Anterior fontanelle pressure recording with the Rotterdam transducer: variation of normal parameters with age

Using a reliable non-invasive technique for ICP monitoring, we realized 93 continuous anterior fontanelle pressure (AFP) recordings in 86 healthy infants aged from 29 to 85 post-conceptional (PC) weeks. For each recording, we calculated the mean and extremes values of AFP, cerebral pulse amplitude, and pressure waves rate and amplitude. We observed the occurrence of plateau-waves of relatively low amplitude and duration in most infants aged of more than 49 PC weeks. We postulate that PW represents a physiological phenomenon which is amplified under pathological conditions. All AFP parameters are correlated to PC age and vary during early infancy according to an ascending sigmoidal relation (this variation may be explained by a connection between several cranio-cerebral characteristics of the young infant). We conclude that the interpretation of AFP recordings must take into account [1] PC age rather than postnatal age, [2] variation of AFP parameters with age, and [3] occurrence of physiological plateau-waves.