Association between increased central venous pressure and hydrocephalus inchildren undergoing cardiac catheterization - A prospective study

Objects: The relationship between increased central venous pressure (CVP) a nd development of hydrocephalus has been extensively discussed in the neuro pediatric literature. However, the possibility of a direct connection has n ot been systematically examined. The purpose of this prospective study was to examine whether there was a correlation between elevated CVP and hydroce phalus in children undergoing cardiac catheterization. Methods: We used car diac catheterization to measure the right atrial and superior vena caval pr essure in 37 children (mean age 30 months) with congenital heart malformati ons. The children had CVP higher than normal (mean 10.2 +/- 3.1 mmHg, range 4-18). To evaluate the size of the lateral and fourth ventricles, we perfo rmed CT scans of the brain on each child. Abnormal scans were found in 15/3 7 children, showing brain atrophy (12/37), ventriculomegaly (3/37), and foc al infarction (1/37). Cerebral atrophy was more likely to occur in young ch ildren (P<0.001). The average head circumference among these children was l ess than 2SD below the mean for healthy children of comparable ages. Using a correlation coefficient regression model, no relationship was found betwe en CVP and ventricular diameters or head circumference. Conclusions: These results argue against the hypothesis that mild to moderately elevated venou s pressure is involved in the mechanism and development of pediatric hydroc ephalus.