Duplex color ultrasound study of infantile progressive ventriculomegaly

Sequential measurements of ventricular sizes and Doppler variables of anterior cerebral artery (ACA) by duplex color ultrasound were performed on 14 ventriculomegalic infants (mean age: 3.4 months): 9 were postmeningitic, 3 posthemorrhagic, and 2 congenital. According to changes of the frontal horn radius (FHR) after shunts, the FHR was decreased > 30% (n = 9) in group I and ≤10% (n = 5) in group II. Before shunting, Pourcelot index (PI) in group I was greater than in group II (P<0.01), but FHR in group II was higher than in group I (P<0.01). The intracranial pressure did not vary between groups. Serial preshunt examinations showed a significant correlation between the degree of cerebrovascular resistance and the degree of ventricular dilation only in group I. After surgery, significant changes of end-diastolic velocity, the area under the velocity curve, and PI were found only in group I. The reservoir pumping test performed on 2 cases of recurrent ventriculomegaly in group I and 3 cases in group II Showed a decreased PI only in group I, in which the outcome was better. PI is useful in differentiating between hydrocephalic and atrophic ventriculomegaly. These data suggest that a ventriculomegalic infant with an unelevated PI value hardly benefits from a ventricular shunt.