Cerebrovascular Doppler-ultrasound examination in children: principle, indication and findings.

ABSTRACT

The cerebrovascular Doppler examination (cv-Doppler) is a reliable noninvasive method for the diagnosis of obstructions in the extracranial cerebral arteries, and of major arteriovenous shunts in adult patients. The method was applied in 38 children aged 4 months to 17 years. 25 patients with symptoms of cerebrovascular disease underwent cerebral angiography. Six patients had extracranial arterial obstruction, all correctly diagnosed by Doppler. Six children had obstruction of the middle cerebral artery, four were indirectly predicted by Doppler. Four of these twelve patients had extra-intracranial bypass surgery. The patency of the anastomosis could be documented in all cases by Doppler. Ten children had arterio-venous shunts. Of these, 7 patients with an av-angioma and one patient with a carotid-cavernous-sinus fistula were diagnosed correctly by Doppler, as was the cessation of pathologically increased blood flow in the feeding and draining vessels in the 5 patients who had surgical intervention. cv-Doppler results were normal in 3 cases with normal angiography. These results demonstrate that cv-Doppler examination can be useful also in children for the diagnosis of cerebrovascular disease and noninvasive documentation of the hemodynamic effect of neurovascular surgery.