Document Detail


Assessment of continuous intracranial pressure recordings in childhood craniosynostosis.
MedLine Citation:
PMID:  12422046     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In this study, we explored two strategies of assessing continuous intracranial pressure (ICP) recordings in children with craniosynostosis, namely either by computation of the mean ICP or by computation of the accurate numbers of ICP elevations of different durations. The ICP recordings of 121 consecutive patients with a tentative diagnosis of craniosynostosis who underwent continuous ICP monitoring were examined. The relationship between mean ICP and numbers of ICP elevations was defined. The distribution of numbers of ICP elevations between patients either undergoing surgery or conservative treatment was also compared, since the choice of treatment was heavily dependent on the results of ICP monitoring. At the time of ICP monitoring, calculation of mean ICP was the main parameter for assessment of ICP curves. After a median observation period of 16 months, the ICP curves were reexamined by means of the software Sensometrics Pressure Analyser, which presents the ICP curve as a matrix of numbers of ICP elevations of different levels (20-40 mm Hg) and durations (0.5- 20 min). Since the recording period differed between the cases, the numbers were standardized to a given recording time of 10 h, to allow for comparisons between patients. Cases with a borderline mean ICP during sleep (mean ICP 10-15 mm Hg) constituted 40.5% of the 121 patients. In this group, a rather weak relationship between mean ICP and the number of ICP elevations above 20 mm Hg was found, as well as a relatively high number of ICP elevations above 20 mm Hg of various durations. As compared to the patients undergoing surgery, a rather high number of ICP elevations above 20 mm Hg of various durations was found in patients undergoing conservative treatment. The study confirmed our hypothesis that in children with craniosynostosis, calculation of mean ICP does not describe the ICP curve in a reliable way. Decision-making should also include the computation of the distribution of numbers of ICP elevations, since this procedure represents a more sensitive strategy of detecting intracranial hypertension.
Authors:
Per Kristian Eide; Eirik Helseth; Bernt Due-Tønnessen; Tryggve Lundar
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Pediatric neurosurgery     Volume:  37     ISSN:  1016-2291     ISO Abbreviation:  Pediatr Neurosurg     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-11-07     Completed Date:  2003-03-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9114967     Medline TA:  Pediatr Neurosurg     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  310-20     Citation Subset:  IM    
Copyright Information:
Copyright 2002 S. Karger AG, Basel
Affiliation:
Department of Neurosurgery, The National Hospital, University of Oslo, Norway. per.kristian.eide@rikshospitalet.no
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MeSH Terms
Descriptor/Qualifier:
Child
Child, Preschool
Craniosynostoses / physiopathology*,  therapy
Data Interpretation, Statistical
Female
Humans
Infant
Infant, Newborn
Intracranial Hypertension / diagnosis,  physiopathology
Intracranial Pressure / physiology*
Male
Mathematics
Monitoring, Physiologic / methods
Regression Analysis
Sensitivity and Specificity
Signal Processing, Computer-Assisted*
Software*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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