The value of transcranial Doppler imaging in children with tuberculous meningitis

Purpose Transcranial Doppler imaging (TCDI) is potentially a valuable investigational tool in children with tuberculous meningitis (TBM), a condition often complicated by pathology relevant to Doppler imaging such as raised intracranial pressure (ICP) and cerebral vasculopathies. Methods Serial TCDI...

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Bibliographic Details
Published in:Child's nervous system 2014-10, Vol.30 (10), p.1711-1716
Main Authors: van Toorn, Ronald, Schaaf, H. Simon, Solomons, Regan, Laubscher, Jacoba A., Schoeman, Johan F.
Format: Article
Language:English
Subjects:
Child
Female
Humans
Intracranial Hypertension - etiology
Magnetic Resonance Imaging
Male
Medicine
Medicine & Public Health
Mycobacterium tuberculosis - pathogenicity
Neurosciences
Neurosurgery
Original Paper
Retrospective Studies
Time
Tuberculosis, Meningeal - diagnostic imaging
Tuberculosis, Meningeal - surgery
Ultrasonography, Doppler, Transcranial - adverse effects
Vasculitis, Central Nervous System - etiology
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Summary:Purpose Transcranial Doppler imaging (TCDI) is potentially a valuable investigational tool in children with tuberculous meningitis (TBM), a condition often complicated by pathology relevant to Doppler imaging such as raised intracranial pressure (ICP) and cerebral vasculopathies. Methods Serial TCDI was performed on 20 TBM children with the aim of investigating cerebrovascular haemodynamics and the relationship between pulsatility index (PI) and ICP. Results We observed a poor correlation between ICP and PI in children with communicating hydrocephalus ( p  = 0.72). No decline in PI was noted following 7 days of medical therapy for communicating hydrocephalus ( p  = 0.78) despite a concomitant decline in ICP. Conversely, a decline in PI was noted in all four children with non-communicating hydrocephalus who underwent cerebrospinal fluid diversion. High blood flow velocities (BFV) in all the basal cerebral arteries were observed in 14 children (70 %). The high BFV persisted for 7 days suggesting stenosis due to vasculitis rather than functional vasospasm. Complete middle cerebral artery (MCA) occlusion, subnormal mean MCA velocities (
ISSN:0256-7040
1433-0350
DOI:10.1007/s00381-014-2435-2