Intracranial pressure monitoring in children with single suture and complex craniosynostosis: a review

Tamburrini, Gianpiero; Caldarelli, Massimo; Massimi, Luca; Santini, Pietro; Rocco, Concezio Di

doi:10.1007/s00381-004-1117-x

Cited by 220 publications

(144 citation statements)

References 33 publications

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“…[4][5][6][7] Multiple suture synostosis, usually syndromic, has been associated with several complications, such as increased intracranial pressure, headaches, and delayed neurodevelopment. 8 The initial imaging study for infants with suspicion of this condition is generally 4-view radiography [9][10][11][12][13] followed by computed tomography (CT) in cases of positive or equivocal findings at radiography. CT with 3-dimensional reconstruction delineates the diagnosis and guides preoperative management.…”

mentioning

confidence: 99%

Cranial Ultrasound as a First-Line Imaging Examination for Craniosynostosis

Rozovsky

Udjus²,

Wilson³

et al. 2016

Pediatrics

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mentioning

confidence: 99%

Cranial Ultrasound as a First-Line Imaging Examination for Craniosynostosis

Rozovsky

Udjus²,

Wilson³

et al. 2016

Pediatrics

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“…Although prior publications suggest that the need for surgery should be considered in these patients based on the hypothesis that pressures in this range could potentially affect cognitive development at a later date, there is no convincing evidence in the literature to support this view. 7 The studies on single-suture craniosynostosis that have included measurements of both ICP and neurodevelopmental status have failed to find any reliable association between the two. 3,5 Without a solid foundation that establishes a relationship between symptoms, neurodevelopment, and ICP and an understanding of the range of numbers, we feel that decision-making guidelines for the treatment of sagittal craniosynostosis should not be based on ICP measurements alone.…”

Section: Discussionmentioning

confidence: 99%

Effect of molding helmets on intracranial pressure and head shape in nonsurgically treated sagittal craniosynostosis patients

Marupudi¹,

Sood²,

Rozzelle³

et al. 2016

PED

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OBJECTIVE Cranial vault expansion is performed in pediatric patients with craniosynostosis to improve head shape. Another argument for performing total cranial vault reconstruction is the potential reduction in the harmful effects of elevated intracranial pressure (ICP) that are associated with craniosynostosis. Alternatively, molding helmets have been shown to improve the cranial index (CI) in patients with sagittal synostosis without surgery. However, it is unknown if the use of molding helmets without surgery contributes to adverse changes in ICP. The effect of molding helmets on ICP and CI in patients with sagittal synostosis was investigated. METHODS A prospective cohort study of 24 pediatric patients with sagittal synostosis who planned to undergo total cranial reconstruction was performed from 2011 to 2014 at the Children's Hospital of Michigan. A preoperative molding helmet was used in 13 patients, and no molding helmet was used in 11 patients. End-tidal carbon dioxide, patient positioning, level of sedation, type of anesthetic, and the monitoring site at the time of intraoperative recording were regulated and standardized to establish the accuracy of the ICP readings. CI and head circumference were monitored for each patient. RESULTS The mean duration of the preoperative use of the molding helmet was 17 weeks (range 7–37 weeks). Under controlled settings, the average intraoperative ICP was 7.2 mm Hg (range 2–18 mm Hg) for patients treated with a preoperative molding helmet and 9.5 mm Hg (range 2–22 mm Hg) for patients with no preoperative molding helmet. ICP was not significantly different between the 2 groups, suggesting that the use of a molding helmet in this population is safe. The average CI at the time of helmet placement was 0.70 (range 0.67–0.73), and this improved to an average of 0.74 (range 0.69–0.79) after using the molding helmet for a mean of 17 weeks. CONCLUSIONS ICPs were not significantly different with the use of a preoperative molding helmet, refuting the prevailing thought that molding helmets would be detrimental in children who have craniosynostosis. The use of molding helmet in this population of patients improves head shape and does not adversely affect ICP.

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“…After the clinical suspicion (or confirmation) of craniosynostosis, the children should be referred to a multidisciplinary team specialized in craniofacial anomalies (anesthesiologist, plastic surgeon, speech therapist, neurosurgeon, orthodontist, otorhinolaryngologist, and psychologist) 15. In these centers, the radiological exam of choice is the three-dimensional CT scan that contributes to elucidation of the extension of suture fusion and the consequent craniofacial deformity and subsequent surgical planning.…”

Section: Methodsmentioning

confidence: 99%

Diagnosis of infant synostotic and nonsynostotic cranial deformities: a review for pediatricians

Ghizoni

Denadai

Raposo‐Amaral

et al. 2016

Revista Paulista de Pediatria (English Edition)

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Objective:To review the current comprehensive care for nonsyndromic craniosynostosis and nonsynostotic cranial deformity and to offer an overall view of these craniofacial conditions.Data source:The review was conducted in the PubMed, SciELO, and LILACS databases without time or language restrictions. Relevant articles were selected for the review.Data synthesis:We included the anatomy and physiology of normal skull development of children, discussing nuances related to nomenclature, epidemiology, etiology, and treatment of the most common forms of nonsyndromic craniosynostosis. The clinical criteria for the differential diagnosis between positional deformities and nonsyndromic craniosynostosis were also discussed, giving to the pediatrician subsidies for a quick and safe clinical diagnosis. If positional deformity is accurately diagnosed, it can be treated successfully with behavior modification. Diagnostic doubts and craniosynostosis patients should be referred straightaway to a multidisciplinary craniofacial center.Conclusions:Pediatricians are in the forefront of the diagnosis of patients with cranial deformities. Thus, it is of paramount importance that they recognize subtle cranial deformities as it may be related to premature fusion of cranial sutures.

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Intracranial pressure monitoring in children with single suture and complex craniosynostosis: a review

Cited by 220 publications

References 33 publications

Cranial Ultrasound as a First-Line Imaging Examination for Craniosynostosis

Cranial Ultrasound as a First-Line Imaging Examination for Craniosynostosis

Effect of molding helmets on intracranial pressure and head shape in nonsurgically treated sagittal craniosynostosis patients

Diagnosis of infant synostotic and nonsynostotic cranial deformities: a review for pediatricians

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