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Intracranial pressure measurement in infants presenting with progressive macrocephaly and enlarged subarachnoid

M Schulz1, S A Ahmadi, B Spors

  • 1Charité Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin, Germany.

Acta Neurochirurgica. Supplement
|February 14, 2012
PubMed

Insights

Intracranial pressure (ICP) monitoring in infants with subarachnoid spaces helps determine the need for ventriculo-peritoneal (VP) shunting. Elevated ICP indicates potential benefit from VP shunting, guiding treatment decisions.

Area of Science:

  • Pediatric Neurosurgery
  • Neurology
  • Medical Imaging

Background:

  • Subarachnoid spaces in infants present a challenge for treatment decisions like observation or ventriculo-peritoneal (VP) shunting.
  • Lack of clear guidelines necessitates further investigation into intracranial pressure (ICP) management.

Purpose of the Study:

  • To measure ICP in infants with enlarged subarachnoid spaces.
  • To elucidate the necessity of VP shunting based on ICP monitoring.

Main Methods:

  • Seven infants with macrocephaly and enlarged CSF spaces underwent continuous ICP monitoring via external ventricular drain.
  • Overnight ICP data were analyzed for baseline, mean values, and histogram distribution.

Main Results:

  • Three infants with baseline ICP > 10 mmHg received VP shunts.
  • One infant with average ICP > 10 mmHg also underwent VP shunting.
  • Three infants with ICP < 10 mmHg were managed observationally, showing significant differences in ICP values compared to the shunted group (p < 0.05).

Conclusions:

  • Subarachnoid spaces in infants pose a dilemma for neurosurgeons regarding observation versus VP shunting.
  • Continuous ICP monitoring can aid in identifying infants who may benefit from VP shunting.
  • Risk-benefit analysis of observation and VP shunting is crucial for treatment decisions.
Abstract

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