THE USE OF CEREBRAL ARTERY PULSATILITY INDEX TO PREDICT NEUROLOGIC OUTCOME

Abstract

Decreased blood flow velocity (increased pulsatility index, PI) in the anterior cerebral arteries (ACA) has been reported in preterm infants with intraventricular hemorrhage. From Feb. 1982 to Aug. 1983, we prospectively evaluated PI, cranial ultrasound and neurologic status (Sarnat Score), in 60 infants ⩽32 weeks gestation on days 1, 3 and 7 and then weekly until discharge, to determine their correlation with PI. PI was calculated from the tracings obtained by doppler ultrasound by the method described by Bada et al. Survival, neurologic status (Sarnat Score), cranial ultrasound, occurrence of seizures, and discharge neurologic examination (Parmalee exam) were assessed.Mean B.Wt. was 1151 grams (640-1750) and mean GA was 30.1 weeks (26-32). There were 31 males and 29 females. Mean Apgar Score at 1 minute was 4.7 and at 5 minutes was 6.6. Forty-two of the infants were inborn.The maximum PI recorded on day 1 correlated negatively with B.Wt. (p<0.05) and positively with mortality (p<0.06), occurrence of seizures (p<0.05) and development of hydrocephalus (p<0.06). There was no correlation between PI done at any time and GA, neurologic status (Sarnat Score), cranial ultrasound or discharge neurologic examination.Decreased cerebral blood flow velocity (high PI) is correlated with mortality, occurrence of seizures and later development of hydrocephalus. Follow-up of these infants is pending.