title: The effect of intracranial pressure on myelination and the relationship with neurodevelopment in infantile hydrocephalus.
abstract: The effect of raised intracranial pressure (ICP), due to infantile hydrocephalus, on the process of myelination has been suggested in the literature. In this study 19 hydrocephalic infants were followed-up with anterior fontanelle pressure (AFP) measurement (assessment of ICP), MRI (assessment of the myelination process and the CSF volume), and neurodevelopmental testing (NDT). There was a high correlation (r = 0.80) between the myelination and NDT scores. The size of the CSF volume showed a poor correlation with the mean AFP, the degree of myelination and the NDT scores. There was, however, a significant correlation between the mean AFP and the degree of myelination (r = 0.67) and also between the mean AFP and the NDT scores (r = 0.70). Longer-term follow-up (mean = 27 months) showed a significant correlation between the early progress of myelination and later developmental level (r = 0.78). Most of the children with a severely delayed myelination, preoperatively, showed a recovery of myelination following CSF drainage. It was concluded that: (1) raised ICP is related to developmental outcome, through the process of myelination; (2) the delay in myelination can be (partially) reversible; and (3) CSF volume is of minor importance regarding neurodevelopment.
authors.affiliation: Department of Child Neurology, Utrecht University Hospital, The Netherlands.
authors.forename: P W
authors.initials: PW
authors.lastname: Hanlo
authors.forename: R J
authors.initials: RJ
authors.lastname: Gooskens
authors.forename: M
authors.initials: M
authors.lastname: van Schooneveld
authors.forename: C A
authors.initials: CA
authors.lastname: Tulleken
authors.forename: M S
authors.initials: MS
authors.lastname: van der Knaap
authors.forename: J A
authors.initials: JA
authors.lastname: Faber
authors.forename: J
authors.initials: J
authors.lastname: Willemse
mesh_terms: D001921:Brain / Q000254:growth & development* / Q000473:pathology*; D002658:Developmental Disabilities / Q000209:etiology* / Q000473:pathology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000150:complications*; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009186:Myelin Sheath / Q000473:pathology*; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011379:Prognosis; D011559:Pseudotumor Cerebri / Q000150:complications* / Q000601:surgery