THE EFFECT OF INTRACRANIAL-PRESSURE ON MYELINATION AND THE RELATIONSHIP WITH NEURODEVELOPMENT IN INFANTILE HYDROCEPHALUS

The effect of raised intracranial pressure (ICP), due to infantile hyd rocephalus, on the process of myelination has been suggested in the li terature, In this study 19 hydrocephalic infants were followed-up with anterior fontanelle pressure (AFP) measurement (assessment of ICP), M RI (assessment of the myelination process and the CSF volume), and neu rodevelopmental testing (NDT), There was a high correlation (r=0.80) b etween the myelination and NDT scores, The size of the CSF volume show ed 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 ch ildren with a severely delayed myelination, preoperatively, showed a r ecovery of myelination following CSF drainage, It was concluded that: (1) raised ICP is related to developmental outcome, through the proces s of myelination; (a) the delay in myelination can be (partially) reve rsible; and (3) CSF volume is of minor importance regarding neurodevel opment.