Operatory indications and licence of craniostenosis

On average 0.04% of the population is affected by craniostenosis. It is believed there are anatomo-clinical forms at moderate risk and others at high risk. The neurosurgical indications are very different according to various Authors. The forms at high risk which are caused by an isolated synostosis of the coronal system with brachicephalia are either associated to other synostosis (oxicephalia) or to facial synostosis should always be operated, with various techniques, within the first 6 months of life. Basing on the experience of 3 cases of craniostenosis, deliberately not operated on, followed and controlled for over 20 years from the decision of not to operate, all in excellent general condition both neurological and psychiatric, the Authors consider and discuss the criteria of surgical indications with particular regard to clinical objectivity (implicity disregarding a precise value of the craniometric data).