Surgical techniques of cranial vault expansion for increases in intracranial pressure in older children

J Craniofac Surg. 1993 Jul;4(3):167-76; discussion 174-6. doi: 10.1097/00001665-199307000-00011.

Abstract

Standard craniofacial techniques to expand the cranial vault were successful in treating elevations of intracranial pressure (ICP) in 7 older children. Of the 7 patients, a diagnosis of craniosynostosis was made in 6 and deformational head deformity with slit ventricle syndrome in 1. There were 5 boys and 2 girls, whose ages ranged from 3 1/2 to 8 years (mean, 5.2 yr). Three patients had previously undergone surgical treatment of craniosynostosis. One patient presented with visual changes and papilledema. Another with a deformational skull deformity was shunt-dependent and was diagnosed with slit ventricle syndrome. This patient had undergone several temporal craniectomies to control recurrent symptoms of increased ICP. The remaining 2 patients appeared to have craniosynostosis as an explanation for reduced cranial vault size and elevated ICP, but the specific sites of sutural fusion could not be identified. Total follow-up ranged from 3 to 18 months, and evidence of resolution of signs and symptoms of increased ICP was achieved in each of the 7 patients. Plastic surgeons involved in caring for children with craniosynostosis should be particularly aware of the possibility of increased ICP developing or recurring following craniofacial surgery.

MeSH terms

  • Cerebral Ventricles / abnormalities
  • Cerebrospinal Fluid Shunts
  • Child
  • Child, Preschool
  • Craniosynostoses / complications
  • Craniosynostoses / surgery*
  • Craniotomy / methods*
  • Female
  • Forehead
  • Frontal Bone / surgery*
  • Humans
  • Hydrocephalus / surgery*
  • Intracranial Pressure*
  • Male
  • Orbit / surgery
  • Osteotomy / methods
  • Papilledema / etiology
  • Recurrence
  • Reoperation