Transcranial Doppler ultrasound is a diagnostic and predicting tool for movement disorders in children after hypoxic ischemic encephalopathy

Aim: to assess brain circulation in the regions supplied by the basilar artery (BA) in children with movement disorders and motor skill delay in the late rehabilitative period after hypoxic ischemic encephalopathy and its importance for the objectivity of clinical data and evaluation of rehabilitative effect. Patients and Methods: 28 children (mean age one year seven months) with movement disorders and motor skill delay (after hypoxic ischemic CNS lesion in the perinatal period) without lower extremity paraparesis or Willis circle abnormalities (by Doppler ultrasound) were examined. Doppler ultrasound was performed using the suboccipital approach at 3–8 months with 3–4-month intervals. The parameters of blood flow in BA, i.e., resistivity index (RI) and mean blood flow velocity (Vm), were measured. Retrospectively, children were divided into three groups based on motor skill delay severity (mild, moderate, or severe) and time for standing unaided to walking. Mean values in the groups and relative deviations (increase/decrease) from reference values in a given age group were compared. Results: motor skill delay severity and predicting time for standing unaided to walking correlated with RI and Vm. RI was a diagnostically valuable parameter whose reference values differed from motor skill delay severity. Isolated increase in Vm and normal RI were reported in children with motor skill delay 1–3 months before standing unaided to walking. This type of blood circulation is a transitional one during clinical improvement in some children. Conclusions: a set of instrumental data allow for describing motor skill delay severity depending on RI deviations from normal values in the regions supplied by BA. The sequence of brain circulation parameter changes is in line with the clinical course, e.g., RI normalization and further gradual recovery of blood flow velocity. KEYWORDS: movement disorders, motor skill delay, Transcranial Doppler ultrasound, basilar artery, resistivity index RI, mean blood flow velocity Vm. FOR CITATION: Pugolovkin K.A., Efimova E.A., Dombrovskaya E.A. et al. Transcranial Doppler ultrasound is a diagnostic and predicting tool for movement disorders in children after hypoxic ischemic encephalopathy. Russian Journal of Woman and Child Health. 2021;4(3):254–259 (in Russ.). DOI: 10.32364/2618-8430-2021-4-3-254-259.