FEASIBILITY OF INVASIVE MONITORING OF INTRACRANIAL-PRESSURE IN TERM NEONATES

Seven term neonates with encephalopathy resulting from asphyxia and/or intracranial hemorrhage underwent invasive monitoring of intracranial pressure through the epidural or intracerebral space. The average age (in hours) at insertion of the monitor was 27 h in the 3 neonates wit h asphyxia and 70 h in the 4 neonates with hemorrhage. Intracranial hy pertension was noted in 6 neonates. The management of the hypertension included hyperventilation followed by mannitol for pressures that wer e sustained above 20 mmHg and pentobarbital for pressures above 30 mmH g. The duration of the hypertension varied in 5 neonates from 4 to 72 h, while in the remaining neonate, the pressure remained elevated unti l death at 70 h. All 4 survivors with intracranial hemorrhage have min imal neuromotor deficits on follow up and 2 survivors with asphyxia ha ve cognitive deficits and are microcephalic. From this small series, i t appears that in the management of term neonates with intracranial he morrhage, monitoring of intracranial pressure should be considered.