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A Detailed Protocol for Physiological Parameters Acquisition and Analysis in Neurosurgical Critical Patients
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Intracranial Pressure Patterns in Children with Sagittal Craniosynostosis
Christopher L Kalmar1, Elizabeth L Malphrus1, Jessica D Blum1
1From the Divisions of Plastic and Reconstructive Surgery.
Plastic and Reconstructive Surgery
|June 7, 2023
Summary
Intracranial pressure (ICP) elevation is uncommon in infants under 6 months with sagittal craniosynostosis. However, ICP significantly increases in children over 6 months and may link to scaphocephaly severity.
Area of Science:
- Pediatric Neurosurgery
- Ophthalmology
- Craniofacial Surgery
Background:
- Sagittal craniosynostosis presents varied intracranial pressure (ICP) incidence.
- Understanding ICP natural history aids in predicting neurocognitive delay risks.
Purpose of the Study:
- To characterize the natural history of intracranial pressure (ICP) in infants and children with sagittal craniosynostosis.
- To identify risk factors and patterns of ICP elevation in this population.
Main Methods:
- Prospective evaluation of infants and children with sagittal craniosynostosis and controls using spectral-domain optical coherence tomography.
- ICP determination via validated algorithms using retinal optical coherence tomography parameters.
Main Results:
- 31.9% of patients with sagittal craniosynostosis showed ICP ≥ 15 mmHg; 27.8% showed ICP ≥ 20 mmHg.
- ICP elevation risk significantly increased after 6 months of age.
- ICP correlated directly with the severity of scaphocephaly.
Conclusions:
- Elevated ICP is rare in infants <6 months with isolated sagittal craniosynostosis.
- ICP becomes significantly more prevalent after 6 months of age.
- ICP elevation may correlate with the severity of scaphocephaly.
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