Clinical and experimental observations with fontanel pressure measurements

Using the Ladd fiberoptic system, fontanel pressure measurements were performed in infants from 1 to 219 days of age. Various holding devices were used for standardizing the application force and remarkably consistent values were found among three different holders. In group I (neonates), 9.45, 8.45 and 8.2 mm Hg were the mean values. In group II (4 days to 4 weeks), 10.3 and 9.2 were the mean values. In group III (34-219 days), the mean values were 9.9 and 12.4. In a group of 36 hydrocephalic children, epidural, ventricular and fontanel pressures were compared during surgery, and linear correlation was found but the ventricular fluid pressure readings were consistently lower. In dogs with artificial fontanels, cisternal and fontanel pressure was monitored while volume pressure studies were performed. In 80% of the cases, close linear correlation was found. Fontanel pressure measurement and monitoring give very valuable data on ICP. The correct zero reference point is a difficulty which can be eliminated with standardized holding devices.