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Blood Flow Velocities in the Anterior Cerebral Artery and Basilar Artery in Asphyxiated Infants

Department of Pediatrics (S.N., S.I., K.S., S.Y.) and Cardiovascular Research Institute (S.M.), Yokohama City University, Yokohama, Japan.

Address correspondence to Shigeru Nishimaki, MD, Department of Pediatrics, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan. E-mail: shigenis{at}med.yokohama-cu.ac.jp

Objective. The aim of this series was to determine whether cerebral blood flow velocities (CBFVs) in the anterior cerebral artery (ACA) and basilar artery (BA) correlate with the severity of asphyxia in infants and whether these velocity measures can be useful for predicting early developmental prognosis. Methods. We measured CBFVs in the ACA and BA by using pulsed Doppler sonography in 29 healthy and 17 asphyxiated infants (11 with mild asphyxia [median gestational age, 38 weeks; median birth weight, 2856 g] and 6 with severe asphyxia [38.5 weeks; 2910 g]). Results. In the mildly asphyxiated infants, the median diastolic and systolic velocities in the ACA were 10.4 and 32.5 cm/s, respectively, and those in the BA were 10.5 and 33.1 cm/sec. In the severely asphyxiated infants, the median diastolic and systolic velocities in the ACA were 19.8 and 40.5 cm/s, and those in the BA were 30.2 and 60.5 cm/s. The BA:ACA ratios (CBFV in the BA/CBFV in the ACA) in both the diastolic and systolic periods were higher in the severely asphyxiated infants than in the mildly asphyxiated infants (0.94 versus 1.35; P < .01; 1.01 versus 1.38; P < .01). Conclusions. These preliminary results suggest that CBFVs in the BA correlate with the degree of neonatal asphyxia and may be useful to predict the neurodevelopmental outcome. We submit that the increased CBFV in the BA may represent the preferential blood flow to the brain stem region.

Key Words: asphyxia • cerebral blood flow velocity • Doppler sonography • neurodevelopmental outcome

Abbreviations: ACA, anterior cerebral artery • BA, basilar artery • CBFV, cerebral blood flow velocity • HIE, hypoxic-ischemic encephalopathy • RI, resistive index