Transcranial Doppler for brain death in infants: the role of the fontanelles

Détails

ID Serval
serval:BIB_DBE980154566
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Titre
Transcranial Doppler for brain death in infants: the role of the fontanelles
Périodique
Eur Neurol
Auteur(s)
Vicenzini E., Pulitano P., Cicchetti R., Randi F., Papov P., Spadetta G., Sirimarco G., Ricciardi M. C., Di Piero V., Lenzi G. L., Mecarelli O.
ISSN
1421-9913 (Electronic)
ISSN-L
0014-3022
Statut éditorial
Publié
Date de publication
2010
Peer-reviewed
Oui
Volume
63
Numéro
3
Pages
164-9
Langue
anglais
Notes
Vicenzini, E
Pulitano, P
Cicchetti, R
Randi, F
Papov, P
Spadetta, G
Sirimarco, G
Ricciardi, M C
Di Piero, V
Lenzi, G L
Mecarelli, O
eng
Case Reports
Switzerland
Eur Neurol. 2010;63(3):164-9. doi: 10.1159/000286232. Epub 2010 Feb 18.
Résumé
OBJECTIVE: Transcranial Doppler (TCD) is a sensitive technique for circulatory arrest diagnosis in brain death when patterns such as reverberant flow and short systolic spikes are observed. In infants, the nonossified fontanelles compensate for intracranial hypertension. We describe TCD patterns in infants with brain death, different from adults, with the hemodynamic modifications induced by anterior fontanelle compression. METHOD: TCD was performed in 2 infants with diagnosed brain death admitted to the neonatal intensive care unit. RESULTS: TCD showed a large peak 'reverberant' flow, with a high peak systolic velocity and a consistent retrograde component, away from the brain. Compression of the anterior fontanelle induced, at first, a reduction in systolic flow with the subsequent appearance of the characteristic short systolic spikes. Upon compression removal, a brief increase in the systolic flow was observed before the prompt reappearance of the reverberant flow. CONCLUSION: TCD for brain death diagnosis should be done cautiously in infants. In these cases, reverberating flow may be indicative of circulatory arrest even if with a large peak and with a high peak systolic velocity. Heavy fontanelle compression may reproduce the classical adult TCD patterns of brain death, thus supporting the diagnosis of cerebral circulatory arrest.
Mots-clé
Brain Death/*diagnosis/physiopathology, Brain Neoplasms/complications/*diagnosis/physiopathology, Cerebrovascular Circulation, Cranial Fontanelles/*physiopathology, Electroencephalography, Female, Glioma/complications/*diagnosis/physiopathology, Humans, Infant, Male, Shaken Baby Syndrome/complications/diagnosis/physiopathology, *Ultrasonography, Doppler, Transcranial
Pubmed
Création de la notice
28/02/2018 14:47
Dernière modification de la notice
20/08/2019 16:00
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