Transcranial Doppler ultrasonography for the evaluation of shunt malfunction in pediatric patients.

Previous studies have demonstrated a high correlation between hydrocephalus and the resistive index (RI), as determined by transcranial Doppler ultrasonography. Measurements of RI, calculated by dividing the difference between the peak systolic velocity and the end-diastolic velocity by the peak systolic velocity, were attempted in 55 pediatric patients during evaluations for ventriculoperitoneal shunt malfunctions; values were obtained in 52. Indications of shunt malfunction included both clinical and radiographic evidence of increased intracranial pressure.

Duplex pulsed Doppler US versus intracranial pressure in the neonate: clinical and experimental studies.

This study was conducted to determine if the resistive index (RI) could be used for the examination and follow-up of neonates with increased intracranial pressure. First, in a laboratory model with four mongrel dogs, RI was found to correlate linearly with cerebral perfusion pressure. Second, RI was studied in 57 healthy neonates and 285 neonates with abnormal clinical or head ultrasound findings.

Cranial Doppler ultrasonography correlates with criteria for ventriculoperitoneal shunting.

Using pulsed Doppler ultrasound through the sonic window of the anterior fontanelle in infants, 46 children with ventriculomegaly had sequential evaluations of Resistive Index for comparison with the need for ventriculoperitoneal shunting. Hydrocephalus was associated with myelomeningocele in 17 patients and posthemorrhagic, postmeningitic, or congenital hydrocephalus accounted for the rest. The Resistive Index was obtained by dividing the difference between the peak systolic and end diastolic frequencies by the systolic frequency.

Incidence of seizures in patients with myelomeningocele: a multifactorial analysis.

To determine the role of ventricular shunts as a cause of seizures in children with hydrocephalus, 190 patients with myelomeningoceles were studied. There was a low incidence of seizures (2%) in the nonshunted patients in spite of a high incidence of ventriculomegaly, whereas the overall frequency of seizures in shunted patients was 22%. Further analysis indicated factors accountable for the increase.

Uptake of indium-111-labeled leukocytes by brain metastasis.

Uptake of indium-labeled leukocytes was seen in two cases of histologically proven brain metastasis. In one, this led to misdiagnosis of the lesion as an abscess. On histological evaluation, a large number of white blood cells or macrophages was seen at the neoplastic sites.

Suppression-burst pattern associated with generalized epileptiform discharges and alpha-theta pattern coma.

In this paper we reported a patient with multisystem failure, whose EEG immediately preceding death demonstrated a unique combination of suppression-burst pattern, generalized epileptiform discharges, and alpha-theta pattern coma. Post-mortem examination showed ischemic-anoxic lesions involving cortical and sub-cortical gray matter. The lack of white matter pathology in our patient indicates that white matter lesions may not be involved in the pathogenesis of the above EEG patterns in anoxic encephalopathy.