Abstract
Recent work suggests absence of elastic elements and lack of reticular fibers in major intracranial (IC) arteries of premature infants, (J. Neurosurg. 85 Hegedus). To study the hemodynamic counterpart of this structural immaturity, we measured the fractional transmission of aortic acceleration (ACC) forces to the IC arteries. Using standard cardiac Doppler techniques and a real time PD device (HP 770200) we measured cardiac out put (CO), maximum velocity (V max), ACC (dVmax/dt), and other time intervals in the aorta & IC vessels. Scanning via the temporal bone, (Transcranial Doppler. Raju JUM. 86) we studied the middle cerebral artery, (MCA) and via the fontanelle, the basilar and anterior cerebral artelres (ACA) in real time with flow/Doppler angle of <5°. Results in 4 term and 4 stable preterms (Wt. 1.2 Kg, GA 3.3 wks) were: 1) Higher aortic V max and ACC in term Vs preterm. 2) But a significantly larger % of aortic ACC transmission to all IC arteries in preterms as compared to the term. We conclude that transmission of high acceleration forces to preterm infants' brain vessels lacking elastic elements could render them vulnerable for intracranial hemorrhage. (*Preterm Vs term. p<0.05, ANOVA and Tukey's test)
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Raju, T., Kim, S. & Ghai, V. TRANSMISSION OF AORTIC ACCELERATION FORCES TO INTRACRANIAL ARTERIES IN NEWBORN INFANTS: A PULSED DOPPLER (PD) STUDY. Pediatr Res 21 (Suppl 4), 193 (1987). https://doi.org/10.1203/00006450-198704010-00160
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DOI: https://doi.org/10.1203/00006450-198704010-00160
