Abstract
We studied non-invasive intracranial pressure monitoring in 20 asymptomatic infants with increased head growth rate. Both basal anterior fontanelle pressure (AFP) traces and occurrence of pressure waves were analysed and compared with normal range values previously established. Eight recordings were classified as pathological; cerebral imaging showed subdural collections or ventricular dilatation in all cases. Five out of these eight infants further developed neurological deficits and/or increase of the ventricular size, and required neurosurgical procedures. Twelve infants had normal AFP traces; six of these had normal cerebral imaging and six showed enlargement of subarachnoid spaces with normal ventricles. All of these 12 patients normalised their head growth rate and remained asymptomatic. This observation suggests that AFP monitoring may be helpful in asymptomatic infants with increased head growth rate to identify a progressive intracranial process and the potential need for a neurosurgical procedure.
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References
Avezaat C, Van Eijndhoven J (1986) Clinical observations on the relationship between cerebrospinal fluid pulse pressure and intracranial pressure. Acta Neurochir (Wien) 79:13–29
Azais M, Echenne B (1992) Epanchements péricérébraux idiopathiques (hydrocéphalie externe) du nourrisson. Ann Pédiatr (Paris) 39:550–558
Braun JK (1991) Mechanisms of production of raised intracranial pressure. In: Minns RA (ed) Problems of intracranial pressure in childhood. McKaith, Oxford, pp 13–37
Brown J (1991) The pathological effects of raised cerebral pressure. In: Minns RA (ed) Problems of intracranial pressure in childhood. McKaith, Oxford, pp 38–76
De Jong DA, Maas A, Van De Voort E (1984) Non-invasive intracranial pressure monitoring. A technique for reproducible fontanelle pressure measurements. Z Kinderchir 39:274–276
Gaab M, Koos T (1984) Hydrocephalus in infancy and childhood: diagnosis and indication for operation. Neuropediatrics 15:173–179
Gaab M, Sorensen N, Brawanski A, Bushe K, Wodarz R (1980) Non-invasive intracranial pressure monitoring by fontanometry. Z Kinderchir 31:339–347
Hill A, Volpe J (1981) Measurement of intracranial pressure using the Ladd intracranial pressure monitor. J Pediatr 98:974–976
Horbar J, Yeager S, Philip A, Lucey J (1980) Effect of application force on noninvasive measurement of intracranial pressure. Pediatrics 66:455–459
Kaiser A, Whitelaw A (1987) Non-invasive monitoring of intracranial pressure — fact or fancy? Dev Med Child Neurol 29:320–326
Laubscher B, Deonna T, Uske A, Van Melle G (1990) Primitive megalencephaly in children: natural history, medium term prognosis with special reference to external hydrocephalus. Eur J Pediatr 149:502–507
Menke J, Miles R, McIlhany M, Bashiru M, Chua C, Shwied E (1982) The fontanelle tonometer: a noninvasive method for measurement of intracranial pressure. J Pediatr 100:960–963
Ment L, Duncan C, Geeher R (1980) Benign enlargement of the subarachnoid spaces in the infant. J Neurosurg 54:504–508
Nogueira G, Zaglul H (1991) Hypodense extracerebral images on computed tomography in children. “External hydrocephalus”: a misnomer? Child's Nerv Syst 7:336–341
Peabody J, Schneider H, Huch R, Huch A (1981) A new device for non-invasive measurements of intracranial pressure in newborns. J Perinat Med 9 [Suppl 1]:125–128
Raftopoulos C, Chaskis C, Delecluse F, Cantraine F, Bidaut L, Brotchi J (1992) Morphological quantitative analysis of intracranial pressure waves in normal pressure hydrocephalus. Neurol Res 14:389–395
Rochefort M, Rolfe P, Wilkinson A (1987) New fontanometer for continuous estimation of intracranial pressure in the newborn. Arch Dis Child 62:152–155
Schettini A, Walsh E (1974) Experimental identification of the subarachnoid and subpial compartments by intracranial pressure measurements. J Neurosurg 40:609–616
Von Wild K, Porksen C (1980) Non-invasive technique for monitoring pressure via the fontanelle in premature infants and newborns with hydrocephalus. Z Kinderchir 31:348–353
Wayenberg JL, Raftopoulos C, Vermeylen D (1993) Non-invasive measurement of intracranial pressure in the newborn and the infant: the Rotterdam Teletransducer. Arch Dis Child 69:493–497
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Massager, N., Wayenberg, J.L., Raftopoulos, C. et al. Anterior fontanelle pressure monitoring for the evaluation of asymptomatic infants with increased head growth rate. Child's Nerv Syst 12, 38–42 (1996). https://doi.org/10.1007/BF00573854
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DOI: https://doi.org/10.1007/BF00573854