Children with many prematurely fused cranial sutures and those who receive surgical correction later in life appear to have poorer neurocognitive outcomes. Still, it’s unclear if increased intracranial pressure (ICP) is to blame. This study determined the impact of age at intervention and the number of implicated cranial sutures on ICP. It determined which type of cranial suture closure was most closely linked to elevated ICP. Researchers searched the prospective craniofacial database at the authors’ institution was for patients who had their ICP measured intraoperatively before craniectomy and were undergoing initial corrective surgery for craniosynostosis. Multiple linear regression was used to examine age, involved sutures, and syndromic status in the setting of observed ICP.
Fifty patients met the inclusion criteria. Multiple-suture involvement (p = 0.010, β = +4.175 mm Hg if multistore) and age at operation (p = 0.028, β= +0.060 mm Hg/month) were also substantially linked to increased ICP. ICP was strongly linked with the number of main sutures used (p = 0.001; β= +1.687 mm Hg/suture). There was a significant difference in median ICP across the suture types among patients with single-suture involvement (p = 0.008), with metopic having the lowest (12.5 mm Hg) and sagittal having the highest (p = 0.008). (16.0 mm Hg). ICP was substantially greater in patients with several sutures involved (p = 0.003; 18.5 mm Hg). Multiple-suture involvement was 79.3 times more prevalent in patients with craniofacial syndromes (p < 0.001). Corrective surgery for craniosynostosis resulted in a significant reduction in increased ICP during the procedure (all p < 0.050). Multiple premature fusion of cranial sutures, syndromic status, and longer age at intervention for craniosynostosis was linked to significantly higher ICP.
Reference:thejns.org/pediatrics/view/journals/j-neurosurg-pediatr/28/6/article-p716.xml
