Analysis of craniospinal hydrodynamics in infants with hydrocephalus after preterm intraventricular hemorrhage.

Abstract

Purpose: Morphological MRI can describe the brain structures and bleeding location but cannot describe the hydrocephalus' mechanisms in intraventricular hemorrhage (HIVH) in preterms. We have shown previously that phase-contrast MRI (PCMRI) can be used to quantify cerebral blood and CSF dynamics in newborns. The objective of the present study was to evaluate the impact of HIVH on CSF oscillations and blood flows in premature infants with hydrocephalus.

Methods: Fifteen preterm infants with HVIH underwent morphological MRI and PCMRI between 3 weeks and 6 years after birth. We used PCMRI to quantify CSF flows in the aqueduct of Sylvius and in the spinal canal.

Results: Different morphological types of hydrocephalus were observed. We found communicating and obstructive hydrocephalus. We found different hydrodynamic behaviors at intraventricular and subarachnoid levels. The morphological analysis of the spinal canal did not systematically correspond to the PCMRI results. At the aqueduct, the results were concordant in three cases only.

Conclusions: PCMRI can quantify CSF and blood flows in newborns, reveal abnormally low or high CSF flows when a morphologic analysis cannot, and provide information that complements the morphological analysis and might be useful for understanding the physiopathology of the condition.