Abstract
Background. It was shown an opportunity of non-invasive diagnostics of intracranial hypertension (ICH) on the base of pulsatility index (PI) using transcranial Doppler (TCD) in most neurosurgical patients. But in patients with hydrocephalus PI is controversial. This may be due to different degree of cerebral autoregulation (CA) impairment in case of cerebral perfusion pressure decrease. Purpose: to assess the informativity of cerebral hemodynamics indices for assessment of cerebrospinal fluid circulation in patients with hydrocephalus. Materials and methods. Routine diagnostics of cerebral blood flow velocity (BFV) by means of TCD was carried out in 26 patients with hydrocephalus. Cerebral autoregulation was assessed perioperatively with cuff test and cross-spectral analysis of spontaneous oscillations of blood pressure and BVF within the range of Meyer waves. Results. Depending on presence of intracranial hypertension (ICH), all patients have been divided in two groups: with signs of ICH (1 st group) and without ICH (2 nd group). Mean values of PI didn’t differ significantly in both groups. At the same time rate of CA were considerably (p st group postoperative clinical improvement was accompanied with considerable (p nd group of operated patients we didn’t observe any positive changes in neurological state postoperatively. After surgery CA hasn’t been changed significantly. Conclusion. Assessment of cerebral autoregulation being more informative than PI evaluation can increase TCD valuability in noninvasive diagnostics of cerebrospinal liquid dynamics and could be used for clarifying indications for operation in patients with hydrocephalus.
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