[Mental prognosis of trigonocephaly and therapeutic implications]

The authors assessed the long-term mental prognosis of trigonocephaly, in a series of 76 operated cases. Mental prognosis factors were studied, showing that early cranial release and reconstruction were effective. Final assessment of mental development was performed on children of school age, and was based on the development of behavioral disturbances, learning disability, school difficulties, and intellectual efficiency. Children were graded into 3 groups: no abnormality, mild abnormalities with normal socialization, major abnormalities; 31.6% presented disorders. Preoperative C-T scans assessed the severity of the cranial deformity and identified associated intracranial abnormalities, such as agenesis of the corpus callosum, dilatation of the subdural spaces, or hydrocephalus. Associated extracranial malformations, and associated family cases were also noted. Finally, the quality of the family context was studied. Several correlations were identified; mental development was correlated with the severity of frontal stenosis, the age at surgery and the associated extracranial malformations. Family environment also had a major influence. Intracranial abnormalities were not correlated with mental development.