Matheus Fernandes de Oliveira1, Manoel Jacobsen Teixeira2,3, Marcelo de Lima Oliveira3, Edson Bor Seng-Shu3, Karen Andrade Norremose3, Fernando Campos Gomes Pinto2,3. 1. Division of Functional Neurosurgery of the Institute of Psychiatry, Hospital das Clínicas, Universidade de São Paulo, Rua Loefgren 700, apto 103, Vila Mariana, São Paulo, São Paulo, 04040-000, Brazil. mafernoliv@yahoo.com.br. 2. Division of Functional Neurosurgery of the Institute of Psychiatry, Hospital das Clínicas, Universidade de São Paulo, Rua Loefgren 700, apto 103, Vila Mariana, São Paulo, São Paulo, 04040-000, Brazil. 3. Division of Neurological Surgery, Hospital das Clinicas, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
Abstract
INTRODUCTION: Hydrocephalus is a prevalent condition among infants. Retrograde ventriculosinus shunt (RVSS) proposes a feasible option to treat hydrocephalus according to the principles presented by El-Shafei. In this essay, we analyze nuances and application of transcranial Doppler (TCD) in patients submitted to RVSS. METHODS: We consecutively enrolled patients diagnosed with hydrocephalus after surgical repair of myelomeningocele from January 2010 to January 2012, users of Hospital das Clinicas, University of Sao Paulo. They were treated with RVSS. Patients enrolled to the study were consecutively evaluated in an outpatient basis with TCD in preoperative, immediate postoperative period, and late postoperative period (1 year). RESULTS: Except for patient 3, there was an increase in mean flow velocity, decreased pulsatility index, and decreased resistance index in all vessels analyzed. DISCUSSION: In our sample, transcranial Doppler could be used as a diagnostic and follow-up tool to evaluate hemodynamics and hydrodynamics in the preoperative and postoperative phases of RVSS. It was technically feasible in all patients, had close relation with other clinical and image parameters, and was sensitive to identify system malfunction.
INTRODUCTION:Hydrocephalus is a prevalent condition among infants. Retrograde ventriculosinus shunt (RVSS) proposes a feasible option to treat hydrocephalus according to the principles presented by El-Shafei. In this essay, we analyze nuances and application of transcranial Doppler (TCD) in patients submitted to RVSS. METHODS: We consecutively enrolled patients diagnosed with hydrocephalus after surgical repair of myelomeningocele from January 2010 to January 2012, users of Hospital das Clinicas, University of Sao Paulo. They were treated with RVSS. Patients enrolled to the study were consecutively evaluated in an outpatient basis with TCD in preoperative, immediate postoperative period, and late postoperative period (1 year). RESULTS: Except for patient 3, there was an increase in mean flow velocity, decreased pulsatility index, and decreased resistance index in all vessels analyzed. DISCUSSION: In our sample, transcranial Doppler could be used as a diagnostic and follow-up tool to evaluate hemodynamics and hydrodynamics in the preoperative and postoperative phases of RVSS. It was technically feasible in all patients, had close relation with other clinical and image parameters, and was sensitive to identify system malfunction.
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