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Pediatric Radiology

, Volume 24, Issue 2, pp 111–115 | Cite as

Alterations in regional cerebral blood flow in neonatal stroke: preliminary findings with color Doppler sonography

  • G. A. Taylor
Originals

Abstract

Little information is available regarding alterations in regional cerebral blood flow and vascularity on cranial sonography in infants with focal ischemic brain injury. This study describes the use of color Doppler sonography in the characterization of these changes following acute neonatal stroke. Color Doppler examinations were performed as part of the series of clinically indicated cranial sonograms in eight infants with clinical, sonographic, and CT evidence of acute cerebral infarction. The cerebral vascularity of each hemisphere was assessed for symmetry and for presence of abnormal blood vessels. Initial Doppler study in four infants with hypoxic-ischemic infarcts showed increased size and number of visible vessels in the periphery of the infarct and increased mean blood flow velocity in vessels supplying or draining the infarcted areas. Diminished vessel number and size and frequency shifts suggestive of decreased hemispheric perfusion was identified in one infant with middle cerebral artery insufficiency. Repeat Doppler studies were performed on two infants. These showed the development of multiple small, irregular blood vessels in the periphery of the infarct. Focal abnormalities in regional cerebral blood flow may be present as part of the normal healing process following neonatal stroke, and can be demonstrated with color Doppler sonography.

Keywords

Cerebral Infarction Blood Flow Velocity Regional Cerebral Blood Flow Color Doppler Sonography Ischemic Brain Injury 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Barmada MA, Moossy J, Shuman RM (1979) Cerebral infarcts with arterial occlusion in neonates. Ann Neurol 6: 495–502PubMedGoogle Scholar
  2. 2.
    de Vries LS, Larroche J-C, Levene MI (1988) Cerebral ischemic lesions. In: Levene MI, Bennett MJ, Punt J (eds) Fetal and neonatal neurology and neurosurgery. Churchill Livingstone, Edinburgh, pp 326–338Google Scholar
  3. 3.
    Klesh KW, Murphy TF, Scher MS, Buchanan DE, Maxwell EP, Guthrie RD (1987) Cerebral infarction in persistent pulmonary hypertension of the newborn. Am J Dis Child 141: 852–857PubMedGoogle Scholar
  4. 4.
    Mannino FL, Trauner DA (1983) Stroke in neonates. J Pediatr 102: 605–610PubMedGoogle Scholar
  5. 5.
    Friede RL (1973) Cerebral infarcts complicating neonatal leptomeningitis: acute and residual lesions. Acta Neuropathol (Berl) 23: 245–253Google Scholar
  6. 6.
    Volpe JJ, Herscovitch P, Perlman JM, Raichle ME (1983) Positron emission tomography in the newborn: extensive impairment of regional cerebral blood flow with intraventricular hemorrhage and hemorrhagic intracerebral involvement. Pediatrics 72: 589–601PubMedGoogle Scholar
  7. 7.
    Taylor GA, Trescher WH, Traystman RJ, Johnston MV (1993) Acute experimental neuronal injury in the newborn lamb: US characterization and demonstration of hemodynamic effects. Pediatr Radiol 23: 268–275PubMedGoogle Scholar
  8. 8.
    Savoiardo M (1986) CT scanning. In: Barnett HJM, Stein BM, Mohr JP, Yatsu J (eds) Stroke. Pathophysiology, diagnosis and management, vol I. Churchill Livingstone, New York, pp 189–219Google Scholar
  9. 9.
    Kinkel WR, Jacobs L, Kinkel PR (1980) Gray matter enhancement: a computerized tomographic sign of cerebral hypoxia. Neurology 30: 810–819PubMedGoogle Scholar
  10. 10.
    Irino T, Taneda M, Minami T (1977) Angiographic manifestations in postrecanalized cerebral infarction. Neurology 27: 471–475PubMedGoogle Scholar
  11. 11.
    Kontos HA (1986) Cerebral microcirculation in stroke. In: Barnett HJM, Stein BM, Mohr JP, Yatsu (eds) Stroke. Pathophysiology, diagnosis and management, vol I. Churchill Livingstone, New York, pp 91–95Google Scholar
  12. 12.
    Lassen NA (1966) The luxury perfusion syndrome and its possible relation to acute metabolic acidosis localised within the brain. Lancet III: 1113–1115Google Scholar
  13. 13.
    Taylor GA, Short BL, Walker LK, Traystman RJ (1990) Intracranial blood flow: quantification with duplex Doppler and color Doppler flow US. Radiology 176: 231–236PubMedGoogle Scholar
  14. 14.
    Lundell BP, Lindstrom DP, Arnold TG (1984) Neonatal cerebral blood flow velocity. I. An in vitro validation of the pulsed Doppler technique. Acta Pediatr Scand 73: 810–815Google Scholar
  15. 15.
    Hernanz-Schulman M, Cohen W, Genieser NB (1988) Sonography of cerebral infarction in infancy. AJR 150: 897–902PubMedGoogle Scholar
  16. 16.
    Hill A, Martin DJ, Daneman A, Fitz CR (1983) Focal ischemic cerebral injury in the newborn: diagnosis by ultrasound and correlation with computed tomographic scanning. Pediatrics 71: 790–793PubMedGoogle Scholar
  17. 17.
    Taylor GA, Perlman EJ, Scherer LR, Gearhart JP, Leventhal BG, Wiley J (1991) Vascular evaluation of tumors in children with color Doppler imaging. AJR 157: 1267–1271PubMedGoogle Scholar
  18. 18.
    du Bois M, Bowman PD, Goldstein GW (1985) Cell proliferation in ischemic injury in gerbil brain. Cell Tissue Res 242: 17–23PubMedGoogle Scholar
  19. 19.
    Iadecola C, Arneric SP, Resi DJ (1989) Local and remote microvascular changes in excitotoxin-induced focal brain lesions. Brain Res 501: 188–193PubMedGoogle Scholar
  20. 20.
    Cancilla PA, Frommes SP, Kahn LE, De Bault LE (1979) Regeneration of cerebral microvessels: a morphological and histochemical study after local freeze-injury. Lab Invest 40: 74–82PubMedGoogle Scholar
  21. 21.
    Yamaguchi T, Walsh AG, Okazaki H (1971) Hyperemia and ischemia in experimental cerebral infarction: correlation of histopathology and regional blood flow. Neurology 21: 565–578PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • G. A. Taylor
    • 1
  1. 1.Russell H. Morgan Department of Radiology and Department of Pediatrics Johns Hopkins Medical InstitutionsBaltimoreUSA

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