Clinical Significance of Monitoring Anterior Fontanel Pressure in Sick Neonates and Infants

Abstract

The intracranial pressure was monitored via the anterior fontanel, using a noninvasive technique, in 78 acutely ill, 39 normal term, and 6 normal preterm infants. In normal term and preterm infants the anterior fontanel pressure (AFP) was 10.2 ± 0.4 and 9.5 ± 0.8 cm H₂O, respectively. Infants with hyaline membrane disease had elevated pressure (13.3 ± 0.6 cm H₂O), which was higher than that of normal preterm infants. Following an episode of intracranial hemorrhage in four infants, the AFP increased to 26.2 ± 2.5 cm H₂O, Elevated pressure was noted in infants with meconium aspiration syndrome (24.1 ± 1.8 cm H₂O); the pressure decreased during the phase of recovery (15.6 ± 3.5 cm H₂O). Elevated pressure was noted in infants with meningitis and hydrocephalus. Repeated measurements helped to diagnose shunt obstruction in an infant with hydrocephalus.