title: Analysis of pre- and post-operative symptoms of patients with mild trigonocephaly using several developmental and psychological tests.
abstract: OBJECTIVE
  Over the past decade, we collected the cases where patients underwent decompressive cranioplasty for the treatment of mild metopic suture synostosis (mild trigonocephaly) with developmental delays. To evaluate the effectiveness of this surgery, we administered several developmental and psychological examinations to children with this condition who underwent decompressive cranioplasty.
  
  
  METHODS
  Thirty-four children (32 boys and 2 girls) who had developmental disorders with mild trigonocephaly underwent four different tests at three different time points (pre-operation, 3 and 6 months after surgery) including the: (a) Kyoto form developmental test (2001) to calculate the developmental quotient (DQ), (b) National Rehabilitation Center Sign-Significance Test (NRC S-S test) to evaluate the patients' language use and acquisition, (c) Pervasive Developmental Disorders Autism Society Japan Rating Scale (PARS) to identify autistic tendencies, and (d) Japanese Child Behavior Checklist (J-CBCL) to evaluate behavioral problems. The scores were initially analyzed using analyses of variance. When significant results were observed, Tukey-Kramer multiple comparison tests were applied for further statistical evaluation.
  
  
  RESULTS
  Significant DQ improvements were observed, as assessed by the Kyoto form developmental test. Additionally, significant improvement in the expression of words (measured with the NRC S-S test), the scores on PARS, and some behavioral factors (measured with the J-CBCL) were observed.
  
  
  CONCLUSIONS
  The results in this cohort suggest that decompressive cranioplasty may play an important role in supporting the improvement of developmental delays in these patients.
authors.affiliation: Department of Neurosurgery, Okinawa Pref. Nanbu Medical Center and Children's Medical Center, 901-1193, 118-1 Arakawa Haebaru, Okinawa, Japan, trigono.research@gmail.com.
authors.forename: Takeyoshi
authors.initials: T
authors.lastname: Shimoji
authors.forename: Daisuke
authors.initials: D
authors.lastname: Tominaga
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Shimoji
authors.forename: Masaichi
authors.initials: M
authors.lastname: Miyajima
authors.forename: Kumiko
authors.initials: K
authors.lastname: Tasato
mesh_terms: D000704:Analysis of Variance; D002675:Child, Preschool; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D015331:Cohort Studies; D003398:Craniosynostoses / Q000601:surgery*; D056424:Decompressive Craniectomy / Q000379:methods*; D002658:Developmental Disabilities / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007223:Infant; D007427:Intracranial Pressure / Q000502:physiology; D008279:Magnetic Resonance Imaging; D008297:Male; D011581:Psychological Tests; D015898:Tomography Scanners, X-Ray Computed; D016896:Treatment Outcome