Transcranial Doppler sonography in the early stage of critical enteroviral infection

Kuo Shin Chen, Kuang Lin Lin, Huei Shyong Wang, Shao Hsuan Hsia, Tzou Yien Lin, Pen Yi Lin

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Objective. There is a high fatality rate in enteroviral infection with central nervous system involvement. Our aim was to investigate the change in intracranial blood flow to disclose the characteristic findings in the early stage of critical enteroviral infection. Methods. We examined 27 patients in critical condition with enteroviral infection in our pediatric intensive care unit. We performed transcranial Doppler sonography within 12 hours of admission to the unit. The data were compared with those of a group of 11 patients with nonenteroviral encephalitis. Results. The peak systolic, end-diastolic, and mean velocities of the critical enteroviral infection group were significantly higher than those of the control group (P < .05). Gosling pulsatility index and Pourcelot resistive index values for the right and left middle cerebral arteries (pulsatility index, [mean ± SD], 0.68 ± 0.22 and 0.77 ± 0.19, respectively; resistive index, 0.48 ± 0.01 and 0.52 ± 0.01) in patients with critical enteroviral infection were significantly lower than those of patients with nonenteroviral encephalitis (pulsatility index, 1.10 ± 0.30 and 0.98 ± 0.22; resistive index, 0.62 ± 0.01 and 0.60 ± 0.01; P < .05). Conclusions. Low pulsatility index and resistive index values for cerebral blood flow were observed in the early stage of critical enteroviral infection. This characteristic finding of cerebral blood flow might be associated with the increased sympathetic discharge induced by a brain stem-involved systemic inflammatory response and dysfunction of autoregulation caused by the infection or other disorders of autoregulation that might cause severe or fatal complications.

Original languageEnglish
Pages (from-to)1061-1066
Number of pages6
JournalJournal of Ultrasound in Medicine
Volume22
Issue number10
Publication statusPublished - Oct 1 2003
Externally publishedYes

Keywords

  • Enteroviral infection
  • Gosling pulsatility index
  • Pourcelot resistive index
  • Transcranial Doppler sonography

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

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