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Late Presenting Multi-Suture Craniosynostosis

Rami P Dibbs1,2, Han Zhuang Beh1,2, Daniel A Donoho3

  • 1Division of Plastic Surgery, Texas Children's Hospital.

The Journal of Craniofacial Surgery
|July 22, 2021
PubMed

Insights

Frontal orbital advancement effectively treated a child with multi-suture craniosynostosis and high intracranial pressures (ICPs). Surgical intervention led to significant improvement, demonstrating its efficacy in cranial vault expansion and deformity correction.

Area of Science:

  • Pediatric Neurosurgery
  • Craniofacial Surgery
  • Medical Case Study

Background:

  • Multi-suture craniosynostosis can lead to chronically elevated intracranial pressures (ICPs).
  • Delayed intervention in pediatric craniosynostosis presents unique surgical challenges.
  • Venous collateralization is a significant consideration in managing high ICP.

Observation:

  • A 6-year-old male presented late with multi-suture craniosynostosis and elevated ICPs.
  • The patient experienced significant bleeding and unique bony pathology during surgery.
  • Surgical management involved frontal orbital advancement.

Findings:

  • Frontal orbital advancement resulted in effective cranial vault expansion.
  • The patient showed significant improvement at 1-month follow-up with no signs of elevated ICP.
  • The procedure corrected frontal deformities associated with craniosynostosis.

Implications:

  • Frontal orbital advancement is an effective treatment for complex craniosynostosis.
  • Understanding bleeding risks and bony pathology in high ICP is crucial for surgical planning.
  • Early intervention remains ideal, but surgical correction can yield positive outcomes even with delays.

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