echogenic ventricular lining. From the above data, we conclude that the TCD has a reliable role in the diagnosis and post shunt assessment of hydrocephalus