TRANSCRANIAL DOPPLER ANALYSIS OF CEREBRAL HEMODYNAMICS IN PRIMARY CRANIOSYNOSTOSIS - STUDY IN PROGRESS

BACKGROUND Regional elevations in intracranial pressure (ICP) have bee n monitored adjacent to areas of cranial stenosis by some authors [9,1 9,20]; however, noninvasive techniques such as transcranial Doppler (T CD) would be preferable if increased ICP could be detected just as rel iably. METHODS TCD examinations of basal cerebral arteries were perfor med in 31 children with skull deformities. Skull X rays and computed t omography (CT) scans or magnetic resonance imaging (MRI) were analyzed for degree of cranial vault abnormality, as well as for presence or a bsence of intracranial pathology. Neurodevelopmental examination and c linical signs of increased ICP, if any, were recorded. RESULTS The ove rall incidence of increased resistivity indices (RI) was 70%. Patients with asymmetric skull deformities (plagiocephaly) or sagittal synosto sis (scaphocephaly) were statistically more prone to exhibit increased RI compared to previously reported prevalences. CONCLUSIONS Because T CD is a convenient, rapid, accurate, and noninvasive method by which t o gauge ICP, it should be considered in the preliminary work-up of a p atient with craniosynostosis.