Abstract
The purpose of this paper is to present our experiences using transcranial Doppler ultrasonography (TCD) in patients with pre and post ventriculoperitoneal (VP) shunt for hydrocephalus and burr hole operations in chronic subdural hematoma. By using Sonolayer α SSA-260A, Toshiba medical corporation, Japan, we performed TCD at pre operation and one week after operation in 14 patients since Feb. 1997 to Jan. 1998. There were four cases with idiopathic normal pressure hydrocephalus (NPH), NPH after subarachnoid hemorrhage (3), congenital hydrocephalus (3), NPH after traumatic brain injury (1), and chronic subdural hematoma (3) . We did TCD in all patients and evaluated the changes in mean flow velocity (MV), pulsatility index (PI), and their concurrent clinical corses. Result: The MV at pre operation was 40.1 ± 15.0 cm/s (mean±SEM), and 45.7±18.4cm/s at post operation. No significant change in MV was found between pre and post operation. (P=0.17) . The PI at preoperation was 1.09±0.05 and 1.09±0.07 at postoperation. No significant change in PI was found between pre and postoperation. (P = 0.99) . Many of cases got clinical improvement with increase in MV and decrease in PI, but some of cases have discrepancy between the TCD findings and their clinical improvement. These cases had parmanent focal brain injury in the computed tomography. TCD examinations in pre and post VP shunt or burr hole procedure are useful.
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