Establishing normal Lindegaard Ratio in healthy children 10-16 years of age.

IF 1.3 4区医学 Q4 CLINICAL NEUROLOGY

Child's Nervous System Pub Date : 2024-09-01 Epub Date: 2024-06-21 DOI:10.1007/s00381-024-06467-9

Namrata D Patel, Mark S Wainwright, Anne Moore, Pilar Suz, Saipin Muangman, Monica S Vavilala

{"title":"Establishing normal Lindegaard Ratio in healthy children 10-16 years of age.","authors":"Namrata D Patel, Mark S Wainwright, Anne Moore, Pilar Suz, Saipin Muangman, Monica S Vavilala","doi":"10.1007/s00381-024-06467-9","DOIUrl":null,"url":null,"abstract":"Purpose: Transcranial doppler based diagnostic criteria for cerebral vasospasm are not well established in the pediatric population because there is no published normative data to support the diagnosis. Studies have relied on expert consensus, but the definitions have not been validated in children diagnosed with angiographic evidence of vasospasm. Obtaining normative data is a prerequisite to defining pediatric cerebral vasospasm and the Lindegaard Ratio (LR). In this study, we obtained normative data and calculation of the normal LR from healthy children aged 10-16 years.Methods: TCD and carotid ultrasonography was used to measure steady state velocities of both the middle cerebral artery (VMCA) and the extracranial internal cerebral artery (VEICA) in healthy children aged 10-16 years. Demographic information, hemodynamic characteristics and the calculated LR (VMCA/VEICA) was determined for each subject using descriptive statistics.Results: Of the 26 healthy children, 13 were male and 13 were female. VMCA ranged between 53 and 93 cm/sec. LR ranged between 1 and 2.2 for the cohort. VMCA for both males and females were within 2 standard deviations (SD) of the normal mean flow velocity. As the VMCA velocities approached 2 SD above the mean, LR did not exceed 2.2.Conclusion: Our results help define a threshold for LR which can be used to establish radiographic criteria for cerebral vasospasm in children. Our data suggests that using VMCA criteria alone would overestimate cerebral vasospasm and raises question of whether an LR threshold other than 3 is more appropriate for the cut off between hyperemia versus vasospasm in children.","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Child's Nervous System","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00381-024-06467-9","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/21 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: Transcranial doppler based diagnostic criteria for cerebral vasospasm are not well established in the pediatric population because there is no published normative data to support the diagnosis. Studies have relied on expert consensus, but the definitions have not been validated in children diagnosed with angiographic evidence of vasospasm. Obtaining normative data is a prerequisite to defining pediatric cerebral vasospasm and the Lindegaard Ratio (LR). In this study, we obtained normative data and calculation of the normal LR from healthy children aged 10-16 years.

Methods: TCD and carotid ultrasonography was used to measure steady state velocities of both the middle cerebral artery (V_MCA) and the extracranial internal cerebral artery (V_EICA) in healthy children aged 10-16 years. Demographic information, hemodynamic characteristics and the calculated LR (V_MCA/V_EICA) was determined for each subject using descriptive statistics.

Results: Of the 26 healthy children, 13 were male and 13 were female. V_MCA ranged between 53 and 93 cm/sec. LR ranged between 1 and 2.2 for the cohort. V_MCA for both males and females were within 2 standard deviations (SD) of the normal mean flow velocity. As the V_MCA velocities approached 2 SD above the mean, LR did not exceed 2.2.

Conclusion: Our results help define a threshold for LR which can be used to establish radiographic criteria for cerebral vasospasm in children. Our data suggests that using V_MCA criteria alone would overestimate cerebral vasospasm and raises question of whether an LR threshold other than 3 is more appropriate for the cut off between hyperemia versus vasospasm in children.

Abstract Image

查看原文本刊更多论文

确定 10-16 岁健康儿童的正常林德加比率。

目的：基于经颅多普勒的脑血管痉挛诊断标准在儿科人群中尚未得到很好的确立，因为没有公开发表的标准数据来支持诊断。研究依赖于专家共识，但这些定义尚未在有血管造影证据的儿童中得到验证。获得常模数据是定义小儿脑血管痉挛和林德加比率（LR）的先决条件。在这项研究中，我们从 10-16 岁的健康儿童中获得了标准数据并计算了正常的 LR：方法：使用 TCD 和颈动脉超声测量 10-16 岁健康儿童大脑中动脉（VMCA）和颅内外动脉（VEICA）的稳态速度。通过描述性统计确定了每个受试者的人口统计学信息、血液动力学特征和计算出的 LR（VMCA/VEICA）：结果：在 26 名健康儿童中，13 人为男性，13 人为女性。VMCA 在 53 至 93 厘米/秒之间。队列中的 LR 在 1 到 2.2 之间。男性和女性的 VMCA 流速均在正常平均流速的 2 个标准差（SD）以内。当 VMCA 流速接近平均值的 2 个标准差时，LR 不超过 2.2：我们的研究结果有助于确定 LR 的阈值，可用于建立儿童脑血管痉挛的影像学标准。我们的数据表明，仅使用 VMCA 标准会高估脑血管痉挛的程度，并提出了一个问题，即 LR 临界值是否比 3 更适合用于区分儿童的充血和血管痉挛。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Child's Nervous System 医学-临床神经学

CiteScore

3.00

自引率

7.10%

发文量

322

审稿时长

3 months

期刊介绍： The journal has been expanded to encompass all aspects of pediatric neurosciences concerning the developmental and acquired abnormalities of the nervous system and its coverings, functional disorders, epilepsy, spasticity, basic and clinical neuro-oncology, rehabilitation and trauma. Global pediatric neurosurgery is an additional field of interest that will be considered for publication in the journal.