Does raised ICP play a role in cognitive outcome in scaphocephaly?

Scaphocephaly, the cranial deformity resulting from premature fusion of the sagittal suture, represents the most common form of nonsyndromic craniosynostosis (Bosnian Journal of Basic Medical Sciences p. 110-6, 2018). Surgical correction is typically performed to normalize cranial morphology and reduce the risk of intracranial hypertension. However, the association between elevated intracranial pressure (ICP) and long-term neurocognitive outcomes remains unclear (Bosnian Journal of Basic Medical Sciences p. 110-6, 2018; Child's Nervous System p. 689-95, 2020). Some studies report an increased prevalence of learning and neuropsychological difficulties in children with sagittal synostosis, yet a direct causal relationship with elevated ICP has not been clearly demonstrated. Evidence suggests that while elevated ICP occurs in a subset of patients, cognitive differences likely arise from a multifactorial interaction between cranial restriction, brain development, and underlying biological mechanisms rather than ICP alone.