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Updated: Jun 14, 2026

Midface Hypoplasia and Cranial Base Morphology in Syndromic Craniosynostosis: A Comparative Analysis Study Using a Predictive Regression Model
Published on: November 4, 2025
About the operative management and post-operative neural development of patients with cloverleaf skull deformity
Matthias Preuss1, Marco Stein, Bernd A Neubauer
1Department of Neurosurgery, University Hospital Marburg, Baldingerstrasse, Marburg, Germany. preuss@neurosurgeon.ch
Introduction:
We present our treatment concept for cloverleaf skull deformity on the basis of two representative cases that had been presented to our multidisciplinary skull deformity board.
Methods:
Perioperatively, we monitored electrophysiologic parameters with median nerve somatosensory-evoked potentials (SSEP), tibial nerve (T) SSEP, brainstem acoustic-evoked potential and flush-elicited visual-evoked potential, as well as intracranial pressure. Both patients underwent decompressive bilateral vault craniectomy, frontal and occipital reshaping at an age of four months.
Results:
Secondary fronto-orbital advancement and cranial vault reshaping was performed after maximal vault reossification was reached at an age of 8 and 12 months, respectively. Additionally, one of the patients underwent treatment of a Chiari malformation via suboccipital decompressive craniectomy and tonsillary resection, as well as ventriculoperitoneal shunting for hydrocephalus.
Discussion:
The patients showed nearly unrestrained neural and neurophysiological development over a follow-up period of 5 years.
