Intracranial Pressure During Compressive Head Wrapping in Treatment of Neonatal Hydrocephalus

Abstract

Cranial compression has been advocated as a rational treatment technique for select cases of neonatal hydrocephalus. In this report the effect of iatrogenically elevated intracranial pressure on underlying spinal fluid hydrodynamics is documented. It was noted that prior to "treatment" intracranial pressure was in the range of 200 to 250 mm H2O. During cranial compression it was elevated to 500 to 700 mm H2O. When treatment was temporarily suspended after three to four hours, pressure abruptly dropped below the pretreatment baseline value and gradually increased over one to two hours. It is concluded that the latter changes were secondary to accelerated CSF absorption during cranial compression and gradual reaccumulation when treatment was terminated.