In a prospective study of the natural development of total cerebral blood flow volume (CBFV), the common, external and internal carotid and vertebral arteries were examined in 94 healthy children and adolescents between 3 and 18 years of age (sex and age evenly distributed) using a 7.0-MHz transducer of a computed sonography system. Intravascular flow volumes were calculated with the product of angle-corrected time-averaged flow velocity and the cross-sectional area of the vessel. CBFV was determined as the sum of flow volumes in the internal carotid and vertebral arteries of both sides. CBFV increased significantly between 3 and 6.5 years of age (from 687 +/- 85 to 896 +/- 110 ml/min; age correlation, p < or = 0.01) and declined thereafter (p < or = 0.001) to a constant level of approximately 700 ml/min at 15 years of age. There was no difference in CBFV between sexes. The proportion of bilateral vertebral artery flow volume in total CBFV decreased significantly between the ages of 3 and 18 years (p < or = 0.001). As the flow volumes of the external carotid arteries increased markedly from childhood to adulthood, flow volumes of the common carotid arteries were not representative of CBFV. Intrasession test-retest correlation of CBFV was high (r = 0.89, p < or = 0.0001). Reference data for the childhood years presented here and previously described results from healthy adults allow us to outline the natural evolution of CBFV in humans. The reliability of the method has already been demonstrated. Thus, it may now be introduced into clinical application.

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A prospective study on transcranial color duplex sonography (TCCD) was performed with 94 healthy children and adolescents between 3 and 18 years of age (age and sex evenly distributed) in order to provide normal data on angle-corrected ("true") flow velocities and wave-form parameters of the main supra- and infratentorial basal cerebral arteries. Using a 2.0 MHz transducer of a computed sonography system, we examined the anterior, middle, and posterior cerebral arteries of either side transcranially, and the vertebrobasilar system suboccipitally. In all arteries, flow velocities decreased continuously from early childhood to adulthood, while wave-form parameters remained constant. There was no difference in flow velocities, and wave-form parameters between girls and boys. On the average, the angle-corrected flow velocities measured by TCCD were about 10%-20% higher than the reference data provided in "blind" transcranial Doppler studies by other groups for the anterior and posterior cerebral arteries as well as the basilar artery, while there were only small differences in the values for the middle cerebral artery. Side-to-side differences in flow velocities were lower in the middle and posterior cerebral arteries than in the anterior cerebral and the vertebral arteries. The reference data presented here provide a basis for the clinical application of the TCCD method in children and adolescents.