Intracranial pressure and cerebral arterial pulsatile flow measurement in neonatal intraventricular hemorrhage.

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.