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The utility and post-operative evolution of head circumference in nonsyndromic single-suture craniosynostosis: a
Dang Do Thanh Can1,2, Jacob R Lepard3,4, Pham Ngoc Thach5
1Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam. drthanhcan@ump.edu.vn.
Insights
Head circumference (HC) is a reliable indicator for monitoring head growth in children with craniosynostosis (CS). In Vietnamese children, HC aids in diagnosis and post-operative assessment, helping detect potential complications like restenosis.
Area of Science:
- Pediatric Surgery
- Neurosurgery
- Developmental Pediatrics
Background:
- Craniosynostosis (CS) requires monitoring of head growth.
- Head circumference (HC) is a key metric in pediatric care.
- Understanding HC trends in CS is crucial for treatment efficacy.
Purpose of the Study:
- To evaluate the utility of head circumference (HC) in diagnosing and monitoring craniosynostosis (CS) in Vietnamese children.
- To assess HC changes from diagnosis through pre- and post-operative care.
- To establish HC as a tool for tracking head growth progression and identifying complications.
Main Methods:
- A prospective cohort study of 54 infants with nonsyndromic single-suture CS in Vietnam.
- Comparison of admission HC z-scores with World Health Organization (WHO) standards for diagnostic utility.
- Analysis of pre-operative and post-operative HC to track head growth evolution.
Main Results:
- Nonsyndromic single-suture CS predominantly affects males (79.6%).
- Initial HC z-scores were similar to WHO standards, indicating HC's diagnostic utility.
- HC z-scores significantly increased by 3 months post-surgery, normalizing over time, but one case of restenosis and delayed intracranial hypertension (DIH) was noted.
Conclusions:
- Head circumference in Vietnamese children with nonsyndromic single-suture CS mirrors healthy children's values.
- HC reliably indicates normal post-operative head growth and can signal recurrent synostosis.
- HC is a consistent and valuable tool for monitoring CS patients in Southeast Asian populations.
Purpose:
Head circumference (HC) is an important clinical tool for following head growth in children with craniosynostosis (CS). The purpose of this study is to quantify the usefulness of HC along continuum of CS care, from diagnosis to pre- and post-operative (pre-op, post-op) follow-up in Vietnamese children.
Methods:
A prospective cohort of 54 nonsyndromic single-suture CS patients undergoing open surgery from January 2015 to January 2020 was collected at Children's Hospital 2, Vietnam. HC z-score on admission was compared with World Health Organization (WHO) standards to evaluate for utility in initial diagnosis. Pre-op and post-op HC were compared to demonstrate the evolution of head growth following reconstruction.
Results:
Nonsyndromic single-suture CS was more predominant in males (79.6%) than in females (20.4%). The mean HC z-score was - 0.38 [Formula: see text] 1.29 similar to normal WHO standards regardless of which sutural involvement. The HC z-score increased above + 1 standard deviation (SD) significantly at 3 months of follow-up (p < 0.001); however, the trajectory gradually decreased after the first year of surgery. One patient (1.8%, 1/54) demonstrated restenosis and delayed intracranial hypertension (DIH) 4 years after reconstruction.
Conclusions:
The HC in nonsyndromic single-suture CS children presents similarly to the values of healthy children. Additionally, HC reliably increased after reconstruction and gradually normalized over subsequent years. This indicator is consistent in Southeast Asian populations and should be used to follow all patients to assess the normal progression of post-op head growth and as a useful indicator of suspected recurrent synostosis.
