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Updated: Jun 11, 2026
Midface Hypoplasia and Cranial Base Morphology in Syndromic Craniosynostosis: A Comparative Analysis Study Using a Predictive Regression Model
Published on: November 4, 2025
Intracranial compartment volume changes in sagittal craniosynostosis patients: influence of comprehensive
Su-Shin Lee1, Charles C Duncan, Bianca I Knoll
1Kaohsiung, Taiwan; and New Haven, Conn. From the Department of Surgery, College of Medicine, Kaohsiung Medical University; Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital; and Department of Neurosurgery and Section of Plastic Surgery, Department of Surgery, School of Medicine, Yale University.
Insights
Sagittal craniosynostosis in children can alter intracranial volume. Early surgical correction (cranioplasty) before 12 months increases intracranial compartment volume, promoting normal skull growth.
Area of Science:
- Pediatric Neurosurgery
- Craniofacial Surgery
- Developmental Biology
Background:
- Sagittal craniosynostosis is a condition where the sagittal suture fuses prematurely, affecting skull development.
- Understanding intracranial volume changes is crucial for surgical planning and optimizing outcomes in affected children.
Purpose of the Study:
- To analyze intracranial compartment volume changes in children with sagittal synostosis.
- To determine the therapeutic objectives for corrective surgery in these patients.
Main Methods:
- Retrospective analysis of 53 children with unoperated sagittal synostosis.
- Comparison of preoperative and postoperative computed tomographic (CT) scans with 143 age- and gender-matched controls.
Main Results:
- Brain volume was reduced in infants (<6 months) with sagittal synostosis compared to controls.
- Intracranial compartment volume was increased in patients aged 7-30 months but decreased in those untreated for 31-60 months.
- Postoperative skull growth in operated patients was comparable to normal growth by 1 year.
Conclusions:
- Intracranial compartment volume increases preoperatively in untreated sagittal synostosis patients over 6 months old, primarily due to brain volume expansion.
- Cranioplasty performed before 12 months of age enhances intracranial compartment volume beyond normal growth patterns.
Background:
A retrospective analysis of intracranial compartment volume changes in children with sagittal craniosynostosis was performed to clarify the therapeutic objectives of corrective surgery.
Methods:
Chart and computed tomographic review of 53 consecutive children with previously unoperated sagittal synostosis was performed, and preoperative and postoperative computed tomographic scans were examined and compared with 143 age- and gender-matched controls.
Results:
Preoperative mean intracranial compartment volume and mean brain tissue volume of each subgroup were age dependent. Brain volume was less in unoperated male sagittal synostosis patients (<6 months old) compared with controls (672.63 ml versus 716.14 ml). Brain tissue volume was approximately the same as controls for the 7- to 12-month and 12- to 30-month age groups. Long-term brain volume, however, again became less than controls with longer periods without treatment (31 to 60 months, 1050.6 versus 1291.51 ml, respectively). Intracranial compartment volume was less in unoperated male sagittal synostosis patients (<6 months old) compared with controls (706.6 ml versus 757.76 ml). Preoperative mean intracranial compartment volume, however, was greater than in controls in the 7- to 12-month (979.78 versus 970.34 ml) and 13- to 30-month age groups (1108.23 versus 1177.52 ml). Long term (31 to 60 months), however, intracranial compartment volume was less in untreated sagittal synostosis patients (1206.3 ml versus 1311.37 ml). Comparing day-1 postoperative sagittal synostosis patient data to age- and gender-matched controls to 1 year postoperatively, the operated patients develop an equivalent increase in skull growth compared with normals.
Conclusions:
Intracranial compartment volume is increased preoperatively in untreated sagittal synostosis patients older than 6 months. Intracranial compartment volume enlargement is largely attributable to an increase in brain volume. Comprehensive cranioplasty before 12 months of age increases intracranial compartment volume over normal growth.
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