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Cerebrospinal fluid (CSF) flow is sensitive to many cerebral disorders. We aimed to develop a noninvasive bedside method to detect physiological and pathological CSF phenomena by measuring pulsation patterns of the third ventricle. By transcranial B-mode ultrasound, electrocardiography (ECG)-gated video loops of the third ventricle were acquired. "Speckle tracking" software was used to quantify the relative change of its width. We conducted measurements of nine cardiac cycles in 11 healthy subjects in sitting and in supine position during Valsalva maneuver to investigate the influence of an increased intracranial pressure on the relative deformation of the third ventricle. In one patient with occlusive hydrocephalus, 19 cardiac cycles were measured in sitting position before and after removal of a tumorous obstruction of the aqueduct of Sylvius. Healthy subjects expressed a pulse-related increased width of the third ventricle ([Formula: see text]: +5.69, 95% confidence interval [CI] = [4.38, 7.00]). No significant difference was found between the sitting and the supine position in healthy adults. In the preoperative state of occlusive hydrocephalus, we found a negative, pulse-related deformation ([Formula: see text]: -1.86, 95% CI = [-2.15, -1.58]) with delayed onset. After surgery, the deformation pattern resembled that of our healthy controls. The difference between pre- and postoperative condition was significant (p < 0.001). Transcranial B-mode sonography can be used to record small movements of the sidewalls of the third ventricle. This noninvasive bedside method is suitable to assess CSF pulsatility within the third ventricle and might be able to distinguish between physiological and pathological flows.

ObjectiveThis study aimed to detect and quantify depressive disorders following strokes and to follow the evolution of such patients after administering anti-depressive medication in association with the rehabilitation program.Materials and methodThis is a prospective study on 36 patients suffering from post stroke hemiplegia, situated in an interval of two to twelve months after the stroke. The patients have been randomly divided into two groups, the study group consisting of 21 patients who received anti-depressive medication in addition to the rehabilitation program, and the control group (15 patients) who only received the rehabilitation therapy. All patients were evaluated for depression using the Hamilton depression scale (HAM-D) at the beginning of the study and after two months of anti-depressive medication. Their clinical and functional evolution was evaluated using standardized scales and quality of life scales (FIM). Other parameters were noted such as age, sex, level of education and family support.ResultsAs expected, both the depression and the functional scores improved significantly after two months of rehabilitation treatment associated with anti-depressive medication in the study group compared to the initial evaluation. Also, improvement was noted when compared to the results of the control group.Conclusionsin accordance with others published studies, this analysis shows the importance of early detection and treatment of post stroke depressionA multi disciplinary team that includes a psychiatrist must be assembled for the treatment of stroke patients, as such a team brings the most benefit to the patients.

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