Papilledema in unicoronal synostosis: a rare finding.

Area of Science:

• Pediatric Neurosurgery
• Craniofacial Surgery
• Ophthalmology

Background:

• Unicoronal synostosis can lead to frontal plagiocephaly and potentially intracranial hypertension (ICH).
• Early surgical intervention (before age 1) is recommended to prevent ICH.
• Data on ICH prevalence in unicoronal synostosis is limited.

Purpose of the Study:

• To determine the prevalence of preoperative and postoperative ICH signs in unicoronal synostosis patients.
• To investigate the correlation between papilledema and occipitofrontal head circumference (OFC) curve stagnation.

Main Methods:

• Retrospective analysis of 104 unicoronal synostosis patients treated before age 2.
• Evaluation of ICH signs via fundoscopy and optical coherence tomography.
• Analysis of OFC growth curves for stagnation and correlation with papilledema.

Main Results:

• No preoperative papilledema observed in patients operated on before age 1.
• Postoperative papilledema occurred in 3-5% of patients.
• OFC stagnation was present in 6 of 78 patients and not significantly correlated with papilledema.
• One syndromic case required re-operation for ICH.

Conclusions:

• Papilledema is uncommon in unicoronal synostosis treated early.
• No significant relationship exists between papilledema and OFC stagnation.
• Routine monitoring for ICH signs is crucial, especially in syndromic cases.