First name
Daniel
Middle name
J
Last name
Licht

Title

Optical Detection of Intracranial Pressure and Perfusion Changes in Neonates With Hydrocephalus.

Year of Publication

2021

Date Published

2021 May 15

ISSN Number

1097-6833

Abstract

<p><strong>OBJECTIVE: </strong>To demonstrate that a novel non-invasive index of intracranial pressure (ICP) derived from diffuse optics-based techniques is associated with intracranial hypertension.</p>

<p><strong>STUDY DESIGN: </strong>We compared non-invasive and invasive ICP measurements in infants with hydrocephalus. Infants born term and preterm were eligible for inclusion if clinically determined to require cerebrospinal fluid (CSF) diversion. Ventricular size was assessed preoperatively via ultrasound measurement of the fronto-occipital (FOR) and fronto-temporal (FTHR) horn ratios. Invasive ICP was obtained at the time of surgical intervention with a manometer. Intracranial hypertension was defined as invasive ICP ≥15 mmHg. Diffuse optical measurements of cerebral perfusion, oxygen extraction, and non-invasive ICP were performed preoperatively, intraoperatively, and postoperatively. Optical and ultrasound measures were compared with invasive ICP measurements, and their change in values after CSF diversion were obtained.</p>

<p><strong>RESULTS: </strong>We included 39 infants; 23 had intracranial hypertension. No group difference in ventricular size was found by FOR (p=0.93) or FTHR (p=0.76). Infants with intracranial hypertension had significantly higher non-invasive ICP (p=0.02) and oxygen extraction fraction (p=0.01) compared with infants without intracranial hypertension. Increased cerebral blood flow (p=0.005) and improved oxygen extraction fraction (P &lt; .001) after CSF diversion were only observed in infants with intracranial hypertension.</p>

<p><strong>CONCLUSIONS: </strong>Non-invasive diffuse optical measures (including a non-invasive ICP index) were associated with intracranial hypertension. The findings suggest impaired perfusion from intracranial hypertension was independent of ventricular size. Hemodynamic evidence of the benefits of CSF diversion was seen in infants with intracranial hypertension. Non-invasive optical techniques hold promise for aiding the assessment of CSF diversion timing.</p>

DOI

10.1016/j.jpeds.2021.05.024

Alternate Title

J Pediatr

PMID

34004191

Title

Remission of seizures with immunosuppressive therapy in Parry-Romberg syndrome and en coup de sabre linear scleroderma: Case report and brief review of the literature.

Year of Publication

2018

Date Published

2018 Aug 31

ISSN Number

1525-1470

Abstract

<p>Parry-Romberg syndrome (PRS) is characterized by progressive atrophy of facial skin, soft tissues, muscle, and bone. En coup de sabre syndrome is a form of linear scleroderma (LS) involving the skin of the frontoparietal forehead and scalp. Both conditions can be associated with neurologic findings, including seizures. We explore a case in which skin findings and seizure burden improved with methotrexate therapy.</p>

DOI

10.1111/pde.13647

Alternate Title

Pediatr Dermatol

PMID

30168188

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