title: Very Low Prevalence of Intracranial Hypertension in Trigonocephaly.
abstract: BACKGROUND
  Trigonocephaly is caused by metopic suture synostosis. It is treated by fronto-orbital remodeling, not only to correct the deformity but also to prevent intracranial hypertension, the reported prevalence in trigonocephaly of which ranges from 0 to 33 percent. To support treatment analysis and the design of a treatment protocol for intracranial hypertension in these patients, the authors wished to more accurately quantify the prevalence of preoperative and postoperative intracranial hypertension in a large patient cohort.
  
  
  METHODS
  The authors included all trigonocephaly patients born between 2001 and 2013 who had all been operated on at a single center. During follow-up, the presence of intracranial hypertension was evaluated by funduscopy, and occipitofrontal head circumference was measured. The occipitofrontal head circumference curve was analyzed and its relation to intracranial hypertension assessed.
  
  
  RESULTS
  In total, 262 patients with trigonocephaly were included. Before surgery, 1.9 percent of them had intracranial hypertension; after surgery, 1.5 percent did (mean age at last follow-up, 4.9 years). Sixteen of 176 patients (9 percent) had occipitofrontal head circumference curve stagnation, which was significantly related to intracranial hypertension (p = 0.001, Fisher's exact test).
  
  
  CONCLUSIONS
  Intracranial hypertension occurs only sporadically in patients with metopic suture synostosis. Occipitofrontal head circumference measurement should take a prominent place in the postoperative follow-up of metopic suture synostosis patients; stagnation of the occipitofrontal head circumference requires additional screening for intracranial hypertension.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Rotterdam, The Netherlands.|From the Departments of Plastic and Reconstructive Surgery and Hand Surgery, Ophthalmology, Child and Adolescent Psychiatry, and Neurosurgery, Erasmus University Medical Center.
authors.forename: Martijn J
authors.initials: MJ
authors.lastname: Cornelissen
authors.affiliation: Rotterdam, The Netherlands.|From the Departments of Plastic and Reconstructive Surgery and Hand Surgery, Ophthalmology, Child and Adolescent Psychiatry, and Neurosurgery, Erasmus University Medical Center.
authors.forename: Sjoukje E
authors.initials: SE
authors.lastname: Loudon
authors.affiliation: Rotterdam, The Netherlands.|From the Departments of Plastic and Reconstructive Surgery and Hand Surgery, Ophthalmology, Child and Adolescent Psychiatry, and Neurosurgery, Erasmus University Medical Center.
authors.forename: Frida E C
authors.initials: FEC
authors.lastname: van Doorn
authors.affiliation: Rotterdam, The Netherlands.|From the Departments of Plastic and Reconstructive Surgery and Hand Surgery, Ophthalmology, Child and Adolescent Psychiatry, and Neurosurgery, Erasmus University Medical Center.
authors.forename: Rogier P M
authors.initials: RPM
authors.lastname: Muller
authors.affiliation: Rotterdam, The Netherlands.|From the Departments of Plastic and Reconstructive Surgery and Hand Surgery, Ophthalmology, Child and Adolescent Psychiatry, and Neurosurgery, Erasmus University Medical Center.
authors.forename: Marie-Lise C
authors.initials: MC
authors.lastname: van Veelen
authors.affiliation: Rotterdam, The Netherlands.|From the Departments of Plastic and Reconstructive Surgery and Hand Surgery, Ophthalmology, Child and Adolescent Psychiatry, and Neurosurgery, Erasmus University Medical Center.
authors.forename: Irene M J
authors.initials: IMJ
authors.lastname: Mathijssen
mesh_terms: D002675:Child, Preschool; D003398:Craniosynostoses / Q000150:complications* / Q000601:surgery; D006257:Head / Q000033:anatomy & histology; D006801:Humans; D019586:Intracranial Hypertension / Q000175:diagnosis / Q000453:epidemiology*; D010211:Papilledema / Q000175:diagnosis; D015995:Prevalence