TRANSCRANIAL DOPPLER ULTRASONOGRAPHY TO EVALUATE NEED FOR CEREBROSPINAL-FLUID DRAINAGE IN HYDROCEPHALIC CHILDREN

The aim of this study was to determine whether the resistive index in the anterior cerebral artery, as measured by transcranial Doppler ultr asonography without and with pressure provocation, predicts the need f or cerebrospinal fluid drainage in hydrocephalic children. Both withou t and with pressure provocation, the resistive index was significantly higher (P > 0.05) in patients with raised intracranial pressure compa red with control group patients and dropped significantly alter draina ge. With receiver operating characteristic analysis, the optimal cutof f point between normal and abnormal resistive index values was determi ned at 0.71 without pressure provocation and at 0.90 with pressure pro vocation. The addition of the pressure provocation test improved accur acy from 81 to 91%, mainly by improving specificity. In conclusion, tr anscranial Doppler ultrasonography with pressure provocation accuratel y identifies hydrocephalic children who require cerebrospinal fluid dr ainage procedures.