MR Venography in Children with Complex Craniosynostosis

Rollins, Nancy; Booth, Timothy N.; Shapiro, Kenneth

doi:10.1159/000028959

Cited by 61 publications

(46 citation statements)

References 12 publications

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“…Showing the prevalence of posterior condylar fossae and posterior condylar foramina according the left and right sides. Rollins et al (2000) reported that the condylar foramen was found in 60% of the specimens studied. They were more frequently found on the right side than on the left side and Muthukumar et al report the condylar foramen was found in 60% of the specimens studied.…”

Section: Discussionmentioning

confidence: 94%

Characterization of Occipital Condyle and Comparison of its Dimensions with Head and Foramen Magnum Circumferences in Dry Skulls of Iran

et al. 2014

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SUMMARY:The occipital condyle (OC) is an important area in craniovertebral surgery, but its anatomical features and the procedures concerning the OC have not been studied in detail yet. The aim of this study was to revisit the anatomy of the occipital condyle region and assess variations of the surrounding structures. Observations, on fifty dry skulls (dried specimens, 100 sides) and determined of condyle measurements. The mean length, width and height of occipital condyle were found to be 19.43±3.27 (right), 19.28±3.57 (left), 9.21±1.97 (right) 9.40±1.87 (left), 7.21±1.9 (right) and 7.33±2.74 mm (left), respectively. There were significant differences between right and left occipital condyles. The mean anterior intercondylar distance and posterior intercondylar distance were measured as 15.39±7 and 35.60±8.4 mm, respectively. Variations of occipital condyle shapes were kidney like (34.4%), S-like (25.6), triangular (13.3%) oval (10.0%), ring like (7.8%), eight like (6.7%) and deformed (2.2%) respectively. The condylar fossa presented in 60% of dry skull, 24% in right side and 36% in left side and also the condylar foramen was found in 60% of the specimens studied. There was no relation between the circumference of the head and the length of OC but we found relation between the circumference of the head and the width of OC (0.527) and foramen magnum circumference (0.433). The OC and FM are the main bony structures obstructing the surround of the brainstem. The differences in the size and the shape of occipital condyle have some differences and also similarities among racial subgroups. The posterior condylar vein may act asymmetrically. The correlation of the size of foramen magnum with the width of occipital condyles shows the importance of occipital condyle for lateral movements besides antero-posterior movements.

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Section: Discussionmentioning

confidence: 94%

Characterization of Occipital Condyle and Comparison of its Dimensions with Head and Foramen Magnum Circumferences in Dry Skulls of Iran

et al. 2014

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“…4,9,10,43 Children with craniofacial disorders as well as hydrocephalus are more likely to have a CM than children with a craniofacial disorder in the absence of hydrocephalus. 4,9,34 Hydrocephalus has also been reported to develop after repair of craniosynostosis, with subsequent development of tonsillar herniation. 9,43 In our own series, 4 of the 5 patients with de novo CM on serial imaging developed hydrocephalus after craniosynostosis repair and were treated with VP shunt placement prior to the CM diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…5 Hydrocephalus, venous hypertension, and associated congenital brain anomalies have also been proposed as possibly important factors leading to CM development in these patients. 5,34,39,40 The optimal management of CM in the setting of craniosynostosis is not well established. Some surgeons advocate simultaneous surgical correction of craniosynostosis and CM, and others suggest that CM should only be treated if it is symptomatic or associated with a syrinx.…”

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confidence: 99%

Chiari malformation associated with craniosynostosis

Strahle

Muraszko

Buchman

et al. 2011

FOC

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Object Chiari malformation (CM) Type I is frequently associated with craniosynostosis. Optimal management of CM in patients with craniosynostosis is not well-established. The goal of this study was to report on a series of pediatric patients with both craniosynostosis and CM and discuss their management. Methods The authors searched the medical records of 383 consecutive patients treated for craniosynostosis at a single institution over a 15-year period to identify those with CM. They recorded demographic data as well as surgical treatment and outcomes for these patients. When MR imaging was performed, cerebellar tonsillar descent was recorded and any other associated findings, such as hydrocephalus or spinal syringes, were noted. Results A total of 29 patients with both CM and craniosynostosis were identified. Of these cases, 28% had associated occipital venous abnormalities, 45% were syndromic, and 52% also had hydrocephalus. Chiari malformation was more likely to be present in those patients with isolated lambdoid synostosis (55%), multisuture synostosis (35%), and pansynostosis (80%), compared with patients with coronal synostosis (6%) or sagittal synostosis (3%). All patients underwent surgical repair of craniosynostosis: 16 had craniosynostosis repair as well as CM decompression, and 13 patients did not undergo CM decompression. Of the 7 patients in whom craniosynostosis repair alone was performed, 5 had decreased tonsillar ectopia postoperatively and 5 had improved CSF flow studies postoperatively. Both patients with a spinal syrinx had imaging-documented syrinx regression after craniosynostosis repair. In 12 patients in whom CM was diagnosed after primary craniosynostosis repair, 5 had multiple cranial vault expansions and evidence of elevated intracranial pressure. In 5 cases, de novo CM development was documented following craniosynostosis repair at a mean of 3.5 years after surgery. Conclusions Chiari malformation is frequently seen in patients with both multi- and single-suture lambdoid craniosynostosis. Chiari malformation, and even a spinal cord syrinx, will occasionally resolve following craniofacial repair. De novo development of CM after craniosynostosis repair is not unusual.

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“…2,3,11 These fusions result in diminished cranial volumes, with small posterior fossae predisposing this population to cerebellar tonsillar herniation and its potential consequences. 12,13,17,18 These findings distinguish these patients from those in the general population with Chiari malformation Type I.…”

confidence: 72%

Suboccipital decompression during posterior cranial vault remodeling for selected cases of Chiari malformations associated with craniosynostosis

Scott

Fearon

Swift

et al. 2013

PED

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Object The optimal management of Chiari malformations in the setting of craniosynostosis is not well established. In this report the authors describe their outcomes with the combined technique of simultaneous suboccipital decompression (SOD) during posterior cranial vault remodeling (PCVR). Methods A retrospective review was performed of all patients undergoing PCVR and simultaneous SOD. Demographic data, diagnosis, imaging studies, operative intervention, and clinical follow-up were evaluated. Results Thirty-four patients were identified as having undergone a simultaneous PCVR/SOD for Chiari malformation associated with craniosynostosis. Eighty-eight percent of these patients had syndromic, multisutural craniosynostosis, and the remaining patients had unilateral lambdoid craniosynostosis. There were no postoperative complications as a direct result from this combined procedure. Two patients required a subsequent direct approach for decompression of the Chiari malformation. The interval between these subsequent surgeries was 3 years and 19 months. Conclusions Chiari malformations are commonly associated with syndromic, complex craniosynostosis and isolated lambdoid craniosynostosis. In appropriately selected patients, a combined posterior cranial vault enlargement and SOD of the foramen magnum is associated with a low complication rate and appears to be an effective procedure.

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MR Venography in Children with Complex Craniosynostosis

Cited by 61 publications

References 12 publications

Characterization of Occipital Condyle and Comparison of its Dimensions with Head and Foramen Magnum Circumferences in Dry Skulls of Iran

Characterization of Occipital Condyle and Comparison of its Dimensions with Head and Foramen Magnum Circumferences in Dry Skulls of Iran

Chiari malformation associated with craniosynostosis

Suboccipital decompression during posterior cranial vault remodeling for selected cases of Chiari malformations associated with craniosynostosis

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