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Insidious craniosynostosis and chronic papilledema in childhood
H Dollfus1, L Vinikoff, D Renier
1Department of Ophthalmology, Hôpital Necker-Enfants Malades, Université Paris V, France.
Insights
A 5-year-old child
Area of Science:
- Pediatric Neurology
- Ophthalmology
- Neurosurgery
Background:
- Craniosynostosis, a premature fusion of skull sutures, can lead to increased intracranial pressure.
- Chronic papilledema, swelling of the optic disc, is a potential sign of elevated intracranial pressure.
Observation:
- A 5-year-old child presented with chronic papilledema and visual loss without apparent cosmetic skull deformities.
- Neuroradiologic imaging suggested craniosynostosis as the underlying cause.
Findings:
- The patient underwent decompressive cranial surgery.
- Post-surgery, the papilledema resolved completely, and visual acuity returned to normal (20/20).
- The papilledema was attributed to harmonious oxycephaly, a form of craniosynostosis.
Implications:
- Craniosynostosis can present insidiously in children, causing chronic papilledema.
- Surgical intervention for craniosynostosis can effectively treat papilledema and prevent vision loss.
- Early diagnosis and surgical management are crucial for preserving vision in affected children.
Purpose:
We studied a case of chronic papilledema in a 5-year-old child with visual loss who presented no obvious cosmetic abnormalities.
Methods:
Neuroradiologic investigations were suggestive of craniosynostosis. The child underwent decompressive cranial surgery. Postoperatively, the papilledema totally regressed, and visual acuity recovered to 20/20 in both eyes.
Results:
The chronic papilledema was confirmed to be related to harmonious oxycephaly.
Conclusion:
Insidious craniosynostosis is an unusual cause of chronic papilledema in childhood. The papilledema may be resolved and visual loss prevented by surgery.