Mesi Mathew, Abdullahi Onimisi Jimoh, Lami Mesi Matthew, Wilfred Chukwuemeka Mezue, Enoch Ogbonnaya Uche, Joseph Igashi, Muhammad Raji Mahmud, Samuel Eze Okpara, Musa Bafeshi Mathew
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Associations between TCD indices and CSF pressure were determined using the t-test and the Wilcoxon rank /Mann-Whitney tests where the normality test failed. A p-value of < 0.05 was considered significant for associations.</p><p><strong>Results: </strong>Fifty-two patients were enrolled with a mean age of 9.9 ± 11.5 months. Of these, 41 (78.8%) were aged ≤ 12 months. The mean CSF opening pressure was 21.4 ± 9.0. When raised, ICP was defined as opening pressure > 15 cm of H<sub>2</sub>O, high PI (≥ 1.19), and high RI (> 0.8) diagnosed it with a sensitivity of 55% and 50%, respectively. The mean pre-operative PI (1.17 ± 0.56) reduced to 0.96 (Z = - 2.032, p = 0.042), while that of RI (0.66 ± 0.17) also decreased to 0.58 (t = 2.906, p = 0.044) after V-P shunt surgery. A strong positive correlation exists between a reduction in PI and RI after V-P shunt (r = 0.743, p = 0.014).</p><p><strong>Conclusion: </strong>Both PI and RI significantly decrease following V-P shunt, but a single reading has a poor sensitivity in predicting ICP.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Assessment of childhood intracranial pressure: a comparative study of transcranial Doppler ultrasound indices and findings at ventriculoperitoneal shunt.\",\"authors\":\"Mesi Mathew, Abdullahi Onimisi Jimoh, Lami Mesi Matthew, Wilfred Chukwuemeka Mezue, Enoch Ogbonnaya Uche, Joseph Igashi, Muhammad Raji Mahmud, Samuel Eze Okpara, Musa Bafeshi Mathew\",\"doi\":\"10.1007/s00381-024-06496-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>This study compares transcranial Doppler (TCD) Pulsatility Index (PI) and Resistivity Index (RI) with intra-operative CSF opening pressure measured by manometric technique during ventriculoperitoneal (V-P) shunt in children with hydrocephalus.</p><p><strong>Methods: </strong>It was a prospective, hospital-based study performed among patients diagnosed with hydrocephalus. Patients had TCD ultrasonography before V-P shunt. The TCD sonography was repeated within 1 week post-op, and at 1 month post-op. The PI and RI were retrieved after insonating the middle cerebral artery. Ventricular CSF opening pressure was measured. Associations between TCD indices and CSF pressure were determined using the t-test and the Wilcoxon rank /Mann-Whitney tests where the normality test failed. A p-value of < 0.05 was considered significant for associations.</p><p><strong>Results: </strong>Fifty-two patients were enrolled with a mean age of 9.9 ± 11.5 months. Of these, 41 (78.8%) were aged ≤ 12 months. The mean CSF opening pressure was 21.4 ± 9.0. When raised, ICP was defined as opening pressure > 15 cm of H<sub>2</sub>O, high PI (≥ 1.19), and high RI (> 0.8) diagnosed it with a sensitivity of 55% and 50%, respectively. 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引用次数: 0
摘要
目的:本研究比较了经颅多普勒(TCD)搏动指数(PI)和电阻率指数(RI)与脑积水儿童脑室腹腔(V-P)分流术中通过测压技术测量的术中 CSF 开放压:这是在确诊为脑积水的患者中开展的一项基于医院的前瞻性研究。患者在 V-P 分流术前接受 TCD 超声波检查。术后一周内和术后一个月内再次进行 TCD 超声波检查。在插入大脑中动脉后提取 PI 和 RI。测量脑室 CSF 开放压。TCD 指数和 CSF 压力之间的关系采用 t 检验和 Wilcoxon 秩/曼-惠特尼检验(如果正态性检验失败)来确定。结果52 名患者入组,平均年龄为(9.9 ± 11.5)个月。其中 41 人(78.8%)的年龄小于 12 个月。平均脑脊液开放压为 21.4 ± 9.0。当升高时,ICP 的定义为开放压 > 15 cm of H2O,高 PI(≥ 1.19)和高 RI(> 0.8)的诊断灵敏度分别为 55% 和 50%。V-P 分流手术后,术前平均 PI(1.17 ± 0.56)降至 0.96(Z = - 2.032,P = 0.042),RI(0.66 ± 0.17)也降至 0.58(t = 2.906,P = 0.044)。结论:V-P 分流术后 PI 和 RI 下降之间存在很强的正相关性(r = 0.743,p = 0.014):结论:V-P 分流术后 PI 和 RI 均明显下降,但单一读数预测 ICP 的灵敏度较低。
Assessment of childhood intracranial pressure: a comparative study of transcranial Doppler ultrasound indices and findings at ventriculoperitoneal shunt.
Purpose: This study compares transcranial Doppler (TCD) Pulsatility Index (PI) and Resistivity Index (RI) with intra-operative CSF opening pressure measured by manometric technique during ventriculoperitoneal (V-P) shunt in children with hydrocephalus.
Methods: It was a prospective, hospital-based study performed among patients diagnosed with hydrocephalus. Patients had TCD ultrasonography before V-P shunt. The TCD sonography was repeated within 1 week post-op, and at 1 month post-op. The PI and RI were retrieved after insonating the middle cerebral artery. Ventricular CSF opening pressure was measured. Associations between TCD indices and CSF pressure were determined using the t-test and the Wilcoxon rank /Mann-Whitney tests where the normality test failed. A p-value of < 0.05 was considered significant for associations.
Results: Fifty-two patients were enrolled with a mean age of 9.9 ± 11.5 months. Of these, 41 (78.8%) were aged ≤ 12 months. The mean CSF opening pressure was 21.4 ± 9.0. When raised, ICP was defined as opening pressure > 15 cm of H2O, high PI (≥ 1.19), and high RI (> 0.8) diagnosed it with a sensitivity of 55% and 50%, respectively. The mean pre-operative PI (1.17 ± 0.56) reduced to 0.96 (Z = - 2.032, p = 0.042), while that of RI (0.66 ± 0.17) also decreased to 0.58 (t = 2.906, p = 0.044) after V-P shunt surgery. A strong positive correlation exists between a reduction in PI and RI after V-P shunt (r = 0.743, p = 0.014).
Conclusion: Both PI and RI significantly decrease following V-P shunt, but a single reading has a poor sensitivity in predicting ICP.
期刊介绍:
The journal has been expanded to encompass all aspects of pediatric neurosciences concerning the developmental and acquired abnormalities of the nervous system and its coverings, functional disorders, epilepsy, spasticity, basic and clinical neuro-oncology, rehabilitation and trauma. Global pediatric neurosurgery is an additional field of interest that will be considered for publication in the journal.