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The Possibility of Intracranial Hypertension in Patients with Autism Spectrum Disorder Using Computed Tomography
Shuichi Yamada1, Ichiro Nakagawa1, Fumihiko Nishimura1
1Department of Neurosurgery, Nara Medical University, Kashihara, Nara 634-8521, Japan.
Insights
Children with autism spectrum disorder (ASD) may have higher intracranial pressure. Noninvasive CT scans revealed lower skull circularity and C-ratios in ASD patients, suggesting a risk for intracranial hypertension.
Area of Science:
- Neuroscience
- Pediatrics
- Radiology
Background:
- Intracranial pressure is typically considered normal in children with autism spectrum disorder (ASD).
- However, subtle indicators of increased intracranial pressure may be present.
- Noninvasive imaging techniques can potentially detect these changes.
Purpose of the Study:
- To assess for increased intracranial pressure in children with autism spectrum disorder (ASD).
- To evaluate the utility of noninvasive computed tomography (CT) imaging in detecting skull shape alterations indicative of intracranial hypertension.
- To investigate the relationship between skull morphology and ASD.
Main Methods:
- Acquired head CT scans from children with ASD (109 cases) and typically developing children (60 cases).
- Processed CT images to map the inner skull surface and calculate circularity and C-ratio (inner/outer circumference ratio).
- Statistically analyzed circularity and C-ratio to compare groups and identify correlations with skull shape complexity.
Main Results:
- Children with ASD exhibited significantly lower circularity and C-ratio compared to typically developing children.
- Lower circularity correlated with a more complex inner skull shape, indicative of intracranial hypertension.
- These findings suggest a potential link between altered skull morphology and elevated intracranial pressure in ASD.
Conclusions:
- Children with ASD may be at risk for chronic intracranial hypertension.
- The developed technique using circularity and C-ratio offers a noninvasive method for screening potential intracranial hypertension in ASD patients.
- This noninvasive approach could significantly influence future research directions in ASD investigations.
Abstract:
Although intracranial pressure is considered to be normal in children with autism spectrum disorder (ASD), we aimed to assess whether such children may have increased intracranial pressure using noninvasive computed tomography (CT). Head CT scans of children with ASD (109 cases, male 91 and female 18, average age 4.3 years) and of children with typical development (60 cases, male 35 and female 25, average age 4.5 years) were acquired. The images were processed to map the shape of the inner skull surface. We predicted that a complex skull shape, based on a marked digital impression, would be indicative of chronically increased intracranial pressure. The data of the scans were extracted and processed to automatically establish inner and outer cranial circumferences. The circularity (reflecting inner skull shape and area) and C-ratio (ratio of inner/outer circumference) were determined and statistically analyzed. The circularity and C-ratio were significantly lower in children with ASD than in children with typical development. A lower circularity was associated with a more complex shape of the inner skull surface, which indicated the presence of intracranial hypertension. Our study suggests that children with ASD may be at a risk for chronic intracranial hypertension. Our technique incorporating the circularity and C-ratio is a useful noninvasive method for screening such patients and could impact future investigations of ASD.
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