Subscribe to RSS
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1055/s-0037-1602692
Head Measurements for the Diagnosis of Craniosynostosis
As medidas cranianas no diagnóstico das craniossinostosesPublication History
12 December 2016
23 February 2017
Publication Date:
20 April 2017 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00028832/201702/lookinside/thumbnails/10-1055-s-0037-1602692_1600096-1.jpg)
Abstract
Objective Craniosynostosis is a group of growth disturbances of the skull, which can result in serious consequences for the children who suffer from it. Early diagnosis provides treatment at the correct time. Most of the time, the pediatrician uses the head circumference (HC) as a parameter for the diagnosis, but the HC does not appear to be changed in this disease, leading to incorrect interpretations. The anteroposterior distance (APD) and biauricular distance (BAD) appear to be more accurate. The aim of this study is to analyze the value of the HC and the ratio between the measurements of the APD and the BAD for this diagnosis.
Methods We analyzed the data from 129 children who had already undergone an operation for craniosynostosis at an institution in Southeastern Brazil. These data were compared with the normal standards of the population and statistically analyzed to establish their alterations.
Results The HC did not change significantly in cases of craniosynostosis, neither when it was considered as a single disease, nor when considering the different subtypes. The APD/BAD ratio changed significantly in the group.
Conclusion The HC does not appear to be useful in the diagnosis of craniosynostosis as an individual parameter. The APD/BAD ratio appears to help in the diagnosis.
Resumo
Objetivo Craniossinostoses são alterações do crescimento do crânio que podem resultar graves consequências para a criança. O diagnóstico precoce propicia o tratamento correto. O perímetro cefálico (PC) é habitualmente usado como parâmetro para o diagnóstico. Porém, como na maioria das vezes há alteração na forma e não no perímetro, sua utilização isolada pode levar a detecção tardia. As medidas do diâmetro ântero posterior (DAB) e bi auricular (DBA) parecem ser mais precisas. O objetivo do trabalho é analisar o valor do PC no diagnóstico, bem como o da razão entre as medidas DAP/ DBA.
Métodos Foram analisadas dados de 139 crianças já operadas no Biocor Instituto, em Minas Gerais. Os dados foram comparados com os parâmetros normais já conhecidos da população.
Resultados O PC não se alterou de maneira significativa nas craniossinostoses, seja como um grupo único ou nos subtipos. A razão das medidas DAP/ DBA alterou-se.
Conclusão O PC isolado parece não ser útil para o diagnóstico das craniossinostoses. A razão das medidas DAP/ DBA parecendo ter utilidade.
Palavras-chave
cuidado infantil - recomendações de diagnóstico - craniossinostoses e perímetro cefálicoFunding Source
No external funding was secured for this study.
-
References
- 1 Marcondes E. Normas para caracterização dos perímetros cefálico e torácico. Pediat (São Paulo) 1983; 5: 249-275
- 2 Triloa MF. Elementary Statistics: High School Edition. 9 ed: Addison-Wesley Educational Publishers; , Incorporated; 2005
- 3 Delashaw JB, Persing JA, Broaddus WC, Jane JA. Cranial vault growth in craniosynostosis. J Neurosurg 1989; 70 (02) 159-165
- 4 Foltz EL, Loeser JD. Craniosynostosis. J Neurosurg 1975; 43 (01) 48-57
- 5 Goodrich JT. Skull base growth in craniosynostosis. Childs Nerv Syst 2005; 21 (10) 871-879
- 6 Lajeunie E, Barcik U, Thorne JA, El Ghouzzi V, Bourgeois M, Renier D. Craniosynostosis and fetal exposure to sodium valproate. J Neurosurg 2001; 95 (05) 778-782
- 7 Persing PPSJA. Craniosynostosis. In: Andelson LAIPD. , editor. Principals and Practice of Pediatric Neurosurgery. 1. New York: Thieme Medical Publishers Inc.; 1999. . p. 219–42.
- 8 Johnson D, Wilkie AO. Craniosynostosis. Eur J Hum Genet 2011; 19 (04) 369-376
- 9 Merritt L. Recognizing craniosynostosis. Neonatal Netw 2009; 28 (06) 369-376
- 10 Wilkie AO, Byren JC, Hurst JA. , et al. Prevalence and complications of single-gene and chromosomal disorders in craniosynostosis. Pediatrics 2010; 126 (02) e391-e400
- 11 Dake JA, Price JH, Telljohann SK. The nature and extent of bullying at school. J Sch Health 2003; 73 (05) 173-180
- 12 Ozgur BM, Aryan HE, Ibrahim D. , et al. Emotional and psychological impact of delayed craniosynostosis repair. Childs Nerv Syst 2006; 22 (12) 1619-1623
- 13 Stavrou P, Sgouros S, Willshaw HE, Goldin JH, Hockley AD, Wake MJ. Visual failure caused by raised intracranial pressure in craniosynostosis. Childs Nerv Syst 1997; 13 (02) 64-67
- 14 Baranello G, Vasco G, Ricci D, Mercuri E. Visual function in nonsyndromic craniosynostosis: past, present, and future. Childs Nerv Syst 2007; 23 (12) 1461-1465
- 15 Clement R, Nischal K. Simulation of oculomotility in Craniosynostosis patients. Strabismus 2003; 11 (04) 239-242
- 16 Hayward R. Venous hypertension and craniosynostosis. Childs Nerv Syst 2005; 21 (10) 880-888
- 17 Weber J, Collmann H, Czarnetzki A, Spring A, Pusch CM. Morphometric analysis of untreated adult skulls in syndromic and nonsyndromic craniosynostosis. Neurosurg Rev 2008; 31 (02) 179-188
- 18 Renier D, Sainte-Rose C, Marchac D, Hirsch JF. Intracranial pressure in craniostenosis. J Neurosurg 1982; 57 (03) 370-377
- 19 Agrawal D, Steinbok P, Cochrane DD. Long-term anthropometric outcomes following surgery for isolated sagittal craniosynostosis. J Neurosurg 2006; 105 (5, Suppl) 357-360
- 20 Inagaki T, Kyutoku S, Seno T. , et al. The intracranial pressure of the patients with mild form of craniosynostosis. Childs Nerv Syst 2007; 23 (12) 1455-1459
- 21 Kamdar MR, Gomez RA, Ascherman JA. Intracranial volumes in a large series of healthy children. Plast Reconstr Surg 2009; 124 (06) 2072-2075
- 22 Seruya M, Oh AK, Boyajian MJ, Posnick JC, Keating RF. Treatment for delayed presentation of sagittal synostosis: challenges pertaining to occult intracranial hypertension. J Neurosurg Pediatr 2011; 8 (01) 40-48
- 23 Smyth MD, Tenenbaum MJ, Kaufman CB, Kane AA. The “clamshell” craniotomy technique in treating sagittal craniosynostosis in older children. J Neurosurg 2006; 105 (4, Suppl) 245-251
- 24 Koizumi T, Komuro Y, Hashizume K, Yanai A. Cephalic index of Japanese children with normal brain development. J Craniofac Surg 2010; 21 (05) 1434-1437
- 25 Netherway DJ, Abbott AH, Anderson PJ, David DJ. Intracranial volume in patients with nonsyndromal craniosynostosis. J Neurosurg 2005; 103 (2, Suppl) 137-141
- 26 Sgouros S. Skull vault growth in craniosynostosis. Childs Nerv Syst 2005; 21 (10) 861-870
- 27 Mota M, Melo A, Burak C, Daltro C, Rodrigues B, Lucena R. [Anthropometric cranial measures of normal newborn]. Arq Neuropsiquiatr 2004; 62 (3A): 626-629
- 28 Di Rocco C, Massimi L. Focus Session “Changing epidemiology in pediatric neurosurgery”. Childs Nerv Syst 2009; 25 (07) 785