Skip to main content
Erschienen in: Child's Nervous System 12/2014

01.12.2014 | Original Paper

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

verfasst von: Junnu Leikola, Virve Koljonen, Arja Heliövaara, Jyri Hukki, Mika Koivikko

Erschienen in: Child's Nervous System | Ausgabe 12/2014

Einloggen, um Zugang zu erhalten

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.
Literatur
2.
3.
4.
Zurück zum Zitat 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 PubMedCrossRef 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 PubMedCrossRef
5.
Zurück zum Zitat 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):394–397PubMedCrossRef 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):394–397PubMedCrossRef
6.
Zurück zum Zitat Gault DT, Renier D, Marchac D, Jones BM (1992) Intracranial pressure and intracranial volume in children with craniosynostosis. Plast Reconstr Surg 90(3):377–381PubMedCrossRef Gault DT, Renier D, Marchac D, Jones BM (1992) Intracranial pressure and intracranial volume in children with craniosynostosis. Plast Reconstr Surg 90(3):377–381PubMedCrossRef
7.
Zurück zum Zitat 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 225-216PubMedCrossRef 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 225-216PubMedCrossRef
8.
Zurück zum Zitat 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 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
13.
Zurück zum Zitat 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 PubMedCrossRef 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​ PubMedCrossRef
18.
Zurück zum Zitat 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 310-295PubMedCrossRef 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 310-295PubMedCrossRef
19.
Zurück zum Zitat 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 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
21.
Zurück zum Zitat 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 PubMedCrossRef 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 PubMedCrossRef
22.
Zurück zum Zitat 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 PubMedCrossRef 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 PubMedCrossRef
23.
Zurück zum Zitat 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 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
25.
Zurück zum Zitat 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 PubMedCrossRef 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 PubMedCrossRef
26.
Zurück zum Zitat Slomic AM, Bernier JP, Morissette J, Renier D (1992) A craniometric study of sagittal craniosynostosis (SC). J Craniofac Genet Dev Biol 12(1):49–54PubMed Slomic AM, Bernier JP, Morissette J, Renier D (1992) A craniometric study of sagittal craniosynostosis (SC). J Craniofac Genet Dev Biol 12(1):49–54PubMed
28.
Zurück zum Zitat 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):269–275PubMedCrossRef 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):269–275PubMedCrossRef
29.
Zurück zum Zitat Thompson DN, Malcolm GP, Jones BM, Harkness WJ, Hayward RD (1995) Intracranial pressure in single-suture craniosynostosis. Pediatr Neurosurg 22(5):235–240PubMedCrossRef Thompson DN, Malcolm GP, Jones BM, Harkness WJ, Hayward RD (1995) Intracranial pressure in single-suture craniosynostosis. Pediatr Neurosurg 22(5):235–240PubMedCrossRef
30.
Zurück zum Zitat 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 PubMedCrossRef 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 PubMedCrossRef
31.
Zurück zum Zitat 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 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
Metadaten
Titel
Cephalic index correlates poorly with intracranial volume in non-syndromic scaphocephalic patients
verfasst von
Junnu Leikola
Virve Koljonen
Arja Heliövaara
Jyri Hukki
Mika Koivikko
Publikationsdatum
01.12.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Child's Nervous System / Ausgabe 12/2014
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-014-2456-x

Weitere Artikel der Ausgabe 12/2014

Child's Nervous System 12/2014 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.