[Cranioplasty for isolated trigonocephaly with developmental disorder]

Area of Science:

• Neurosurgery
• Pediatric Neurology
• Medical Imaging

Background:

• Trigonocephaly, characterized by a premature fusion of the metopic suture, can lead to significant developmental and behavioral issues.
• Mild to moderate cases often present with symptoms like hyperactivity, speech delay, and irritability.
• Constricted frontal lobes and narrow anterior fossae are common neuroanatomical findings.

Purpose of the Study:

• To evaluate the efficacy of cranioplasty in treating mild to moderate trigonocephaly.
• To assess the impact of cranioplasty on clinical symptoms and cerebral blood flow.
• To compare outcomes in operated versus non-operated trigonocephaly patients.

Main Methods:

• Retrospective analysis of 50 patients with mild to moderate trigonocephaly undergoing cranioplasty.
• Pre-operative and post-operative neuroimaging (CT, MRI, 3D-CT) to assess skull and brain morphology.
• Technetium-99m ethylcysteinate dimer single-photon emission computed tomography (TcECD SPECT) to measure cerebral blood flow (CBF).

Main Results:

• Pre-operative SPECT revealed decreased CBF in the frontal lobes of 31 out of 43 patients.
• Post-operative improvement in clinical symptoms (hyperactivity, communication, self-mutilation, irritability) was observed in the cranioplasty group.
• Post-operative SPECT showed increased CBF in 30 patients, and imaging confirmed expanded frontal lobes.

Conclusions:

• Cranioplasty is an effective treatment for mild to moderate trigonocephaly with associated developmental disorders.
• The surgical intervention leads to significant improvements in neurological function and cerebral perfusion.
• Cranioplasty offers a viable therapeutic option to alleviate symptoms and improve quality of life in affected children.