RESUMO
The use of a modified pneumotonometer as a noninvasive method to measure intracranial pressure through the fontanel was evaluated in the animal laboratory and in the clinical setting. Pressure measured with the tonometer from a surgically created fontanel in an adult mongrel dog demonstrated good correlation with pressure measured from an epidural balloon catheter. Pressure recorded with the tonometer was compared with direct measurements in a single infant. There were 20 paired measurements with a correlation coefficient of 0.91. Fontanel pressure was measured in 72 healthy infants. The mean pressure was 7.0 mm Hg with a standard deviation of 1.75. This result compares favorably with previous reports utilizing other methods. The machine is safe and simple to use.
Assuntos
Recém-Nascido , Pressão Intracraniana , Crânio , Animais , Cães , Equipamentos e Provisões , Estudos de Avaliação como Assunto , Humanos , Valores de ReferênciaRESUMO
We examined the clinical significance of noninvasive intracranial pressure measurements and pulsatility indices in 74 infants with confirmed IC-IVh. The intracranial pressure measurements were obtained using the applanation principle, and the pulsatility indices were calculated from the Doppler flow velocity tracings of the anterior cerebral artery. Fifty-three infants (71.6%) who died had a significantly lower birth weight and gestational age than those who survived. Survival rate decreased significantly with increased intracranial pressure (P less than 0.0002) and increased pulsatility indices (P less than 0.0001). We found no significant relationship between outcome and the size of IC-IVH demonstrated by CT scan. Birth weight, intracranial pressure measurements, and cerebral arterial pulsatile flow changes appear to be major prognostic indicators in neonatal IC-IVH.