[Diagnosis of increases in acute intracranial pressure in infancy and early childhood].

The results reported in this paper were obtained from 276 cases (babies and infants) with increases in intracranial pressure. In 88 cases the cause of disease was not clear, while 35 patients showed symptoms of an acute increase in intracranial pressure so that diagnosis was an urgent necessity. With subdural hygromata, clinical results obtained for acute rises of pressure usually differ greatly from those obtained for chronic increases of pressure. The diaphany of skull is usually negative. Fundal hemorrhages were observed in acute cases only. Critical cerebral pressures were most frequently observed in the case of tumors. The diagnosis is rather difficult. In the case of functional immaturity of the brain localized neurological symptoms are not usually observed. The cerebral pressure is generally counterbalanced for a long time so that an acute cerebral symptomatology is not produced until tumoral complications, shifts in cerebrospinal fluid passages, intracranial mass shifts, or tumoral hemorrhages occur. Unlike all other groups of diseases, symptoms of rises of intracranial pressure were very marked. Malformations of the posterior cranical fossa included acute occlusions in the case of Dandy-Walker syndromes and arachnoidal cysts. In the case of severe cerebral malformations, acute increases in intracranial pressure are sometimes erroneously concluded from an abnormal increase of the size of head accompanied by a complete lack of reactions on the part of children affected with them. Children with hydrocephalus caused by a disturbance of the circulation of liquor are now treated with pressure-controlled liquor drainage systems. Critical cerebral pressures may occur if the drainage system suddenly fails to operate properly.