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Changes in cerebral hemodynamics and child growth
Last reviewed: 04.07.2025
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Changes in brain hemodynamics associated with child growth and development
The cerebral blood flow parameters of a healthy newborn are determined primarily by the gestational age and the presence (or absence) of a hemodynamically significant functioning ductus arteriosus. The persistence of the latter is accompanied by a blood discharge into the pulmonary circulation with depletion of blood flow in the cerebral vessels, which is characterized by low diastolic velocity, and sometimes a change in systolic velocity. Normally, with an increase in gestational, postnatal age and weight during the first months of life, a gradual increase in LBFV parameters, a decrease in IP and IR in the arteries and an increase in the average velocity in large venous collectors are noted. The greatest changes occur on the first 2-4 days of life, which is associated with the closure of fetal communications and a gradual decrease in the resistance of the cerebral vessels.
Blood flow indices in intracranial arteries, obtained on the basis of a dynamic study of newborns on the 1st-7th day of life with an uncomplicated course of the early neonatal period in full-term and “conditionally healthy” premature infants, depending on gestational age, did not reveal any significant differences and can be taken as normal.
However, when interpreting Doppler sonography data of the vessels of the base of the brain, it is necessary to take into account not only the weight, gestational and postnatal age of the child, but also the influence of such factors as hematocrit, partial pressure of oxygen and carbon dioxide, glucose concentration in the blood, and circulating blood volume. Hemodynamically significant patent ductus arteriosus leads to left-right shunting of blood and depletion of the flow to the head, which is expressed in a sharp decrease in diastolic velocity (sometimes even retrograde reflux during diastole can be noted) and high IR values.
With age, an increase in the linear velocity of blood flow through the veins and sinuses of the brain is noted.
When qualitatively assessing the nature of the Dopplerogram, it is necessary to pay attention to its monophasic spectrum in the vein of Galen and the thalamo-striatal vein and the presence of pulsation (pseudoarterial character) in the cerebral sinuses. The pseudoarterial character of blood flow in the vein of Galen may indicate the presence of signs of venous discirculation, which subsequently leads to the development of hypertension-hydrocephalic syndrome at the age of 3-4 months in children with perinatal encephalopathy.
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