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Acute increase in intracranial pressure revealed by transcranial Doppler sonography

Acute increase in intracranial pressure revealed by transcranial Doppler sonography Increased pulsatility of blood flow in the basal cerebral arteries recorded with the use of transcranial Doppler sonography (TCD) corresponds to increased intracranial pressure (ICP) to near the level of the diastolic arterial blood pressure. We describe the case of a 39‐year‐old woman who developed acute reduction in consciousness, anisocoria, gaze deviation, and right‐sided hemiparesis 2 days after resection of a relapsed astrocytoma. MRI revealed only a moderate enlargement of the ventricles, but TCD revealed highly pulsatile waveforms of all basal cerebral arteries, showing a biphasic pattern with diastolic backflow. This pattern was interpreted as a massive increase in ICP with imminent danger of cerebral circulatory arrest corresponding to acute malresorptive hydrocephalus. External cerebrospinal fluid drainage was immediately undertaken, revealing excessive ICP of more than 50 cm H2O. Twenty‐four hours after this intervention, both the ICP and the Doppler waveforms had returned to normal. This case illustrates the usefulness of TCD for diagnosing a critical but potentially reversible acute increase in ICP with imminent cerebral circulatory arrest. © 2003 Wiley Periodicals, Inc. J Clin Ultrasound 31:324–327, 2003 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Clinical Ultrasound Wiley

Acute increase in intracranial pressure revealed by transcranial Doppler sonography

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References (12)

Publisher
Wiley
Copyright
Copyright © 2003 Wiley Periodicals, Inc.
ISSN
0091-2751
eISSN
1097-0096
DOI
10.1002/jcu.10174
pmid
12811793
Publisher site
See Article on Publisher Site

Abstract

Increased pulsatility of blood flow in the basal cerebral arteries recorded with the use of transcranial Doppler sonography (TCD) corresponds to increased intracranial pressure (ICP) to near the level of the diastolic arterial blood pressure. We describe the case of a 39‐year‐old woman who developed acute reduction in consciousness, anisocoria, gaze deviation, and right‐sided hemiparesis 2 days after resection of a relapsed astrocytoma. MRI revealed only a moderate enlargement of the ventricles, but TCD revealed highly pulsatile waveforms of all basal cerebral arteries, showing a biphasic pattern with diastolic backflow. This pattern was interpreted as a massive increase in ICP with imminent danger of cerebral circulatory arrest corresponding to acute malresorptive hydrocephalus. External cerebrospinal fluid drainage was immediately undertaken, revealing excessive ICP of more than 50 cm H2O. Twenty‐four hours after this intervention, both the ICP and the Doppler waveforms had returned to normal. This case illustrates the usefulness of TCD for diagnosing a critical but potentially reversible acute increase in ICP with imminent cerebral circulatory arrest. © 2003 Wiley Periodicals, Inc. J Clin Ultrasound 31:324–327, 2003

Journal

Journal of Clinical Ultrasound – Wiley

Published: Jul 1, 2003

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