Object-Although most infants with single-suture craniosynostosis (SSC) appear to have neurodevelopmental test scores in the average range, SSC has been associated with cognitive and motor delays during infancy. Whether and when surgery improves such deficits are not yet known. The authors aimed to compare the pre-and postsurgical neurodevelopmental status of patients with SSC with those of control infants without craniosynostosis.Methods-The authors conducted a large, multicenter, longitudinal study of 168 infants with craniosynostosis and 115 controls without synostosis who were of similar age, race, sex, and socioeconomic status. The authors assessed participants by using the Bayley Scales of Infant Development, Second Edition (BSID-II) and the Preschool Language Scale, Third Edition (PLS-3) at enrollment, before patients' intracranial surgery, and when participants were 18 months of age (after surgery for patients).Results-After adjusting for potential confounding factors in linear regression analyses, the authors found a tendency for patients to perform similarly to or slightly worse than controls on neurodevelopmental examinations at both visits. After surgery, the patients' mean scores were 0.6 to three points lower than those of controls on the five BSID-II and PLS-3 scales (p = 0.02-0.07). Compared with controls, patients had 2.3 and 1.9 times the adjusted odds of scoring in the delayed range on either BSID-II scale (Mental Development Index and Psychomotor Development Index) for the first and second visits, respectively (p = 0.001 and p = 0.015, respectively). The patients' mean adjusted test scores were nearly unrelated to the timing of their surgery.Address reprint requests to: Jacqueline R. Starr, Ph.D., Children's Hospital and Regional Medical Center, 4800 Sand Point Way NE, Mailstop W-7847, Seattle, Washington 98105. jrstarr@u.washington.edu.
NIH Public AccessAuthor Manuscript J Neurosurg. Author manuscript; available in PMC 2012 August 13.
NIH-PA Author ManuscriptNIH-PA Author Manuscript
NIH-PA Author ManuscriptConclusions-These findings support recommendations for neurodevelopmental screening in infants with SSC. Longer follow-up, as is being conducted with the patients in the present study, will be critical for identifying the potential longer-term correlates of SSC and its surgical correction.
Keywordscranioplasty; neurodevelopment; pediatric neurosurgery; single-suture craniosynostosisSingle-suture craniosynostosis is the premature fusion of one suture in an infant's skull and occurs in approximately one in 2000 live births. Infants in whom a diagnosis of SSC is made typically undergo surgery as soon as it is deemed safe, both for cosmesis and to reduce the risk of sequelae such as raised ICP. A further justification for surgery is to reduce the possibility of neurodevelopmental deficits that may be caused either directly by the brain malformations that appear to accompany the skull malformation, 1,2 or indirectly through ICP. Single-suture craniosynostosis has been associated with co...