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70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

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Perioperative monitoring of intracranial pressure and cerebral perfusion in infants with non-syndromic craniosynostosis

Perioperatives Monitoring von intrakraniellem Druck und zerebraler Perfusion bei Säuglingen mit nicht-syndromaler Kraniosynostose

Meeting Abstract

Suche in Medline nach

  • presenting/speaker Helene Hurth - Universitätsklinikum Tübingen, Neurochirurgie, Tübingen, Deutschland
  • Karlheinz Decker - Universitätsklinikum Tübingen, Anästhesie und Intensivmedizin, Tübingen, Deutschland
  • Felix Neunhoeffer - Universitätsklinikum Tübingen, Pädiatrie II, Tübingen, Deutschland
  • Karin Haas-Lude - Universitätsklinikum Tübingen, Pädiatrie III, Tübingen, Deutschland
  • Michael Krimmel - Universitätsklinikum Tübingen, Mund-, Kiefer- und Gesichtschirurgie, Tübingen, Deutschland
  • Martin Schuhmann - Universitätsklinikum Tübingen, Neurochirurgie, Tübingen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV029

doi: 10.3205/19dgnc041, urn:nbn:de:0183-19dgnc0411

Veröffentlicht: 8. Mai 2019

© 2019 Hurth et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: While it is commonly known that children with syndromic craniosynostoses often suffer from increased intracranial pressure at an early age of infancy, it still remains unclear if elevated intracranial pressure and if so, impaired cerebral perfusion, might play a role in children with single suture synostosis. The objective was to evaluate intracranial pressure and cerebral perfusion in children with monosynostosis before and after craniectomy.

Methods: During a two-year period, 20 children younger than 15 months of age with non-syndromic craniosynostosis underwent perioperative measurement of intracranial pressure and perfusion with an epidural ICP probe (Spiegelberg) as well as a tissue perfusion probe (O2C) before and after craniectomy for a period of 20 minutes, respectively. Intraoperative anaesthesiological parameters were standardized for age.

Results: Twelve patients were treated with a biparietal decompression due to sagittal synostosis. Frontoorbital advancement was performed for metopic synostosis in six patients and for coronal synostosis in two patients. The mean ICP was significantly higher before (15,43 mmHg) than after (11,80 mmHg) bone decompression. A subanalysis of the different synostosis types showed significantly elevated ICP values (mean 19,0 mmHg, p=0,024)) as well as reduced perfusion rates (p=0,038) in patients with sagittal synostosis with postoperative improvement. Values were within normal limits in patients with other synostosis types before and after decompression.

Conclusion: These results suggest elevated intracranial pressure and impaired cerebral perfusion in children of a very young age with non-syndromic sagittal synostosis. Further investigations are needed to evaluate its possible effect on brain development.