Internal cranial expansion procedure for the treatment of symptomatic intracranial hypertension
Technical note
Todd C. Hankinson, M.D., J Mocco, M.D., Brent Kimball, M.D., Richard C. E. Anderson, M.D., and Neil A. Feldstein, M.D.
Department of Neurosurgery, Columbia University, College of Physicians and Surgeons, New York, New York
Abbreviations used in this paper: CSF = cerebrospinal fluid; CT = computed tomography; EVD = extraventricular drain; ICE = internal cranial expansion; ICP = intracranial pressure; STD = subtemporal decompression; VP = ventriculoperitoneal.
Address correspondence to: Todd C. Hankinson, M.D., Department of Neurosurgery, Columbia University, College of Physicians and Surgeons, 710 West 168th Street, NI Box #132, New York, New York 10032. email:
tch12@columbia.edu.
DOI: 10.3171/PED-07/11/402
The authors describe the internal cranial expansion (ICE) procedure, a surgical technique that was used to treat two chronically shunt-treated children who presented with medically and surgically refractory intracranial hypertension despite the presence of functioning cerebrospinal fluid shunt systems. The ICE procedure was used as a means to increase intracranial volume without sacrificing calvarial rigidity. Intracranial volume was increased by 5% in one case and 10% in the other. Both patients have returned to their neurological and functional baselines, and they are free of symptoms related to intracranial hypertension.
KEYWORDS:internal cranial expansion; pediatric neurosurgery; symptomatic intracranial hypertension.
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