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Cephalic index correlates poorly with intracranial volume in non-syndromic scaphocephalic patients

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Abstract

Objectives

This study aims to compare pre- and postoperative cephalic indexes (CI) with corresponding segmented intracranial volumes (SIV) obtained from volumetric CT in scaphocephalic patients.

Methods

Twenty-four patients (17 boys) who had undergone cranial vault remodeling due to scaphocephaly were compared from 3D-CT imaging datasets. The mean age of the patients at preoperative CT imaging was 5.5 months, and that at 1-year postoperative imaging, 21.5 months. The mean interval between preoperative CT imaging and surgery was 3.3 months. Pearson’s correlation was used to test the correlation of both pre- and postoperative CI with SIV. A paired t test was used to compare differences in the pre- and postoperative mean values of CI and SIV.

Results and discussion

CI correlated poorly with intracranial volume both preoperatively (r = 0.274) and postoperatively (r = 0.128). The mean preoperative CI was 65.92 (range 57.99–73.97), and the mean postoperative, CI 70.24 (range 60.23–75.57). The mean preoperative intracranial volume was 877.79 cm3 (range 638–1,256), and the 1-year postoperative volume, 1,249.04 cm3 (range 1,039–1,529). The mean values of both CI and SIV increased significantly after surgery. In one patient, the CI in postoperative measurements was smaller, whereas in all patients, the postoperative SIV was larger than the preoperative intracranial volume. The mean percentage increase in CI was 6.6 %, whereas the mean increase in SIV was 43.1 %.

Conclusion

Cephalic index correlates poorly with intracranial volume in non-syndromic scaphocephalic patients. For some patients, surgery and growth resulted in only subtle or no change in CI despite a notable increase in intracranial volume.

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References

  1. Antunez S, Arnaud E, Cruz A, Marchac D, Renier D (2009) Scaphocephaly: part I: indices for scaphocephalic frontal and occipital morphology evaluation: long-term results. J Craniofac Surg 20(Suppl 2):1837–1842. doi:10.1097/SCS.0b013e3181b6c4ea

    Article  PubMed  Google Scholar 

  2. Boas F (1899) The cephalic index. Am Anthropol 1(3):448–461

    Article  Google Scholar 

  3. Dekaban AS (1977) Tables of cranial and orbital measurements, cranial volume, and derived indexes in males and females from 7 days to 20 years of age. Ann Neurol 2(6):485–491. doi:10.1002/ana.410020607

    Article  CAS  PubMed  Google Scholar 

  4. Engel M, Hoffmann J, Muhling J, Castrillon-Oberndorfer G, Seeberger R, Freudlsperger C (2012) Subtotal cranial vault remodelling in anterior sagittal suture closure: impact of age on surgical outcome. Int J Oral Maxillofac Surg 41(10):1232–1237. doi:10.1016/j.ijom.2012.05.026

    Article  CAS  PubMed  Google Scholar 

  5. Fok H, Jones BM, Gault DG, Andar U, Hayward R (1992) Relationship between intracranial pressure and intracranial volume in craniosynostosis. Br J Plast Surg 45(5):394–397

    Article  CAS  PubMed  Google Scholar 

  6. Gault DT, Renier D, Marchac D, Jones BM (1992) Intracranial pressure and intracranial volume in children with craniosynostosis. Plast Reconstr Surg 90(3):377–381

    Article  CAS  PubMed  Google Scholar 

  7. Guimaraes-Ferreira J, Gewalli F, David L, Olsson R, Friede H, Lauritzen CG (2001) Clinical outcome of the modified pi-plasty procedure for sagittal synostosis. J Craniofac Surg 12(3):218–224, discussion 225-216

    Article  CAS  PubMed  Google Scholar 

  8. Haataja J (1963) (Eräiden pään ja kasvojen alueen anatomisten indeksien käyttäytyminen kasvuaikana poikkileikkaustutkimuksen valossa) Regarding changes in some craniofacial indices during growth phase in Dissertation

  9. Heller JB, Heller MM, Knoll B, Gabbay JS, Duncan C, Persing JA (2008) Intracranial volume and cephalic index outcomes for total calvarial reconstruction among nonsyndromic sagittal synostosis patients. Plast Reconstr Surg 121(1):187–195. doi:10.1097/01.prs.0000293762.71115.c5

    Article  CAS  PubMed  Google Scholar 

  10. Jimenez DF, Barone CM (2012) Endoscopic technique for sagittal synostosis. Childs Nerv Syst 28(9):1333–1339. doi:10.1007/s00381-012-1768-y

    Article  PubMed  Google Scholar 

  11. Johnson D, Wilkie AO (2011) Craniosynostosis. Eur J Hum Genet 19(4):369–376. doi:10.1038/ejhg.2010.235

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  12. Kamdar MR, Gomez RA, Ascherman JA (2009) Intracranial volumes in a large series of healthy children. Plast Reconstr Surg 124(6):2072–2075. doi:10.1097/PRS.0b013e3181bcefc4

    Article  CAS  PubMed  Google Scholar 

  13. Kucuker I, Demir Y, Kaya B, Cukurluoglu O, Tuncer S, Emmez H, Yavuzer R, Baykaner K (2012) Effects of different surgical techniques on cephalic index and intracranial volume in isolated bilateral coronal synostosis model. J Craniofac Surg 23(3):878–880. doi:10.1097/SCS.0b013e31824ddd76

    Article  PubMed  Google Scholar 

  14. Lajeunie E, Le Merrer M, Bonaiti-Pellie C, Marchac D, Renier D (1996) Genetic study of scaphocephaly. Am J Med Genet 62(3):282–285. doi:10.1002/(SICI)1096-8628(19960329)62:3<282::AID-AJMG15>3.0.CO;2-G

    Article  CAS  PubMed  Google Scholar 

  15. Lee SS, Duncan CC, Knoll BI, Persing JA (2010) Intracranial compartment volume changes in sagittal craniosynostosis patients: influence of comprehensive cranioplasty. Plast Reconstr Surg 126(1):187–196. doi:10.1097/PRS.0b013e3181dab5be

    Article  CAS  PubMed  Google Scholar 

  16. Murray DJ, Kelleher MO, McGillivary A, Allcutt D, Earley MJ (2007) Sagittal synostosis: a review of 53 cases of sagittal suturectomy in one unit. J Plast Reconstr Aesthet Surg 60(9):991–997. doi:10.1016/j.bjps.2007.02.003

    Article  PubMed  Google Scholar 

  17. Netherway DJ, Abbott AH, Anderson PJ, David DJ (2005) Intracranial volume in patients with nonsyndromal craniosynostosis. J Neurosurg 103(2 Suppl):137–141. doi:10.3171/ped.2005.103.2.0137

    PubMed  Google Scholar 

  18. Posnick JC, Armstrong D, Bite U (1995) Metopic and sagittal synostosis: intracranial volume measurements prior to and after cranio-orbital reshaping in childhood. Plast Reconstr Surg 96(2):299–309, discussion 310-295

    Article  CAS  PubMed  Google Scholar 

  19. Renier D (1989) Intracranial pressure in craniosynostosis: pre- and postoperative recording-correlation with functional results. In: Persing JA (ed) Scientific Foundations and Surgical Treatment of Craniosynostosis. Williams & Wilkins, Baltimore, pp 263–269

    Google Scholar 

  20. Renier D, Sainte-Rose C, Marchac D, Hirsch JF (1982) Intracranial pressure in craniostenosis. J Neurosurg 57(3):370–377. doi:10.3171/jns.1982.57.3.0370

    Article  CAS  PubMed  Google Scholar 

  21. Ruiz-Correa S, Sze RW, Starr JR, Lin HT, Speltz ML, Cunningham ML, Hing AV (2006) New scaphocephaly severity indices of sagittal craniosynostosis: a comparative study with cranial index quantifications. Cleft Palate Craniofac J 43(2):211–221. doi:10.1597/04-208.1

    Article  PubMed  Google Scholar 

  22. Sahin B, Acer N, Sonmez OF, Emirzeoglu M, Basaloglu H, Uzun A, Bilgic S (2007) Comparison of four methods for the estimation of intracranial volume: a gold standard study. Clin Anat 20(7):766–773. doi:10.1002/ca.20520

    Article  CAS  PubMed  Google Scholar 

  23. Salyer K, Marchac D (1999) Surgery of craniosynostosis in infants. In: Salyer KE, Bardach J (eds) Atlas of craniofacial and cleft surgery, vol 1. Lippincott-Raven, Philadelphia, pp 86–88

    Google Scholar 

  24. Sgouros S, Goldin JH, Hockley AD, Wake MJ, Natarajan K (1999) Intracranial volume change in childhood. J Neurosurg 91(4):610–616. doi:10.3171/jns.1999.91.4.0610

    Article  CAS  PubMed  Google Scholar 

  25. Shah MN, Kane AA, Petersen JD, Woo AS, Naidoo SD, Smyth MD (2011) Endoscopically assisted versus open repair of sagittal craniosynostosis: the St. Louis Children’s Hospital experience. J Neurosurg Pediatr 8(2):165–170. doi:10.3171/2011.5.PEDS1128

    Article  PubMed  Google Scholar 

  26. Slomic AM, Bernier JP, Morissette J, Renier D (1992) A craniometric study of sagittal craniosynostosis (SC). J Craniofac Genet Dev Biol 12(1):49–54

    CAS  PubMed  Google Scholar 

  27. Sood S, Rozzelle A, Shaqiri B, Sood N, Ham SD (2011) Effect of molding helmet on head shape in nonsurgically treated sagittal craniosynostosis. J Neurosurg Pediatr 7(6):627–632. doi:10.3171/2011.4.PEDS116

    Article  PubMed  Google Scholar 

  28. Thompson DN, Harkness W, Jones B, Gonsalez S, Andar U, Hayward R (1995) Subdural intracranial pressure monitoring in craniosynostosis: its role in surgical management. Childs Nerv Syst 11(5):269–275

    Article  CAS  PubMed  Google Scholar 

  29. Thompson DN, Malcolm GP, Jones BM, Harkness WJ, Hayward RD (1995) Intracranial pressure in single-suture craniosynostosis. Pediatr Neurosurg 22(5):235–240

    Article  CAS  PubMed  Google Scholar 

  30. Van den Broek MJ, Arbues AS, Chalard F, Pinto Da Costa NM, Trang H, Dorfmuller G, Evrard PP, Husson I, Servais LJ (2009) Chiari type I malformation causing central apnoeas in a 4-month-old boy. Eur J Paediatr Neurol 13(5):463–465. doi:10.1016/j.ejpn.2008.07.012

    Article  PubMed  Google Scholar 

  31. Wilbrand JF, Szczukowski A, Blecher JC, Pons-Kuehnemann J, Christophis P, Howaldt HP, Schaaf H (2012) Objectification of cranial vault correction for craniosynostosis by three-dimensional photography. J Craniomaxillofac Surg. doi:10.1016/j.jcms.2012.01.007

    Google Scholar 

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Authors and Affiliations

  1. Department of Plastic Surgery, Cleft Palate and Craniofacial Center, Helsinki University Central Hospital, Helsinki, Finland

    Junnu Leikola, Arja Heliövaara & Jyri Hukki

  2. Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland

    Virve Koljonen

  3. Helsinki Medical Imaging Center, Department of Radiology, Helsinki University Central Hospital, Helsinki, Finland

    Mika Koivikko

  4. Department of Plastic Surgery, Töölö Hospital, P.O. Box 266, 00029, HUS, Finland

    Junnu Leikola & Virve Koljonen

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  1. Junnu Leikola
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Correspondence to Junnu Leikola.

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Leikola, J., Koljonen, V., Heliövaara, A. et al. Cephalic index correlates poorly with intracranial volume in non-syndromic scaphocephalic patients. Childs Nerv Syst 30, 2097–2102 (2014). https://doi.org/10.1007/s00381-014-2456-x

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  • DOI: https://doi.org/10.1007/s00381-014-2456-x

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