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Related Experiment Videos

Intracranial pressure changes during intermittent CSF drainage.

J Kirk Bass1, W Thomas Bass, Glen A Green

  • 1Department of Pediatrics, Eastern Virginia Medical School, Children's Hospital of The King's Daughters, Norfolk, Virginia 23507, USA.

Pediatric Neurology
|May 29, 2003
PubMed
Summary

Direct intracranial pressure monitoring in premature infants with posthemorrhagic hydrocephalus is feasible. Monitoring helps optimize cerebrospinal fluid drainage and shunt settings for better management of hydrocephalus.

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Area of Science:

  • Neonatalogy
  • Pediatric Neurosurgery
  • Critical Care Medicine

Background:

  • Posthemorrhagic hydrocephalus is a complication in very-low-birth-weight infants.
  • Management often involves intermittent cerebrospinal fluid drainage via ventricular reservoirs.
  • Limited data exists on intracranial pressure (ICP) dynamics during drainage to guide treatment.

Observation:

  • Continuous ICP monitoring was performed in three premature infants with ventricular reservoirs.
  • ICP was measured for 7 days, starting 48 hours after reservoir placement.
  • Daily removal of 10 cc/kg cerebrospinal fluid was administered.

Findings:

  • ICP before initial drainage was within normal reported ranges.
  • Cerebrospinal fluid removal lowered ICP below baseline but caused significant pressure fluctuations.

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  • One infant experienced sustained negative intracranial pressure post-drainage.

    • Implications:

    • Direct ICP monitoring can assess the safety and efficacy of cerebrospinal fluid removal.
    • This technique may guide optimal drainage volume and frequency for hydrocephalus management.
    • ICP monitoring data could inform the selection of appropriate resistance values for programmable shunts.