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Intracranial volume versus static and pulsatile intracranial pressure values in children with craniosynostosis

Erlend Aambø Langvatn1, Radek Frič1, Bernt J Due-Tønnessen1

  • 11Department of Neurosurgery, Oslo University Hospital-Rikshospitalet, Oslo, Norway; and.

Journal of Neurosurgery. Pediatrics
|April 20, 2019
PubMed

Insights

Reduced intracranial volume (ICV) does not reliably estimate intracranial pressure (ICP) in children with craniosynostosis. This study found no significant association between ICV and ICP, suggesting other factors contribute to intracranial hypertension.

Area of Science:

  • Pediatric Neurosurgery
  • Craniofacial Surgery
  • Neurology

Background:

  • Childhood craniosynostosis is often associated with assumptions of reduced intracranial volume (ICV) and elevated intracranial pressure (ICP).
  • Understanding the relationship between ICV and ICP is crucial for managing craniosynostosis.

Purpose of the Study:

  • To investigate the association between ICV and ICP in children with craniosynostosis.
  • To determine if ICV can be used as a reliable estimator for ICP in this patient population.

Main Methods:

  • Analysis of ICV and ICP measurements from children with craniosynostosis and age-matched controls.
  • Comparison of ICV and ICP values before and after cranial vault expansion surgery (CVES) in a subset of patients.

Main Results:

  • No significant difference in ICV was found between craniosynostosis patients and controls.
  • Higher mean ICP and wave amplitude were observed in the craniosynostosis cohort.
  • No significant association was identified between ICV and ICP, either before or after CVES.

Conclusions:

  • ICV cannot reliably estimate ICP in children with craniosynostosis.
  • Intracranial hypertension in craniosynostosis may result from a complex interplay between ICV and intracranial content volume, not solely reduced ICV.
Abstract

Keywords:
CVES = cranial vault expansion surgeryICC = intracranial complianceICP = intracranial pressureICV = intracranial volumeMWA = mean ICP wave amplitudeOSA = obstructive sleep apneacraniofacialcraniosynostosisintracranial pressureintracranial volume

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