<< Back to the abstract archive
A Treatment Protocol for Atypical Sagittal Craniosynostosis
Edward J Ruane, MD; Catharine B Garland, MD; Liliana Camison, MD; Regina A Fenton, CRNP; Ian F Pollack, MD; Mandeep S Tamber, MD, PhD; Lorelei J Grunwaldt, MD; Joseph E Losee, MD; Jesse A Goldstein, MD
University of Pittsburgh
2016-02-01
Presenter: Edward Ruane
Affidavit:
I certify that the material proposed for presentation in this abstract represents the original work of the resident.
Director Name: Joseph E Losee
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background: Sagittal craniosynostosis typically presents shortly after birth with a scaphocephalic head shape. Herein the authors highlight their experience with a challenging patient population: those with phenotypically mild, missed, and late-presenting sagittal craniosynostosis.
Methods: A prospective cohort study was conducted for all cases of sagittal craniosynostosis presenting to our institution between July 2013 and August 2015. Patients older than 1 year of age with isolated sagittal craniosynostosis were selected.
Results: Fifty-one patients met inclusion criteria. Only nine patients have been treated surgically (17.6 percent). Two patients had obvious scaphocephaly which was felt to require operative correction. Four patients presented with ophthalmologic evaluations concerning for intracranial hypertension (ICH) and underwent cranial vault expansion. Another patient presented with classic ICH-related headaches and was taken to surgery. Eight patients presented either with signs of ICH in the setting of other potential causes or with inconclusive ophthalmologic evaluations. These patients were admitted for intracranial pressure monitoring, of which two were found to be elevated (25 percent) and taken to surgery. Thirty-six other patients presented with isolated sagittal craniosynostosis in the setting of overall normocephaly without any signs concerning for ICH and continue to undergo serial ophthalmologic evaluation.
Conclusions: Here we present a unique treatment protocol which has been utilized on the largest series of patients presenting with atypical sagittal craniosynostosis to date. Based upon our center's early experience, it appears as if the risk of ICH is low in this population, and the majority of patients can be safely monitored.
