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Headache in Postoperative Isolated Sagittal Synostosis

Stephanie D C van de Beeten1, Irene M J Mathijssen1, Nathalie W Kamst1

  • 1From the Department of Plastic and Reconstructive Surgery and Hand Surgery and Department of Neurosurgery, Dutch Craniofacial Centre, Erasmus University Medical Center.

Plastic and Reconstructive Surgery
|March 29, 2019
PubMed

Insights

Frequent headaches in children after sagittal synostosis surgery are linked to the type of operation and head size. Regular head circumference measurements and headache monitoring are recommended for these patients.

Area of Science:

  • Pediatric Neurosurgery
  • Craniofacial Surgery
  • Ophthalmology

Background:

  • Sagittal synostosis is a condition requiring surgical correction in children.
  • Headaches and signs of intracranial hypertension can occur post-surgery.
  • Understanding headache triggers is crucial for patient management.

Purpose of the Study:

  • To investigate the relationship between headaches and intracranial hypertension signs in children post-sagittal synostosis surgery.
  • To identify predictors of frequent headaches in this patient population.

Main Methods:

  • A cohort of 94 children (6-18 years) with sagittal synostosis were assessed.
  • Data collected included headache frequency, surgical approach (frontobiparietal remodeling vs. extended strip craniotomy), funduscopy, OCT, occipitofrontal head circumference, and vertex bulge.
  • Retrospective data analysis was performed.

Main Results:

  • Univariate analysis indicated that extended strip craniotomy, ophthalmic signs, and smaller occipitofrontal head circumference correlated with increased headache frequency.
  • Multivariate analysis confirmed that surgical type and occipitofrontal head circumference at follow-up were significant independent predictors of headaches.

Conclusions:

  • Frequent headaches in children after sagittal synostosis correction are independently associated with surgical approach and occipitofrontal head circumference.
  • Ophthalmic findings like papilledema may contribute to headaches.
  • Routine measurement of occipitofrontal head circumference and inquiry about headaches are recommended during follow-up.
Abstract

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