Longitudinal study of the neurodevelopmental characteristics of treated and untreated nonsyndromic craniosynostosis in infancy

Costa, Annette C Da; Anderson, Vicki; Holmes, Anthony D.; Lo, Patrick; Wray, Alison; Chong, David; Greensmith, Andrew; Meara, John G.

doi:10.1007/s00381-012-2017-0

Cited by 51 publications

(39 citation statements)

References 45 publications

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“…9,20,38,39 The conclusions that these studies reach are in part based on the implicit assumption that early surgery corrects raised ICP where present and prevents its future occurrence. The data presented here contradict this assumption and suggest that any developmental or psychomotor assessment not accompanied by contemporary ICP measurements should be interpreted with caution.…”

Section: Discussionmentioning

confidence: 99%

The incidence of raised intracranial pressure in nonsyndromic sagittal craniosynostosis following primary surgery

Thomas

Johnson

Byren

et al. 2015

PED

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OBJECT Raised intracranial pressure (ICP) is recognized to occur in patients with nonsyndromic isolated sagittal craniosynostosis (SC) prior to surgery. However, the incidence of raised ICP following primary surgery is rarely reported and there appears to be a widely held assumption that corrective surgery for SC prevents the later development of intracranial hypertension. This study reports the incidence of postoperative raised ICP in a large cohort of patients with SC treated by 1 of 2 surgical procedures in a single craniofacial unit. METHODS A retrospective review was performed of all patients with SC who underwent either a modified strip craniectomy (MSC) or calvarial remodeling (CR) procedure under the care of the Oxford Craniofacial Unit between 1995 and 2010 and who were followed up for more than 2 years. The influence of patient age at surgery, year of surgery, sex, procedure type, and the presence of raised ICP preoperatively were analyzed. RESULTS Two hundred seventeen children had primary surgery for SC and were followed up for a mean of 86 months. The overall rate of raised ICP following surgery was 6.9%, occurring at a mean of 51 months after the primary surgical procedure. Raised ICP was significantly more common in those patients treated by MSC (13 of 89 patients, 14.6%) than CR (2 of 128 patients, 1.6%). Also, raised ICP was more common in patients under 1 year of age, the majority of whom were treated by MCS. No other factor was found to have a significant effect. CONCLUSIONS Postoperative raised ICP was found in more than 1 in 20 children treated for nonsyndromic SC in this series. It was significantly influenced by the primary surgical procedure and age at primary surgery. Careful long-term follow-up is essential if children who develop raised ICP following surgery are not to be overlooked.

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Section: Discussionmentioning

confidence: 99%

The incidence of raised intracranial pressure in nonsyndromic sagittal craniosynostosis following primary surgery

Thomas

Johnson

Byren

et al. 2015

PED

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“…13,28,45,47 However, it is difficult to infer anything directly from these observations without corresponding ICP data, because in the authors' and others' experience, raised ICP can occur after surgical corrective procedures. 9 Any resultant decline in neurocognitive function in affected individuals could mask an improvement in the overall group.…”

mentioning

confidence: 99%

“…This rate is consistent with findings of several studies that examined developmental attainment, learning disability, and speech and language abnormalities in isolated SC. 7,8,13,14,33,44,46 Although, in 1982, Renier et al 41 found that raised ICP was correlated with lower IQ, more recent studies 6,23,34 have failed to confirm the relationship between elevated ICP and neurocognitive outcomes in SC or other single-suture craniosynostosis. The lack of a correlation between developmental delay and raised ICP found in the present study supports the hypothesis that there is no simple causal relationship between ICP and neurocognitive anomalies found in SC.…”

mentioning

confidence: 99%

The preoperative incidence of raised intracranial pressure in nonsyndromic sagittal craniosynostosis is underestimated in the literature

Wall¹,

Thomas²,

Johnson³

et al. 2014

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Object The presence of raised intracranial pressure (ICP) in untreated nonsyndromic, isolated sagittal craniosynostosis (SC) is an important functional indication for surgery. Methods A retrospective review was performed of all 284 patients presenting with SC to the Oxford Craniofacial Unit between 1995 and 2010. Results Intraparenchymal ICP monitoring was performed in 39 children following a standard unit protocol. Monitoring of ICP was offered for all patients in whom nonoperative management was considered on the basis of minimal deformity or in cases in which parents were reluctant to agree to corrective surgery. These patients presented at an older age than the rest of the cohort (mean age 56 months), with marked scaphocephaly (16/39, 41%), mild scaphocephaly (11, 28%), or no scaphocephalic deformity (12, 31%). Raised ICP was found in 17 (44%) patients, with no significant difference in its incidence among the 3 different deformity types. Raised ICP was not predicted by the presence of symptoms of ICP or developmental delay or by ophthalmological or radiological findings. Conclusions The incidence of raised ICP in SC reported here is greater than that previously published in the literature. The lack of a reliable noninvasive method to identify individuals with elevated ICP in SC mandates consideration of intraparenchymal ICP monitoring in all patients for whom nonoperative management is contemplated.

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“…Es relevante mencionar que la mayoría de los estudios que mencionan deficiencias en niños con craneosinostosis carecen de grupo control (e.g [25][26][27][28][29] ), sólo son referidos a normas, por lo que sería importante conocer si los déficits encontrados persisten cuando se compara el desempeño con un grupo control pareado.…”

Section: Del Nacimiento a Los 3 Años De Edadunclassified

“…Los detalles de las investigaciones que tienen evaluaciones prequirúrgicas se resumen en la Tabla 1. Cuando se realizan evaluaciones pre y postquirúrgicas, algunos estudios 24,25,29 reportan mejoría en las evaluaciones posteriores a la cirugía sobre todo en la motricidad, otros estudios a pesar de la realización de la cirugía siguen reportando déficits en comparación con niños sanos 27,30 (Tabla 2).…”

Section: Del Nacimiento a Los 3 Años De Edadunclassified

Una revisión de la literatura acerca de las características neuropsicológicas de niños con craneosinostosis simple en diferentes edades

Moreno

et al. 2017

Rev. chil. neuro-psiquiatr.

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Longitudinal study of the neurodevelopmental characteristics of treated and untreated nonsyndromic craniosynostosis in infancy

Abstract: NSC is associated with an increased incidence of developmental delay in both treated and untreated conditions. Timing of surgery appears unrelated to developmental outcome.

Cited by 51 publications

References 45 publications

The incidence of raised intracranial pressure in nonsyndromic sagittal craniosynostosis following primary surgery

The incidence of raised intracranial pressure in nonsyndromic sagittal craniosynostosis following primary surgery

The preoperative incidence of raised intracranial pressure in nonsyndromic sagittal craniosynostosis is underestimated in the literature

Una revisión de la literatura acerca de las características neuropsicológicas de niños con craneosinostosis simple en diferentes edades

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