Isolated sagittal craniosynostosis: definition, classification, and surgical indications

Sagittal craniosynostosis (SC) remains the most common type of synostosis, accounting for about a half of all forms. It would result from a mesenchymal disorder involving the intramembranous ossification of the sagittal suture and leading to its early fusion. No specific data on the etiologic factor...

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Bibliographic Details
Published in:Child's nervous system 2012-09, Vol.28 (9), p.1311-1317
Main Authors: Massimi, Luca, Caldarelli, Massimo, Tamburrini, Gianpiero, Paternoster, Giovanna, Di Rocco, Concezio
Format: Article
Language:English
Subjects:
Craniosynostoses - classification
Craniosynostoses - diagnosis
Craniosynostoses - epidemiology
Craniosynostoses - surgery
Humans
Medicine
Medicine & Public Health
Neurosciences
Neurosurgery
Special Annual Issue
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Summary:Sagittal craniosynostosis (SC) remains the most common type of synostosis, accounting for about a half of all forms. It would result from a mesenchymal disorder involving the intramembranous ossification of the sagittal suture and leading to its early fusion. No specific data on the etiologic factors are currently available. The premature ossification of the sagittal suture can result in three main types of SC, according to the different segment prevalently involved: anterior, posterior, and complete SC. The diagnosis is easily obtained by clinical examination. However, a radiological work up (3D CT scan) may be necessary to rule out hidden venous or cranial anomalies possibly associated with most severe cases, or for the surgical planning. The most common indication for surgery is the improvement of the cosmetic appearance of the skull, since a cranial deformation may have a significant psychological impact on affected subjects. To relieve from raised intracranial pressure is a further indication to surgery. Although an increased intracranial pressure can be demonstrated in a minority of affected children at diagnosis, indeed, it can present later (usually after the second/third year of life) with chronic symptoms. The role of surgery in the preservation of cognitive functions in scaphocephalic patients does not seem to be relevant, since minor anomalies of the cerebral development associated with SC would occur independently from the cranial shape. On the other hand, the surgical correction may show a protective effect on some visual skills, like the ability to fix and follow, and the fixation shift.
ISSN:0256-7040
1433-0350
DOI:10.1007/s00381-012-1834-5