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Delayed intracranial hypertension after cranial vault remodeling for nonsyndromic single-suture synostosis

Justin S Cetas1, Morad Nasseri, Targol Saedi

  • 1Department of Neurological Surgery, Oregon Health & Science University, Portland, OR, USA.

Journal of Neurosurgery. Pediatrics
|April 16, 2013
PubMed

Insights

Delayed intracranial hypertension after single-suture synostosis repair is uncommon but can occur. Reoperation for this condition was observed in 6.2% of patients, particularly males undergoing early sagittal synostosis repair.

Area of Science:

  • Pediatric Neurosurgery
  • Craniofacial Surgery
  • Developmental Pediatrics

Background:

  • Delayed intracranial hypertension (ICH) can lead to visual loss and developmental delays after cranial vault remodeling for synostosis.
  • While common in syndromic cases, its incidence in single-suture nonsyndromic synostosis is not well-defined.

Purpose of the Study:

  • To evaluate the frequency of reoperation for delayed intracranial hypertension (ICH) following single-suture nonsyndromic synostosis repair.
  • To identify risk factors associated with the development of delayed ICH in this patient population.

Main Methods:

  • Retrospective analysis of 156 patients undergoing cranial vault remodeling for nonsyndromic single-suture synostosis.
  • Focus on 81 patients with at least 3 years of follow-up for delayed ICH and reoperation.

Main Results:

  • Five out of 81 patients (6.2%) developed delayed ICH requiring reoperation.
  • ICH was confirmed by CT findings and intracranial pressure monitoring.
  • All affected patients were male, undergoing primary repair of isolated sagittal synostoses at age ≤5 months.

Conclusions:

  • Delayed intracranial hypertension sporadically occurs after primary cranial vault reconstruction for single-suture nonsyndromic synostosis.
  • Early sagittal synostosis repair in males under 5 months may be a risk factor for delayed ICH.
Abstract

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