Intracranial volume versus static and pulsatile intracranial pressure values in children with craniosynostosis.

OBJECTIVEReduced intracranial volume (ICV) and raised intracranial pressure (ICP) are assumed to be principal pathophysiological mechanisms in childhood craniosynostosis. This study examined the association between ICV and ICP and whether ICV can be used to estimate the ICP.METHODSThe authors analyzed ICV and ICP measurements from children with craniosynostosis without concurrent hydrocephalus and from age-matched individuals without craniosynostosis who underwent diagnostic ICP measurement.RESULTSThe study included 19 children with craniosynostosis (mean age 2.2 ± 1.9 years) and 12 reference individuals without craniosynostosis (mean age 2.5 ± 1.6 years). There was no difference in ICV between the patient and reference cohorts. Both mean ICP (17.1 ± 5.6 mm Hg) and mean wave amplitude (5.9 ± 2.6 mm Hg) were higher in the patient cohort. The results disclosed no significant association between ICV and ICP values in the patient or reference cohorts, and no association was seen between change in ICV and ICP values after cranial vault expansion surgery (CVES) in 5 children in whom ICV and ICP were measured before and after CVES.CONCLUSIONSIn this cohort of children with craniosynostosis, there was no significant association between ICV and ICP values prior to CVES and no significant association between change in ICV and ICP values after CVES in a subset of patients. Therefore, ICV could not reliably estimate the ICP values. The authors suggest that intracranial hypertension in childhood craniosynostosis may not be caused by reduced ICV alone but rather by a distorted relationship between ICV and the volume of intracranial content (brain tissue, CSF, and blood).

[1]  S. Bartlett,et al.  Intraoperative intracranial pressure monitoring in the pediatric craniosynostosis population. , 2018, Journal of neurosurgery. Pediatrics.

[2]  R. Tasker,et al.  Letter to the Editor. Raised intracranial pressure and cognitive delay in craniosynostosis. , 2017, Journal of neurosurgery. Pediatrics.

[3]  P. Eide,et al.  Comparative observational study on the clinical presentation, intracranial volume measurements, and intracranial pressure scores in patients with either Chiari malformation Type I or idiopathic intracranial hypertension. , 2017, Journal of neurosurgery.

[4]  S. Sood,et al.  Effect of molding helmets on intracranial pressure and head shape in nonsurgically treated sagittal craniosynostosis patients. , 2016, Journal of neurosurgery. Pediatrics.

[5]  P. Eide.  The correlation between pulsatile intracranial pressure and indices of intracranial pressure-volume reserve capacity: results from ventricular infusion testing. , 2016, Journal of neurosurgery.

[6]  I. Mathijssen,et al.  Guideline for Care of Patients With the Diagnoses of Craniosynostosis: Working Group on Craniosynostosis , 2015, The Journal of craniofacial surgery.

[7]  D. Rizopoulos,et al.  Algorithm for the Management of Intracranial Hypertension in Children with Syndromic Craniosynostosis , 2015, Plastic and reconstructive surgery.

[8]  M. Urata,et al.  Intracranial hypertension after surgical correction for craniosynostosis: a systematic review. , 2015, Neurosurgical focus.

[9]  J. Jayamohan,et al.  The incidence of raised intracranial pressure in nonsyndromic sagittal craniosynostosis following primary surgery. , 2015, Journal of neurosurgery. Pediatrics.

[10]  J. Jayamohan,et al.  The preoperative incidence of raised intracranial pressure in nonsyndromic sagittal craniosynostosis is underestimated in the literature. , 2014, Journal of neurosurgery. Pediatrics.

[11]  Y. Okada,et al.  Intraoperative pre- and post-craniofacial reconstruction intracranial pressure (ICP) monitoring in children with craniosynostosis , 2013, Child's Nervous System.

[12]  R. Keating,et al.  Treatment for delayed presentation of sagittal synostosis: challenges pertaining to occult intracranial hypertension. , 2011, Journal of neurosurgery. Pediatrics.

[13]  E. Kerty,et al.  Static and pulsatile intracranial pressure in idiopathic intracranial hypertension , 2011, Clinical Neurology and Neurosurgery.

[14]  Per Kristian Eide,et al.  Diagnostic Intracranial Pressure Monitoring and Surgical Management in Idiopathic Normal Pressure Hydrocephalus: A 6‐Year Review of 214 Patients , 2010, Neurosurgery.

[15]  J. Ascherman,et al.  Intracranial Volumes in a Large Series of Healthy Children , 2009, Plastic and reconstructive surgery.

[16]  P. Eide,et al.  Is Intracranial Pressure Waveform Analysis Useful in the Management of Pediatric Neurosurgical Patients? , 2007, Pediatric Neurosurgery.

[17]  K. Kawamoto,et al.  The intracranial pressure of the patients with mild form of craniosynostosis , 2007, Child's Nervous System.

[18]  David J. David,et al.  Intracranial volume measurement of sagittal craniosynostosis , 2007, Journal of Clinical Neuroscience.

[19]  D. David,et al.  Intracranial volume in patients with nonsyndromal craniosynostosis. , 2005, Journal of neurosurgery.

[20]  R. Hayward,et al.  How low can you go? Intracranial pressure, cerebral perfusion pressure, and respiratory obstruction in children with complex craniosynostosis. , 2005, Journal of neurosurgery.

[21]  L. Massimi,et al.  Intracranial pressure monitoring in children with single suture and complex craniosynostosis: a review , 2005, Child's Nervous System.

[22]  R. Hayward,et al.  Subdural intracranial pressure monitoring in craniosynostosis: its role in surgical management , 1995, Child's Nervous System.

[23]  P. Eide,et al.  Assessment of Continuous Intracranial Pressure Recordings in Childhood Craniosynostosis , 2002, Pediatric Neurosurgery.

[24]  P. Eide,et al.  Changes in Intracranial Pressure after Calvarial Expansion Surgery in Children with Slit Ventricle Syndrome , 2001, Pediatric Neurosurgery.

[25]  A. Hockley,et al.  Intracranial volume change in craniosynostosis. , 1999, Journal of neurosurgery.

[26]  S. R. Cohen,et al.  Intracranial Pressure in Single-Suture Craniosynostosis , 1998, The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association.

[27]  W. K. Chong,et al.  The effectiveness of papilledema as an indicator of raised intracranial pressure in children with craniosynostosis. , 1996, Neurosurgery.

[28]  A. Biglan,et al.  Incidence of increased intracranial pressure after early surgical treatment of syndromic craniosynostosis. , 1996, Pediatric neurosurgery.

[29]  R. Hayward,et al.  Relationship between intracranial pressure and intracranial volume in craniosynostosis. , 1993, British journal of plastic surgery.

[30]  D. Rénier,et al.  Intracranial pressure and intracranial volume in children with craniosynostosis. , 1992, Plastic and reconstructive surgery.

[31]  J. Hirsch,et al.  Intracranial pressure in craniostenosis. , 1982, Journal of neurosurgery.