title: Papilledema in isolated single-suture craniosynostosis: prevalence and predictive factors.
abstract: The purpose of this retrospective study was to assess the prevalence of papilledema in patients with isolated craniosynostosis. Second, we wanted to assess if the presence of ventricular dilatation on computed tomography (CT) scan is a predictive factor for the occurrence of papilledema. We included 205 consecutive children with an isolated single-suture craniosynostosis, who had at least 1 fundus examination. Preoperative CT scans of the brain were examined for the presence of ventricular dilatation.Papilledema developed in 14 of 205 patients: 10 developed papilledema before surgery and 4 during the follow-up period. Ten of the patients with papilledema had a synostosis of the sagittal suture, and 4 of the metopic suture. Prevalence of papilledema in scaphocephaly was 9.7%, and in trigonocephaly, 5.6%. Based on evaluation of all CT scans, ventricular dilatation seemed not to be a predictive factor for papilledema in children with isolated craniosynostosis.The incidence of papilledema in almost 10% of scaphocephaly patients is remarkably higher than expected. Therefore, we recommend routine preoperative screening, especially for patients with scaphocephaly, but also for patients with trigonocephaly. Postoperative screening is recommended in all patients when there is any uncertainty.
authors.affiliation: Craniofacial Center, Departments of Plastic and Reconstructive Surgery, Erasmus Medical Center Rotterdam, The Netherlands. j.florisson@erasmusmc.nl
authors.forename: Joyce M G
authors.initials: JM
authors.lastname: Florisson
authors.forename: Marie-Lise C
authors.initials: ML
authors.lastname: van Veelen
authors.forename: Natalja
authors.initials: N
authors.lastname: Bannink
authors.forename: Léon N A
authors.initials: LN
authors.lastname: van Adrichem
authors.forename: Jacques J N M
authors.initials: JJ
authors.lastname: van der Meulen
authors.forename: Marjolijn C
authors.initials: MC
authors.lastname: Bartels
authors.forename: Irene M J
authors.initials: IM
authors.lastname: Mathijssen
mesh_terms: D003398:Craniosynostoses / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D010211:Papilledema / Q000000981:diagnostic imaging / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome