Secondary Raised Intracranial Pressure After Cranial Vault Remodeling for Isolated Sagittal Craniosynostosis

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Mark H. Moore ◽  
Sarut Chaisrisawadisuk ◽  
Vani Prasad ◽  
Stephen Santoreneos ◽  
Cindy J. Molloy
Keyword(s):  
Intracranial Pressure ◽  
Cranial Vault ◽  
Raised Intracranial Pressure ◽  
Sagittal Craniosynostosis ◽  
Cranial Vault Remodeling

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

2014 ◽  
Vol 14 (6) ◽  
pp. 674-681 ◽  
Author(s):  
Steven A. Wall ◽  
Gregory P. L. Thomas ◽  
David Johnson ◽  
Jo C. Byren ◽  
Jayaratnam Jayamohan ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Nonoperative Management ◽  
Raised Intracranial Pressure ◽  
Corrective Surgery ◽  
Icp Monitoring ◽  
Noninvasive Method ◽  
Radiological Findings ◽  
Indication For Surgery ◽  
Sagittal Craniosynostosis ◽  
Significant Difference

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.

scholarly journals Hydatid cyst of the cranial vault

2009 ◽  
Vol 3 (10) ◽  
pp. 807-810 ◽  
Author(s):  
Faten Limaiem ◽  
Selma Bellil ◽  
Khadija Bellil ◽  
Ines Chelly ◽  
Amina Mekni ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Intracranial Pressure ◽  
Soft Tissue ◽  
Literature Review ◽  
Hydatid Cyst ◽  
Osteolytic Lesion ◽  
Cranial Vault ◽  
Raised Intracranial Pressure ◽  
Hydatid Cysts ◽  
Soft Tissue Swelling

Only 0.5 to 2% of hydatid cysts are localized in the skeleton and of these, 3 to 4% are found in the skull. In this paper, the authors report a case of primary hydatidosis involving the cranial vault revealed by a bulging mass of the forehead and symptoms of raised intracranial pressure that occurred in a 22-year-old woman who came from a rural area. Through this case and literature review, the authors analyse the epidemiological, clinical and radiological aspects of skull hydatidosis. They conclude that hydatid cyst should be considered in the differential diagnosis of any soft tissue swelling or osteolytic lesion in the scalp of patients living in endemic areas.

scholarly journals Letter to the Editor: Raised intracranial pressure and nonsyndromic sagittal craniosynostosis

2015 ◽  
Vol 16 (3) ◽  
pp. 346-349 ◽  
Author(s):  
Richard Hayward ◽  
Jonathan A. Britto ◽  
David Dunaway ◽  
Robert Evans ◽  
Noor ul Owase Jeelani ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Raised Intracranial Pressure ◽  
Sagittal Craniosynostosis ◽  
Letter To The Editor

Intracranial volume versus static and pulsatile intracranial pressure values in children with craniosynostosis

2019 ◽  
Vol 24 (1) ◽  
pp. 66-74 ◽  
Author(s):  
Erlend Aambø Langvatn ◽  
Radek Frič ◽  
Bernt J. Due-Tønnessen ◽  
Per Kristian Eide
Keyword(s):  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Brain Tissue ◽  
Wave Amplitude ◽  
Cranial Vault ◽  
Intracranial Volume ◽  
Raised Intracranial Pressure ◽  
Pathophysiological Mechanisms ◽  
Patient Cohort ◽  
Before And After

OBJECTIVEReduced intracranial volume (ICV) and raised intracranial pressure (ICP) are assumed to be principal pathophysiological mechanisms in childhood craniosynostosis. This study examined the association between ICV and ICP and whether ICV can be used to estimate the ICP.METHODSThe authors analyzed ICV and ICP measurements from children with craniosynostosis without concurrent hydrocephalus and from age-matched individuals without craniosynostosis who underwent diagnostic ICP measurement.RESULTSThe study included 19 children with craniosynostosis (mean age 2.2 ± 1.9 years) and 12 reference individuals without craniosynostosis (mean age 2.5 ± 1.6 years). There was no difference in ICV between the patient and reference cohorts. Both mean ICP (17.1 ± 5.6 mm Hg) and mean wave amplitude (5.9 ± 2.6 mm Hg) were higher in the patient cohort. The results disclosed no significant association between ICV and ICP values in the patient or reference cohorts, and no association was seen between change in ICV and ICP values after cranial vault expansion surgery (CVES) in 5 children in whom ICV and ICP were measured before and after CVES.CONCLUSIONSIn this cohort of children with craniosynostosis, there was no significant association between ICV and ICP values prior to CVES and no significant association between change in ICV and ICP values after CVES in a subset of patients. Therefore, ICV could not reliably estimate the ICP values. The authors suggest that intracranial hypertension in childhood craniosynostosis may not be caused by reduced ICV alone but rather by a distorted relationship between ICV and the volume of intracranial content (brain tissue, CSF, and blood).

Use of Absorbable Poly (D,L) Lactic Acid Plates in Cranial-Vault Remodeling: Presentation of the First Case and Lessons Learned about Its Use

2005 ◽  
Vol 42 (4) ◽  
pp. 333-339 ◽  
Author(s):  
Humberto L. Acosta ◽  
Eric J. Stelnicki ◽  
Luis Rodriguez ◽  
Lisa A. Slingbaum
Keyword(s):  
Lactic Acid ◽  
Phenotypic Expression ◽  
The United States ◽  
Lessons Learned ◽  
Cranial Vault ◽  
Sagittal Craniosynostosis ◽  
First Case ◽  
Cranial Index ◽  
American Case ◽  
Cranial Vault Remodeling

Objective To present the first clinical use of a new bioabsorbable material, poly (D,L) lactic acid (PDLLA), in pediatric cranial-vault remodeling procedures. This discussion will highlight the benefits and detriments of PDLLA in comparison with currently used absorbable plating systems. Design This was a case study documenting the first North American case in which PDLLA was used to treat craniosynostosis. Materials and Methods Evaluation of pure PDLLA, a copolymer product of the mixture of poly L-lactic acid and its D-isomer, was used in an 8-month-old boy with a severe phenotypic expression of sagittal craniosynostosis. No signs of elevated intracranial pressure were present, and the neurological examination did not show impairments. Total cranial-vault remodeling with the “hung-span” technique was performed. The Resorb X system, containing 2.2-mm screws and 0.6- to 1-mm-thick plates, was used to stabilize the reconstructed cranial vault. Results No surgical complications occurred. The preoperative cranial index measured 62. The scaphocephalic appearance of the skull was eliminated, and the cranial index was normalized to 77. The screws and plates were less palpable than other plating systems. Twelve months postoperatively, none of the plates and screws were identifiable by external palpation. Conclusion Resorb X has been successfully used in the treatment of sagittal craniosynostosis. Its rapid rate of resorption and lower profile make it an advantageous system for pediatric skull reconstruction. This represents the first use of this product in the United States for any pathology.

The Effects of Molding Helmet Therapy on Spring-Mediated Cranial Vault Remodeling for Sagittal Craniosynostosis

2016 ◽  
Vol 27 (6) ◽  
pp. 1398-1403 ◽  
Author(s):  
Jordan W. Swanson ◽  
Jacqueline A. Haas ◽  
Brianne T. Mitchell ◽  
Philip B. Storm ◽  
Scott P. Bartlett ◽  
...  
Keyword(s):  
Cranial Vault ◽  
Sagittal Craniosynostosis ◽  
Helmet Therapy ◽  
Cranial Vault Remodeling

Cranial vault remodeling for sagittal craniosynostosis in older children

2011 ◽  
Vol 31 (2) ◽  
pp. E3 ◽  
Author(s):  
S. Alex Rottgers ◽  
Peter D. Kim ◽  
Anand Raj Kumar ◽  
James J. Cray ◽  
Joseph E. Losee ◽  
...  
Keyword(s):  
Retrospective Chart Review ◽  
Cranial Vault ◽  
First Year ◽  
Older Children ◽  
Sagittal Craniosynostosis ◽  
Calvarial Defects ◽  
Clinically Significant ◽  
First Year Of Life ◽  
Cranial Vault Remodeling

Object Sagittal craniosynostosis is the most common form of craniosynostosis and is commonly treated within the first year of life. Optimal treatment of patients older than 1 year of age is not well characterized. The authors reviewed cases of sagittal craniosynostosis involving patients who were treated surgically at their institution when they were older than 1 year in order to determine the rate of intracranial hypertension (ICH), potential to develop nonhealing cranial defects, and the need for various surgical procedures to treat the more mature phenotype. Methods A retrospective chart review was conducted of all cases in the Children's Hospital of Pittsburgh Neurosurgery Database involving patients who underwent cranial vault remodeling for scaphocephaly after 1 year of age between October 2000 and December 2010. Results Ten patients were identified who met the inclusion criteria. Five patients underwent anterior two-thirds cranial vault remodeling procedures, 3 patients underwent posterior vault remodeling, and 2 patients underwent 2-staged total vault remodeling. All patients had improved head shapes, and mean cephalic indices improved from 65.4 to 69.1 (p = 0.05). Six patients exhibited signs of ICH. No patients with more than 3 months of follow-up exhibited palpable calvarial defects. Conclusions Patients with sagittal synostosis treated after 1 year of age demonstrate increased rates of ICH, warranting diligent evaluations and surveillance to detect it; rarely develop clinically significant cranial defects if appropriate bone grafting is performed at the time of surgery; and achieve acceptable improvements in head shape.

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