The Role of Cranial Expansion for Craniocephalic Disproportion

• Published in: Pediatric neurosurgery Vol. 41; no. 2; pp. 61 - 69
• Main Authors: Gough, Jenny, Walker, David G., Theile, Richard, Tomlinson, Francis H.
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.03.2005
• Subjects: Brain surgery; Cephalometry; Child; Child, Preschool; Children & youth; Clinical outcomes; Craniosynostoses - surgery; Craniotomy - methods; Decompression, Surgical; Deformities; Female; Headache - etiology; Headache - surgery; Humans; Infant; Intracranial Pressure; Male; Neurosurgery; Original Paper; Pediatrics; Preschool children; Skull - abnormalities; Skull - surgery; Surgical techniques; Ventriculoperitoneal Shunt; Slit ventricle syndrome; Cranial expansion; Craniocephalic disproportion; Craniosynostosis
• ISSN: 1016-2291; 1423-0305
• DOI: 10.1159/000085158

The appropriate treatment for craniocephalic disproportion, such as caused by slit ventricle syndrome, is uncertain. We have reviewed the treatment and outcomes of 4 children who underwent cranial expansion over a period of 5 years. The ages at cranial expansion were 16 months, 3 years 6 months and 2 at 6 years. Two children had slit ventricle syndrome and were treated with bilateral parietal expansions. Two children had non-syndromic craniosynostosis, one of these having vitamin D-resistant rickets. The latter 2 were treated with posterior cranial vault expansion, and one also had a craniocervical junction decompression performed. Post-operatively, symptoms of raised intracranial pressure resolved in all cases, and there was radiological evidence of re-establishment of normal CSF pathways. Although a rare condition, cranial expansion operations can be successful in appropriately selected cases of craniocephalic disproportion.