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Single-suture craniosynostosis: is there a correlation between preoperative ophthalmological, neuroradiological, and
D P R Chieffo1, V Arcangeli1, F Bianchi2
1Institute of Pediatric Neurology, Fondazione Policlinico Gemelli IRCCS, Catholic University Medical School, Rome, Italy.
Insights
Children with single-suture craniosynostosis may have neuropsychological deficits linked to CT scan findings. These deficits, particularly eye coordination issues, can persist post-surgery, indicating neuroradiological abnormalities as key risk factors.
Area of Science:
- Pediatric Neurosurgery
- Neurodevelopmental Pediatrics
- Neuroradiology
Background:
- Single-suture craniosynostosis is associated with an increased risk of neuropsychological deficits in children.
- However, specific risk factors contributing to these deficits remain unclear.
Purpose of the Study:
- To identify potential risk factors for neuropsychological deficits in children with non-syndromic single-suture craniosynostosis.
- To investigate the relationship between neuroradiological findings and neurocognitive/neuro-ophthalmological outcomes.
Main Methods:
- A cohort of 142 children with non-syndromic single-suture craniosynostosis underwent comprehensive neurocognitive and neuro-ophthalmological evaluations before and after surgery.
- Preoperative CT/MR imaging was analyzed.
- Follow-up evaluations were conducted at 6 and 12 months post-surgery.
Main Results:
- Neurocognitive impairment was observed in a significant portion of patients (scaphocephaly: 25%, trigonocephaly: 13%, anterior plagiocephaly: 35%).
- A strong correlation was found between ophthalmological evaluation results, global IQ, and CT findings at diagnosis (p < 0.001).
- Pathological CT findings correlated with persistent neuro-ophthalmological and neurocognitive deficits post-surgery.
Conclusions:
- Neuroradiological abnormalities are linked to ophthalmological and neurocognitive deficits in children with single-suture craniosynostosis.
- These deficits and their association with CT findings persist post-surgery, highlighting the importance of preoperative assessment.
Background:
In spite of literature data stating that children with single-suture craniosynostosis have an increased risk for neuropsychological deficits, no data are present clarifying the potential risk factors.
Methods:
All children with non-syndromic single-suture craniosynostosis operated on from January 2014 to January 2017 were enrolled. A comprehensive neurocognitive and neuro-ophthalmological evaluation was performed before surgery and 6 months after surgery. A further neurocognitive evaluation was performed 12 months after surgery. All children had a preoperative CT/MR study.
Results:
One hundred forty-two patients were enrolled; 87 are affected by sagittal craniosynostosis, 38 by trigonocephaly, and 17 by plagiocephaly. A global neurocognitive impairment was documented in 22/87 children with scaphocephaly, 5/38 children with trigonocephaly, and 6/17 children with anterior plagiocephaly. There was a significant relationship between results of the ophthalmological evaluation, global IQ, and CT findings at diagnosis (r = 0.296, p < 0.001; r =0.187, p 0.05). Though a significant recovery was documented after surgery, a persistence of eye coordination deficits was present at 6 months in 1 out of 3 children with abnormal preoperative exams. A significant correlation was found between pathological CT findings and persistence of below average neuro-ophthalmological and neurocognitive findings 6 months after surgery, as well as between CT findings and neurocognitive scores at the 1 year follow-up (r = 0.411; p < 0.01).
Conclusion:
The presence of neuroradiological abnormalities appears to be related to both ophthalmological and neurocognitive deficits at diagnosis. This relationship is maintained in spite of the surgical treatment in children who show the persistence of ophthalmological and neurocognitive deficits during the follow-up.
