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Intracranial pressure changes in arrested hydrocephalus.

I R Whittle, I H Johnston, M Besser

    Journal of Neurosurgery
    |January 1, 1985
    PubMed
    Summary

    Many children with arrested hydrocephalus experience dangerous intracranial hypertension. Continuous monitoring of intracranial pressure (ICP) and cognitive tests are crucial for ongoing assessment of this progressive disorder.

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    Area of Science:

    • Pediatric Neurology
    • Neurosurgery
    • Neuroscience

    Background:

    • Arrested hydrocephalus is often diagnosed clinically.
    • Previous treatment with cerebrospinal fluid diversion may lead to shunt malfunction.

    Purpose of the Study:

    • To evaluate the utility of continuous intracranial pressure (ICP) monitoring in children and adolescents with clinically diagnosed arrested hydrocephalus.
    • To determine the prevalence of intracranial hypertension in this patient population.

    Main Methods:

    • Continuous ICP monitoring was performed on 46 children and adolescents with arrested hydrocephalus.
    • Patients were divided into two groups: those with prior cerebrospinal fluid diversion (Group A) and those without (Group B).
    • Serial psychometric testing was conducted to assess cognitive functioning.

    Main Results:

    • 80% of Group A and 63% of Group B patients exhibited intracranial hypertension.
    • ICP monitoring revealed decompensation in 25% of patients with initially normal or equivocal ICP.
    • Abnormal ICP was detected in 88% of patients with declining cognitive function.

    Conclusions:

    • Apparent arrested hydrocephalus can be an insidiously progressive disorder.
    • Continuous ICP monitoring and serial psychometric evaluation are essential for managing arrested hydrocephalus.
    • These monitoring methods aid in detecting decompensation and guiding treatment decisions.

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