title: Delayed intracranial hypertension after cranial vault remodeling for nonsyndromic single-suture synostosis.
abstract: OBJECTIVE
  Delayed intracranial hypertension may occur after cranial vault remodeling for synostosis and may result in visual loss and developmental delay. Delayed intracranial hypertension is relatively common in children with syndromic, multisuture synostosis, but the incidence is poorly defined in children with single-suture nonsyndromic synostosis. This study evaluates the frequency of reoperation for delayed intracranial hypertension after single-suture synostosis repair.
  
  
  METHODS
  Patients who had undergone cranial vault remodeling for nonsyndromic single-suture synostosis and were treated at a single tertiary pediatric hospital between July 2000 and December 2010 were analyzed for the occurrence of delayed intracranial hypertension and reoperation for cranial vault remodeling.
  
  
  RESULTS
  Eighty-one patients with clinical follow-up of at least 3 years were analyzed from a total of 156 consecutive patients. The average patient age at the initial operation was 9.1 months. Five (6.2%) of 81 patients presented with delayed clinical and ophthalmological signs and symptoms of intracranial hypertension following initial cranial vault reconstruction, confirmed indirectly in each case by CT findings and directly by intracranial pressure monitoring. These 5 patients underwent repeat cranial vault reconstruction.
  
  
  CONCLUSIONS
  Calvarial growth restriction and intracranial hypertension occur sporadically following primary cranial vault reconstruction for single-suture nonsyndromic cranial synostosis. In this series, delayed intracranial hypertension occurred only in male patients who underwent primary repair of isolated sagittal synostoses at an age less than or equal to 5 months.
authors.affiliation: Department of Neurological Surgery, Oregon Health & Science University, Portland, OR, USA.
authors.forename: Justin S
authors.initials: JS
authors.lastname: Cetas
authors.forename: Morad
authors.initials: M
authors.lastname: Nasseri
authors.forename: Targol
authors.initials: T
authors.lastname: Saedi
authors.forename: Anna A
authors.initials: AA
authors.lastname: Kuang
authors.forename: Nathan R
authors.initials: NR
authors.lastname: Selden
mesh_terms: D000367:Age Factors; D002675:Child, Preschool; D003393:Cranial Sutures / Q000000981:diagnostic imaging / Q000601:surgery*; D003398:Craniosynostoses / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D019586:Intracranial Hypertension / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed