RESUMO
Two techniques of Doppler ultrasound examination, continuous-wave and range-gated, applied to the anterior cerebral artery and to the internal carotid artery, were compared with 133xenon clearance after intravenous injection. Thirty-two sets of measurements were obtained in 16 newborn infants. The pulsatility index, the mean flow velocity, and the end-diastolic flow velocity were read from the Doppler recordings. Mean cerebral blood flow was estimated from the 133Xe clearance curves. The correlation coefficients between the Doppler and the 133Xe measurements ranged from 0.41 to 0.82. In the subset of 16 first measurements in each infant, there were no statistically significant differences between the correlation coefficients of the various Doppler ultrasound variables, but the correlation coefficients were consistently lower for the pulsatility index than for mean flow velocity or end-diastolic flow velocity, and they were consistently higher for the range-gated than for the continuous-wave Doppler technique.
Assuntos
Hemorragia Cerebral/diagnóstico , Circulação Cerebrovascular , Ultrassonografia , Radioisótopos de Xenônio , Velocidade do Fluxo Sanguíneo , Diástole , Humanos , Recém-NascidoRESUMO
Ninety-six newborn infants with seizures were scored during the initial hospitalization on abnormality of EEG, neurologic examination, etiology of seizures, length of seizure, type of seizure, and birth weight under or over 1,500 gm. At 3 months, corrected for gestational age, the 80 surviving infants were scored on abnormality of current EEG, neurologic examination, etiology of seizure, presence or absence of seizure since hospital discharge, and birth weight under or over 1,500 gm. At age 10 months, 76 of 77 surviving infants were evaluated with the Gesell Developmental Inventory, physical examination, and neurologic examination. Chi square analysis documented that the scoring system was an accurate predictor of those infants with seizure disorders, mental retardation, and motor dysfunction. The score may assist the clinician in making decisions in regard to anticonvulsant therapy during initial hospitalization or at age 3 months.
Assuntos
Doenças do Recém-Nascido/diagnóstico , Convulsões/diagnóstico , Anticonvulsivantes/uso terapêutico , Peso ao Nascer , Desenvolvimento Infantil , Eletroencefalografia , Humanos , Lactente , Recém-Nascido , Exame Neurológico , Planejamento de Assistência ao Paciente , Convulsões/tratamento farmacológico , Convulsões/etiologiaRESUMO
Increased transcephalic impedance readings (greater than 3 SD) were recorded in 13 asphyxiated infants 35 weeks or more in gestation, and in 13 preterm infants 34 weeks or less in gestation and with intracranial hemorrhage (greater than 2 SD). Six infants had decreased TCZ recordings in the weeks following intracranial hemorrhage, without ultrasound evidence of ventricular enlargement. TCZ provides quick, inexpensive, noninvasive indication of tissue necrosis, moderate-to-severe intracranial hemorrhage, and delayed brain maturation.