[Value of the intracranial pressue measurement in the craniosynostoses detected after the age of 1 year].

Notwithstanding the fact that there is a general agreement on the necessity of surgery in the first year of life in craniosynostosis, the problem is more difficult for older children. Deterioration of clinical status is, in general, in relation with an increase in intracranial pressure (ICP), which may happen abruptly following different causes (slight head injury, for example). The purpose of this study was to determine, in different varieties of synostosis, if a high intracranial pressure could exist without clinical signs and consequently, if a surgical opening of the sutures would be necessary. IPC has been measured through a ventricular catheter connected with a transducer and recorder for 24 hours. In half of the cases (11 out of 22) a high ICP (above 20 mmHg) was recorded either permanently or during sleep. This increase in ICP should lead to a surgical decompression, event without clinical signs. On the other hand, psychomotor retardation, abnormal EEG, increased digitation should not be considered as an indication for surgical treatment in cases with normal ICP. The measurement of decreased ICP after operation on a long term basis would be a great value.