P 7 Speckle tracking in the brain – transcranial ultrasound reveals pathological cerebrospinal fluid dynamics. Issue 10 (October 2017)

• Record Type: Journal Article
• Authors: Würzer, B.; Laza, C.; Kaps, M.; Junge, B.; Roessler, F.C.
• Is Part Of: Clinical neurophysiology. Volume 128:Issue 10(2017:Oct.)
• Page Start: e328
• Page End: e329
• Publication Date: 2017-10
• Subjects: Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2017.06.086
• Languages: English
• ISSNs: 1388-2457

Abstract

Abstract : Background: The mechanics of cerebrospinal fluid (CSF) circulation is complex and technical limitations in measuring CSF flow prevent a complete understanding of its physiology. On the other hand, CSF flow is vulnerable to many cerebral disorders. It was our aim to develop a non-invasive and favorable method to detect pathological and physiological CSF phenomena by measuring the wall movement of the third ventricle. Methods: By diagnostical transcranial B-mode ultrasound the cardiac related pulsatile deformation of the third ventricle was measured over time. ECG-gated video loops were saved and analyzed off-line to quantify the relative change of its width. We conducted measurements of 9 cardiac cycles in 11 healthy volunteers. In one patient with occlusive hydrocephalus 19 cardiac cycles were measured, each before and after removal of a tumorous obstruction of the aqueduct of Sylvius. Results: Healthy volunteers expressed a pulse related increased width of the third ventricle (max +5.69 ± 2.54%). The deformation courses were in accordance with known literature about CSF dynamics. In case of occlusive hydrocephalus, we found a negative pulse related deformation (min −1.84 ± 0.21%) with delayed onset for the preoperative state. After surgery, the deformation pattern resembled that of our healthy controls. The difference between pre- and postoperative condition was significant ( p < 0.001 ). Conclusion: Conventional transcranial B-mode-sonography can be used to record small movements of the sidewalls of the third ventricle. Therefore, this non-invasive bedside-method is suitable to assess CSF pulsatility within the third ventricle and might be able to distinguish between physiological and pathophysiological flow conditions. Further investigations should prove the reliability of this technique.