Steady-state lumbar infusion tests in the management of children with craniosynostosis.

Sixty lumbar steady-state infusion tests were used as a guideline in the management of 30 children with craniosynostosis during a 3-year period. The primary decompressive procedure was performed during the same anesthetic period and was made more extensive in cases with pathological outflow resistance (Ro) values. In 11 children with scaphocephaly the test revealed normal to moderately increased cerebrospinal fluid (CSF) Ro. In 6 children with oxycephaly, 4 with trigonocephaly or combined forms, especially in 7 children with syndromic forms, the need for decompressive surgery was usually more obvious. Also, many of these demonstrated severely increased CSF outflow resistance (above 12 mmHg/ml per min). Spinal infusion tests were particularly helpful in the management of severe syndromic or familial cases where the indication for repeat or further extensive decompression was sometimes difficult to assess on clinical and radiological grounds.