Anterior fontanelle pressure monitoring in infants

The objectives of this study were 1 To evaluate whether the R TT could be used as a 'fontanometer'. The literature on non-invasive ICP measurement techniques used in infants and children was studied to avoid problems already encountered by others. Subsequently, a special R TT holding device with fixation frame was developed for the accurate measuring of AFP. 2 To test this measuring technique in a clinical setting AFP was established in healthy newborns and infants and the pressure values thus gathered were related to the normal values reported in the literature. Thereafter, AFP was monitored in patients with various neurological and pediatric diseases. The technique was tested both during short term and long term (continuous) measurements. The AFP recordings themselves, were tested on their readability by four observers by performing an inter-observer analysis. 3 To test whether the results of AFP measurements could have played a role in clinical practice with respect to the question of whether or not shunting operations should be pedormed, a retrospective study of the patient data was undertaken. In the following six chapters of this thesis these objectives will be clarified. After a historical review (chapter 2) the AFP monitoring technique will be described (chapter 3). Normal AFP values and AFP values in patients will be given and discussed in 12 the chapters 4 and 5 respectively. An interobserver study of the AFP recordings including statistical analysis procedures is the subject of chapter 6. In chapter 7 the role of AFP monitoring in daily clinical practice will be viewed in the aspect of pedorming shunting operations m children.

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