Intracranial hypertension and cortical thickness in syndromic craniosynostosis.

Autor: Wilson AT; Department of Plastic and Reconstructive Surgery, Erasmus Medical Center, Rotterdam, the Netherlands.; Department of Surgery, Section of Plastic Surgery, Yale School of Medicine, New Haven, CT, USA., Den Ottelander BK; Department of Plastic and Reconstructive Surgery, Erasmus Medical Center, Rotterdam, the Netherlands., De Goederen R; Department of Plastic and Reconstructive Surgery, Erasmus Medical Center, Rotterdam, the Netherlands., Van Veelen MC; Department of Neurological Surgery, Erasmus Medical Center, Rotterdam, the Netherlands., Dremmen MHG; Department of Radiology, Erasmus Medical Center, Rotterdam, the Netherlands., Persing JA; Department of Surgery, Section of Plastic Surgery, Yale School of Medicine, New Haven, CT, USA., Vrooman HA; Department of Radiology, Erasmus Medical Center, Rotterdam, the Netherlands.; Department of Medical Informatics, Erasmus Medical Center, Rotterdam, the Netherlands., Mathijssen IMJ; Department of Plastic and Reconstructive Surgery, Erasmus Medical Center, Rotterdam, the Netherlands.
Jazyk: angličtina
Zdroj: Developmental medicine and child neurology [Dev Med Child Neurol] 2020 Jul; Vol. 62 (7), pp. 799-805. Date of Electronic Publication: 2020 Feb 14.
DOI: 10.1111/dmcn.14487
Abstrakt: Aim: To evaluate the impact of risk factors for intracranial hypertension (ICH) on cerebral cortex thickness in syndromic craniosynostosis.
Method: ICH risk factors including papilloedema, hydrocephalus, obstructive sleep apnea (OSA), cerebellar tonsillar position, occipitofrontal circumference (OFC) curve deflection, age, and sex were collected from the records of patients with syndromic craniosynostosis (Apert, Crouzon, Pfeiffer, Muenke, Saethre-Chotzen syndromes) and imaging. Magnetic resonance images were analysed and exported for statistical analysis. A linear mixed model was developed to determine correlations with cerebral cortex thickness changes.
Results: In total, 171 scans from 107 patients (83 males, 88 females [including repeated scans], mean age 8y 10mo, range 1y 1mo-34y, SD 5y 9mo) were evaluated. Mean cortical thickness in this cohort was 2.78mm (SD 0.17). Previous findings of papilloedema (p=0.036) and of hydrocephalus (p=0.007) were independently associated with cortical thinning. Cortical thickness did not vary significantly by sex (p=0.534), syndrome (p=0.896), OSA (p=0.464), OFC (p=0.375), or tonsillar position (p=0.682).
Interpretation: Detection of papilloedema or hydrocephalus in syndromic craniosynostosis is associated with significant changes in cortical thickness, supporting the need for preventative rather than reactive treatment strategies.
What This Paper Adds: Papilloedema is associated with thinning of the cerebral cortex in syndromic craniosynostosis, independently of hydrocephalus.
(© 2020 Mac Keith Press.)
Databáze: MEDLINE
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