The effect of intracranial pressure on myelination and the relationship with neurodevelopment in infantile hydrocephalus

Dev Med Child Neurol. 1997 May;39(5):286-91. doi: 10.1111/j.1469-8749.1997.tb07433.x.


The effect of raised intracranial pressure (ICP), due to infantile hydrocephalus, on the process of myelination has been suggested in the literature. In this study 19 hydrocephalic infants were followed-up with anterior fontanelle pressure (AFP) measurement (assessment of ICP), MRI (assessment of the myelination process and the CSF volume), and neurodevelopmental testing (NDT). There was a high correlation (r = 0.80) between the myelination and NDT scores. The size of the CSF volume showed 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 children with a severely delayed myelination, preoperatively, showed a recovery of myelination following CSF drainage. It was concluded that: (1) raised ICP is related to developmental outcome, through the process of myelination; (2) the delay in myelination can be (partially) reversible; and (3) CSF volume is of minor importance regarding neurodevelopment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain / growth & development*
  • Brain / pathology*
  • Developmental Disabilities / etiology*
  • Developmental Disabilities / pathology
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Hydrocephalus / complications*
  • Infant
  • Magnetic Resonance Imaging
  • Male
  • Myelin Sheath / pathology*
  • Neuropsychological Tests
  • Predictive Value of Tests
  • Prognosis
  • Pseudotumor Cerebri / complications*
  • Pseudotumor Cerebri / surgery