Abstract â–¡ 100

Introduction: 1997 Deeg measured perfusion in the vertebrobasilar system of infants after an ALTE (apparent life-threatening event) and observed a marked decrease upon rotation of the head in prone position. The decreased perfusion could be a reason for brainstem gliosis as has been described in victims of SIDS. With Doppler sonography we investigated the position dependent perfusion in premature infants with a birthweight < 1750g.

Patients and Methods: n=15; BW: 1088g (775 - 1750); GA: 29 wks (26 -32); date of measurement within the first 10 days of life and in two follow-up measurements (7-10 days later and at the corrected age of one month). Measurement with transfontanellar colour-coded Doppler sonography. Target vessels: ICA (internal carotid artery), BA (basilar artery), VA (vertebral artery) in prone (head centered - baseline) and supine position (maximal rotation of the head to the right and left).

Results: In none of the premature infants a position dependent perfusion was seen in the ICA. In prone position with rotation of the head 3 of 15 premature infants showed an incomplete steal effect in the contralateral VA: One of these infants showed an inconstant signal with changes in perfusion during measurement itself. Upon follow-up another of these 3 infants showed the incomplete steal effect in the other VA, again contralateral to rotation of the head.

Conclusion: The maximal rotation of the head in prone position can lead to a significant decrease in cerebral blood flow of the vertebral artery. This was also observed in follow-up measurements. In order to evaluate the relevance of these observations a larger patient group will have to be investigated.