Abstract
Purpose
Children with sagittal craniosynostosis (SC) are at risk of developing raised intracranial pressure (ICP). This is thought to result from cephalocranial disproportion—the restriction of normal cerebral development by a small cranial vault. It remains unclear whether intracranial volume (ICV) is altered in SC. This study offers a novel volumetric analysis of the scaphocephalic skull, comparing supratentorial (ST) volume, infratentorial (IT) volume, and total ICV of patients with sagittal synostosis to normal controls.
Methods
ICVs of 32 consecutive patients undergoing total calvarial vault remodelling (TCVR) for isolated SC were compared to 32 age- and sex-matched normal controls. ICV was measured with manual techniques on head computerised tomographic (CT) scans using OsiriX software. A paired t test was used to compare data between cases and controls.
Results
Mean total ICV, ST volume and IT volume were larger in SC than in controls, except in females > 6 months of age. There was no statistical significance. Regression analysis demonstrated larger ICVs in diseased children than in controls younger than 10 months, at which age trend lines intersected and the reverse became true for older children. This likely represents an evolving risk of cephalocranial disproportion beyond 10 months of age. The IT/ST volume ratio was conserved in scaphocephaly, and very closely approximated that of controls.
Conclusions
Sagittal craniosynostosis appears to be associated with a larger cranial vault at less than 10 months and a smaller vault at greater than 10 months, although statistical significance was not achieved.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Anderson P, Netherway D, McGlaughlin K, David D (2007) Intracranial volume measurement of sagittal craniosynostosis. J Clin Neurosci 14(5):455–458
Breakey W, Knoops P, Borghi A, Rodriguez-Florez N, Dunaway D, Schievano S et al (2017) Intracranial Volume Measurement. J Craniofac Surg 28(7):1746–1751
Cloonan Y, Collett B, Speltz M, Anderka M, Werler M (2013) Psychosocial outcomes in children with and without non-syndromic craniosynostosis: findings from two studies. Cleft Palate Craniofac J 50(4):406–413
Fischer S, Maltese G, Tarnow P, Wikberg E, Bernhardt P, Tovetjärn R, Kölby L (2014) Intracranial volume is normal in infants with sagittal synostosis. J Plast Surg Hand Surg 49(1):62–64
Garza R, Khosla R (2012) Nonsyndromic craniosynostosis. Semin Plast Surg 26(02):053–063
Gault D, Renier D, Marchac D, Ackland F, Jones B (1990) Intracranial volume in children with Craniosynostosis. J Craniofac Surg 1(1):1–3
Heliövaara A, Leikola J, Koljonen V, Vuola P, Koivikko M (2017) Length of synostosis and segmented intracranial volume correlate with age in patients with non-syndromic sagittal synostosis. Childs Nerv Syst 34(3):511–515
Heller J, Heller M, Knoll B, Gabbay J, Duncan C, Persing J (2008) Intracranial volume and cephalic index outcomes for Total Calvarial reconstruction among Nonsyndromic sagittal Synostosis patients. Plast Reconstr Surg 121(1):187–195
Kapp-Simon K, Speltz M, Cunningham M, Patel P, Tomita T (2006) Neurodevelopment of children with single suture craniosynostosis: a review. Childs Nerv Syst 23(3):269–281
Kimiwada T, Hayashi T, Sanada T, Shirane R, Tominaga T (2013) Surgical treatment of scaphocephaly with sinus pericranii. Neurol Med Chir 53(2):121–125
Lavigne J, Faier-Routman J (1992) Psychological adjustment to pediatric physical disorders: a meta-analytic review. J Pediatr Psychol 17(2):133–157
Lee S, Duncan C, Knoll B, Persing J (2010) Intracranial compartment volume changes in sagittal craniosynostosis patients: influence of comprehensive cranioplasty. Plast Reconstr Surg 126(1):187–196
Mursch K, Enk T, Christen H, Markakis E, Behnke-Mursch J. Venous intracranial haemodynamics in children undergoing operative treatment for the repair of craniosynostosis. Childs Nerv Syst 15(2-3):110–116
Netherway D, Abbott A, Anderson P, David D (2005) Intracranial volume in patients with nonsyndromal craniosynostosis. J Neurosurg Pediatr 103(2):137–141
Park S, Kim S, Cho B, Kim H, Kim J, Phi J, Kim IO, Wang KC (2009) Sinus pericranii in children: report of 16 patients and preoperative evaluation of surgical risk. J Neurosurg Pediatr 4(6):536–542
Posnick J, Armstrong D, Bite U (1995) Metopic and sagittal Synostosis. Plast Reconstr Surg 96(2):310–315
Rifkinson-Mann S, Goraj B, Leslie D, Visintainer P, Padua H (1995) Transcranial Doppler analysis of cerebral hemodynamics in primary craniosynostosis: study in progress. Surg Neurol 44(4):334–337
Seeberger R, Hoffmann J, Freudlsperger C, Berger M, Bodem J, Horn D, Engel M (2016) Intracranial volume (ICV) in isolated sagittal craniosynostosis measured by 3D photocephalometry: a new perspective on a controversial issue. J Cranio-Maxillofac Surg 44(5):626–631
Snyder H, Pope A (2010) Psychosocial adjustment in children and adolescents with a craniofacial anomaly: diagnosis-specific patterns. Cleft Palate Craniofac J 47(3):264–272
Speltz M (2004) Single-suture craniosynostosis: a review of neurobehavioral research and theory. J Pediatr Psychol 29(8):651–668
Taylor W, Hayward R, Lasjaunias P, Britto J, Thompson D, Jones B, Evans RD (2001) Enigma of raised intracranial pressure in patients with complex craniosynostosis: the role of abnormal intracranial venous drainage. J Neurosurg 94(3):377–385
Toma R, Greensmith A, Meara J, Da Costa A, Ellis L, Willams S et al (2010) Quantitative morphometric outcomes following the Melbourne method of total vault remodelling for scaphocephaly. J Craniofac Surg 21(3):637–643
Wall S, Thomas G, Johnson D, Byren J, Jayamohan J, Magdum S, McAuley D, Richards PG (2014) The preoperative incidence of raised intracranial pressure in nonsyndromic sagittal craniosynostosis is underestimated in the literature. J Neurosurg Pediatr 14(6):674–681
Funding
This work was part funded by the University of Birmingham Medical School Intercalated BSc Clinical Anatomy Programme.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest statement
On behalf of all authors, the corresponding author states that there is no conflict of interest.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
ESM 1
(DOCX 33 kb)
Rights and permissions
About this article
Cite this article
Holland, J., Rodrigues, D., Mohan, S. et al. Intracranial volume (ICV) in isolated sagittal craniosynostosis: a retrospective case-matched-control study. Childs Nerv Syst 35, 509–516 (2019). https://doi.org/10.1007/s00381-018-4018-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00381-018-4018-0