The Relationship Between Intracranial Pressure and Age - Chasing Age-Related Reference Values

TY - JOUR

T1 - The Relationship Between Intracranial Pressure and Age - Chasing Age-Related Reference Values

AU - Pedersen, Sarah Hornshøj

AU - Lilja-Cyron, Alexander

AU - Andresen, Morten

AU - Juhler, Marianne

PY - 2018/2

Y1 - 2018/2

N2 - Background: No true reference values for intracranial pressure (ICP) in humans exist; current values are estimated from measurements in adults who undergo treatment in order to correct ICP. We report ICP values in a "pseudonormal" group of children and adults to examine if age affects ICP. Methods: We analyzed data from all nonshunted patients undergoing a 24-hour ICP monitoring as part of a diagnostic work-up and included patients with no subsequent suspicion of increased ICP and no need for pressure-relieving treatment with a minimum follow-up period of 3 years. Results: From February 2008 to November 2014, a 24-hour ICP monitoring was performed in 221 patients. Of these patients, 35 (14 children, 21 adults) met the inclusion criteria. Follow-up time to confirm absence of ICP-related disease was 3-9 years. Daytime ICP was 2.8 mmHg ± 2.2 in children and 1.9 mmHg ± 4.2 in adults (P = 0.39). Of 35 patients, 32 had higher nighttime ICP. The difference between daytime and nighttime ICP was similar in children (ΔICP = 5.8 mmHg ± 4.0, P < 0.0001) and adults (ΔICP = 6.1 mm Hg ± 3.3, P < 0.0001). ICP could be described as a decreasing function of age, with an ICP decrement of 0.69 mmHg per decade (P = 0.015). Conclusions: We found similar differences in daytime and nighttime ICP between children and adults with no ICP-related disease. ICP seems to decrease with age across all ages. This has implications for therapeutic interventions (e.g., shunt valve selection or resistance in external ventricular drainage).

AB - Background: No true reference values for intracranial pressure (ICP) in humans exist; current values are estimated from measurements in adults who undergo treatment in order to correct ICP. We report ICP values in a "pseudonormal" group of children and adults to examine if age affects ICP. Methods: We analyzed data from all nonshunted patients undergoing a 24-hour ICP monitoring as part of a diagnostic work-up and included patients with no subsequent suspicion of increased ICP and no need for pressure-relieving treatment with a minimum follow-up period of 3 years. Results: From February 2008 to November 2014, a 24-hour ICP monitoring was performed in 221 patients. Of these patients, 35 (14 children, 21 adults) met the inclusion criteria. Follow-up time to confirm absence of ICP-related disease was 3-9 years. Daytime ICP was 2.8 mmHg ± 2.2 in children and 1.9 mmHg ± 4.2 in adults (P = 0.39). Of 35 patients, 32 had higher nighttime ICP. The difference between daytime and nighttime ICP was similar in children (ΔICP = 5.8 mmHg ± 4.0, P < 0.0001) and adults (ΔICP = 6.1 mm Hg ± 3.3, P < 0.0001). ICP could be described as a decreasing function of age, with an ICP decrement of 0.69 mmHg per decade (P = 0.015). Conclusions: We found similar differences in daytime and nighttime ICP between children and adults with no ICP-related disease. ICP seems to decrease with age across all ages. This has implications for therapeutic interventions (e.g., shunt valve selection or resistance in external ventricular drainage).

KW - Age

KW - Children

KW - Day vs. night

KW - Intracranial pressure

KW - Reference values

U2 - 10.1016/j.wneu.2017.10.086

DO - 10.1016/j.wneu.2017.10.086

M3 - Journal article

C2 - 29107158

AN - SCOPUS:85035076698

SN - 1878-8750

VL - 110

SP - e119-e123

JO - World Neurosurgery

JF - World Neurosurgery

ER -