Neurodevelopmental Outcomes Among Nonsyndromic Craniosynostosis Subtypes
John Y Ha1,2, Claire Semerjian2,3, Krystal L Tomei2,4
1Division of Pediatric Plastic and Reconstructive Surgery, University Hospitals Rainbow Babies and Children's Hospital.
The Journal of Craniofacial Surgery
|July 29, 2026
Summary
Nonsyndromic craniosynostosis (NSCS) is linked to developmental delays across all subtypes. Metopic craniosynostosis presents the most severe neurodevelopmental issues, while sagittal craniosynostosis shows milder outcomes despite high intracranial pressure.
Area of Science:
- Pediatric neurosurgery
- Developmental neuroscience
- Craniofacial anomalies
Background:
- Nonsyndromic craniosynostosis (NSCS) is associated with increased cognitive, developmental, and motor delays.
- Understanding neurodevelopmental outcomes across different NSCS subtypes is crucial for patient management.
Purpose of the Study:
- To compare neurodevelopmental outcomes among patients with sagittal (SCS), metopic (MCS), and coronal (CCS) craniosynostosis.
- To identify specific NSCS subtypes with distinct neurodevelopmental profiles.
Main Methods:
- Retrospective cohort study utilizing a multi-institutional database.
- Propensity-score matching of 3,517 SCS, 1,776 MCS, and 379 CCS patients with age-matched controls.
- Analysis of outcomes including intellectual disability, motor delays, speech/language disorders, neurodevelopmental disorders (ASD, ADHD), learning disorders, and intracranial pressure (ICP) abnormalities.
Main Results:
- All NSCS subtypes showed significantly higher rates of intellectual disability and motor delays compared to controls.
- Metopic craniosynostosis (MCS) exhibited the most severe neurodevelopmental profile, with elevated risks for speech/language disorders, ASD, and learning disorders.
- Sagittal craniosynostosis (SCS) had the highest rates of intracranial pressure (ICP) abnormalities but comparable or lower rates of psychiatric and neurodevelopmental diagnoses than controls.
Conclusions:
- Intellectual disability and motor delays are prevalent across all nonsyndromic craniosynostosis subtypes.
- Metopic craniosynostosis is associated with the most severe neurodevelopmental phenotype.
- Sagittal craniosynostosis, despite higher ICP, presents a milder developmental and behavioral profile.
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