title: Does the incidence of traumatic brain injury in children increase after craniofrontal surgery?
abstract: BACKGROUND
  Craniofrontal reshaping (CR) for the treatment of craniosynostosis results in a temporary cranial defect due to the advancement and/or expansion of the supraorbital and frontal bones. The goal of the present study was to determine whether the incidence traumatic brain injury (TBI) was increased in patients after CR as a result of this breach in skull integrity.
  
  
  METHODS
  We performed a retrospective chart review of all patients with a diagnosis of craniosynostosis who underwent CR between 1997 and 2007 at our institution. The incidence of TBI (defined as a computed tomography-documented brain or skull injury or loss of consciousness) was determined during a 2-year postoperative follow-up period. Patients older than 1 year at the time of surgery, or those with less than 2 years of follow-up after surgery, were excluded.
  
  
  RESULTS
  A total of 396 patients met the inclusion criteria. The incidence of TBI was zero (95% confidence interval, 0-760/100,000).
  
  
  CONCLUSIONS
  The estimated incidence of TBI after CR surgery is between 0 and 760 per 100,000 patients in our clinic population. These data indicate that although CR may be associated with a slightly increased risk of TBI while the skull is healing, the absolute incidence of such injury remains extremely rare.
authors.affiliation: Montreal Children's Hospital, McGill University Health Center, Montreal, Canada. mirko.gilardino@muhc.mcgill.ca
authors.forename: Mirko S
authors.initials: MS
authors.lastname: Gilardino
authors.forename: Shareef
authors.initials: S
authors.lastname: Jandali
authors.forename: Linton A
authors.initials: LA
authors.lastname: Whitaker
authors.forename: Scott P
authors.initials: SP
authors.lastname: Bartlett
mesh_terms: D000058:Accidental Falls; D001930:Brain Injuries / Q000209:etiology*; D015331:Cohort Studies; D006259:Craniocerebral Trauma / Q000209:etiology; D003398:Craniosynostoses / Q000601:surgery*; D005500:Follow-Up Studies; D005624:Frontal Bone / Q000601:surgery*; D006801:Humans; D007223:Infant; D020300:Intracranial Hemorrhages / Q000209:etiology; D009915:Orbit / Q000601:surgery; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D012887:Skull Fractures / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014474:Unconsciousness / Q000209:etiology