Relationships of intracranial pressure, cerebrospinal fluid space and head circumference in young children

The purpose of this study was to retrospectively evaluate and analyze the relationships between intracranial pressure (ICP), cerebrospinal fluid space (CSF) and head circumference (HC). The medical records at single institution from 2007 through 2011 inclusive were reviewed to identify 780 patients under 6-year-old who underwent a lumbar puncture for measuring the ICP. Exclusion criteria were as follows; 1) unrecorded HC or ICP on chart; 2) diagnosed craniosynostosis or intracranial tumor; and 3) performed shunt or cranial vault operation. The enrolled patients were divided into three age-groups (group 1: up to 12 months; group 2: over 12 to 36 months; group 3: over 36 to 72 months). Eighty eight of total 780 patients were enrolled. The study group was composed of 62 boys and 26 girls, with a mean age of 20.6 ± 17.9 months. First aged group (group 1, n=38) was composed of 23 boys and 15 girls, with a mean age of 6.6 ± 2.7 months. In this group, a mean HC was 43.7 ± 4.8cm (56.6 ± 38.4 percentile) and a mean ICP was 24.1 ± 5.8cmH2O. An average Evans ratio was 0.27 ± 0.06. The significant subdural hygroma (SDHG) was detected in 25 patients and the average thickness of it was 3.4 ± 2.7mm. There was a significant positive correlation between the ICP and the HC (r=.474, p=.003). Second aged group (group 2, n=31) was composed of 23 boys and 8 girls, with a mean age of 19.5 ± 6.7 months. In this group, a mean HC was 48.9 ± 3.4cm (68.6 ± 35.6 percentile) and a mean ICP was 27.6 ± 7.7cmH2O. An average Evans ratio was 0.29 ± 0.10. The SDHG was detected in 11 patients and the average thickness of it was 1.9 ± 2.5mm. There was a significant positive correlation between the ICP and the HC percentile (r=.408, p=.023). The ICP and the thickness of SDHG were also significantly correlated (r=.429, p=.016). Third aged group (group 3, n=19) was composed of 16 boys and 3 girls, with a mean age of 50.5 (± 9.9 months). A mean HC was 50.1 ± 3.2cm (54.1 ± 36.9 percentile) and a mean ICP was 25.9 ± 6.6cmH2O. An average Evans ratio was 0.25 ± 0.05. The SDHG was detected in two cases. There was no significant correlation between any factors in this group. With closure of cranial suture, the ICP related to the HC especially in infant with non- or less closed sutures, and the SDHG related to the ICP in toddler with partial closed cranial sutures. In these results, the HC may be reflected in the ICP at early period with rapidly growing HC, and thickness of the SDHG could be expected from the ICP at period with cranial suture closure to some degree.

Author dc:creator

• 김, 명진

Contributors dc:contributor

• 윤, 수한
• 대학원 의학과
• 200424392

• head circumference
• intracranial pressure
• subdural hygroma
• ventricle
• 뇌압
• 뇌실
• 뇌경막하수종
• 두위

Language dc:language

en

Identifier

http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000013554
000000013554

OAI identifier oai:identifier

oai:repository.ajou.ac.kr:201003/8632