Some children with craniosynostosis demonstrate raised. intracranial pressu
re (ICP), requiring surgical decompression. Conventional methods of measuri
ng ICP in such children are invasive, expensive, and require expertise. Tra
nscranial Doppler ultrasonography (TCD) is an alternative, useful means of
assessing ICP qualitatively, and is noninvasive, inexpensive, and safe, We
evaluated the use of TCD prospectively in 16 children with craniosynostosis
and correlated TCD findings with intraoperative ICP measurements by lumbar
puncture (LP) and with computed tomographic (CT) findings. TCD evaluations
were performed before and after surgery to determine the pulsatility index
(PI), which is known to show close correlation with ICP. The three modalit
ies-TCD, ICP, and CT-showed poor correlation with each other. However, the
fall in the PI value after surgery, as determined by TCD, was shown to be c
linically useful, with a rise in the PI value after surgery being an ominou
s sign.