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Continuous Intracranial Pressure Monitoring in Children with 'Benign' External Hydrocephalus.

作者信息

Poca Maria A, Lopez-Bermeo Diego, Cano Paola, Maruccia Federica, Fajardo Carolina, Delgado Ignacio, Munar Francisca, Garcia-Merino Anna, Sahuquillo Juan

机构信息

Department of Neurosurgery, Vall d'Hebron University Hospital, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain.

Neurotraumatology and Neurosurgery Research Unit, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain.

出版信息

J Clin Med. 2025 Apr 28;14(9):3042. doi: 10.3390/jcm14093042.


DOI:10.3390/jcm14093042
PMID:40364074
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12072479/
Abstract

This study aimed to evaluate the results of continuous intracranial pressure (ICP) monitoring in children with macrocephaly or rapidly increasing head circumference (HC) diagnosed as benign external hydrocephalus (BEH). Here, we report the absolute ICP measurements, ICP pulsatility, and slow ICP waves after at least 48 h of continuous monitoring in a cohort of 36 children diagnosed with BEH. A prospective study of continuous ICP monitoring was performed in 36 consecutive children with macrocephaly (HC above the 97.5th percentile) or rapidly increasing HC (at least crossing two percentile curves), diagnosed with BEH (22 boys and 14 girls with a mean age of 23.6 ± 13.3 months, minimum: 6, maximum 65), using an epidural sensor. For the first four children in the study, hard copies of the ICP values were obtained using an analog recorder. Starting from the fifth patient, the ICP signal was sampled at 200 Hz and stored on a computer using a computer-based data acquisition and analysis system (LabChart v8.1 software). Clinical signs or symptoms were identified in 20 patients (55.6%). Delayed motor or language development was noted in 18 (50%) and 20 (55.6%) patients, respectively. In 13 patients, the enlargement of the subarachnoid spaces was found to be associated with an additional condition. The median of mean ICP values for the entire cohort was 17 mmHg, with a minimum of 6.7 mmHg and a maximum of 29 mmHg. All patients exhibited a percentage of B waves exceeding 20% during the night, with a median value of 47.4% (min: 23.2, max: 75). Three children had nocturnal plateau waves. At night, regular ICP recordings alternated with periods of significant increases in ICP, often exceeding 10 mmHg above baseline values. High-amplitude B waves were noted during these episodes, and the amplitude of the cardiac waveform at the peak of the B waves was consistently greater than 5 mmHg, displaying an abnormal morphology (P2 > P1). A ventriculoperitoneal shunt was implanted in 30 of the 36 patients. Patients with BEH may present significant abnormalities in ICP. Monitoring this variable in certain cases can assist in determining the necessity for surgical treatment.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cec5/12072479/d10e1f817c01/jcm-14-03042-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cec5/12072479/a1738a6b2c60/jcm-14-03042-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cec5/12072479/2ac3b26d495b/jcm-14-03042-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cec5/12072479/b109af113090/jcm-14-03042-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cec5/12072479/b53f0d5fdf9b/jcm-14-03042-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cec5/12072479/3200e0f4af03/jcm-14-03042-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cec5/12072479/d10e1f817c01/jcm-14-03042-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cec5/12072479/a1738a6b2c60/jcm-14-03042-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cec5/12072479/2ac3b26d495b/jcm-14-03042-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cec5/12072479/b109af113090/jcm-14-03042-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cec5/12072479/b53f0d5fdf9b/jcm-14-03042-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cec5/12072479/3200e0f4af03/jcm-14-03042-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cec5/12072479/d10e1f817c01/jcm-14-03042-g006.jpg

相似文献

[1]
Continuous Intracranial Pressure Monitoring in Children with 'Benign' External Hydrocephalus.

J Clin Med. 2025-4-28

[2]
Transcranial optical monitoring for detecting intracranial pressure alterations in children with benign external hydrocephalus: a proof-of-concept study.

Neurophotonics. 2022-10

[3]
Intracranial pressure monitoring and lumbar puncture after endoscopic third ventriculostomy in children.

Neurosurgery. 2006-1

[4]
Intracranial pressure measurement in infants presenting with progressive macrocephaly and enlarged subarachnoid spaces.

Acta Neurochir Suppl. 2012

[5]
Intracranial pressure monitoring in pediatric and adult patients with hydrocephalus and tentative shunt failure: a single-center experience over 10 years in 146 patients.

J Neurosurg. 2015-5

[6]
Enlarged subarachnoid spaces and intracranial hemorrhage in children with accidental head trauma.

J Neurosurg Pediatr. 2017-2

[7]
The Prediction of Shunt Response in Idiopathic Normal-Pressure Hydrocephalus Based on Intracranial Pressure Monitoring and Lumbar Infusion.

Acta Neurochir Suppl. 2016

[8]
ICP wave morphology as a screening test to exclude intracranial hypertension in brain-injured patients: a non-invasive perspective.

J Clin Monit Comput. 2024-8

[9]
The pathophysiology of chronic noncommunicating hydrocephalus: lessons from continuous intracranial pressure monitoring and ventricular infusion testing.

J Neurosurg. 2017-8-11

[10]
Ventriculomegaly in children: nocturnal ICP dynamics identify pressure-compensated but active paediatric hydrocephalus.

Childs Nerv Syst. 2021-6

本文引用的文献

[1]
Prospective measurement of the width of cerebrospinal fluid spaces by cranial ultrasound in neurologically healthy children aged 0-19 months.

BMC Pediatr. 2024-5-7

[2]
Jugular foramen stenosis in external hydrocephalus in infants.

Childs Nerv Syst. 2024-7

[3]
Transient intracranial pressure elevations (B waves) are associated with sleep apnea.

Fluids Barriers CNS. 2023-10-2

[4]
Adverse events in neurosurgery: a comprehensive single-center analysis of a prospectively compiled database.

Acta Neurochir (Wien). 2023-3

[5]
Neurodevelopmental Outcomes of Infants with Benign Enlargement of the Subarachnoid Space.

Iran J Child Neurol. 2021

[6]
External hydrocephalus associated with dural sigmoid sinus arteriovenous fistula: a case report.

Br J Neurosurg. 2024-10

[7]
Subarachnomegaly-venous congestion of infancy.

Childs Nerv Syst. 2021-11

[8]
Abnormal Intracranial Pulse Pressure Amplitude Despite Normalized Static Intracranial Pressure in Idiopathic Intracranial Hypertension Refractory to Conservative Medical Therapy.

Life (Basel). 2021-6-9

[9]
Neurodevelopmental profile in children with benign external hydrocephalus syndrome. A pilot cohort study.

Childs Nerv Syst. 2021-9

[10]
Distorted Optic Nerve Portends Neurological Complications in Infants With External Hydrocephalus.

Front Neurol. 2021-2-1

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