INTRACRANIAL COMPLIANCE IN INFANTS - EVALUATION WITH DOPPLER US

PURPOSE: To test graded fontanelle compression during Doppler ultrasou nd (US) scanning to identify and monitor infants with altered cranial compliance. MATERIALS AND METHODS: An ophthalmodynamometer exerted pre ssure on the anterior fontanelle during Doppler US scanning of the mid dle cerebral artery. Sixty examinations were performed in 43 infants-1 3 full-term and 11 premature healthy control subjects, 10 with increas ed intracranial volume, and nine with suspected abnormal cranial compl iance but without increased intracranial volume. Resistive index (RI) and angle-corrected time-averaged mean velocities (TAV) of blood flow were compared at three different pressures. RESULTS: Baseline RI value s in healthy full-term infants were significantly lower than in health y premature infants and infants with abnormal compliance (P < .05). Va lues for healthy premature infants and infants with abnormal complianc e were indistinguishable (P > .5). Neither RI nor TAV changed signific antly in healthy infants, but both changed significantly with compress ion in infants with abnormal cranial compliance. CONCLUSION: This proc edure may be more useful than measurement of RI of the anterior cerebr al artery alone to evaluate infants with altered cranial compliance.