Deepak Agrawal1, Paul Steinbok, D Douglas Cochrane. 1. Division of Pediatric Neurosurgery, Department of Pediatric Surgery, British Columbia's Children's Hospital, Children's and Women's Health Centre, Vancouver, BC, Canada.
Abstract
AIMS AND OBJECTIVES: Isolated sagittal synostosis can be diagnosed easily on clinical grounds. This study was designed to determine if children could be operated on based solely on a clinical diagnosis or whether such an approach would result in any potentially unnecessary surgeries. MATERIALS AND METHODS: Records of 114 consecutive children operated on for isolated nonsyndromic sagittal synostosis over a 14-year period (1987-2000) were reviewed to see whether the clinical findings were in concordance with the intraoperative findings and histopathology of the sagittal suture. RESULTS: The age at surgery ranged from 1.9 to 81.3 months (median 4.3 months). Preoperative skull radiographs were done in 78 children and computer tomography (CT) scans of the head in 12 children. One hundred percent of the skull radiographs and 83.3% of the CT scans were completed prior to referring the children to a pediatric neurosurgeon. CT scans confirmed the diagnosis in all patients in whom it was available. For the rest, pathology reports and/or operative records were available for 108 (94.7%) children and were confirmatory for sagittal craniosynostosis in all. CONCLUSIONS: Accurate diagnosis of isolated sagittal synostosis can be made clinically, and operative correction can proceed without a need for radiological investigations, unless the clinical features are not completely typical. This approach could result in significantly reduced radiation exposure for the developing brain and could provide economic benefits to health care providers.
AIMS AND OBJECTIVES:Isolated sagittal synostosis can be diagnosed easily on clinical grounds. This study was designed to determine if children could be operated on based solely on a clinical diagnosis or whether such an approach would result in any potentially unnecessary surgeries. MATERIALS AND METHODS: Records of 114 consecutive children operated on for isolated nonsyndromic sagittal synostosis over a 14-year period (1987-2000) were reviewed to see whether the clinical findings were in concordance with the intraoperative findings and histopathology of the sagittal suture. RESULTS: The age at surgery ranged from 1.9 to 81.3 months (median 4.3 months). Preoperative skull radiographs were done in 78 children and computer tomography (CT) scans of the head in 12 children. One hundred percent of the skull radiographs and 83.3% of the CT scans were completed prior to referring the children to a pediatric neurosurgeon. CT scans confirmed the diagnosis in all patients in whom it was available. For the rest, pathology reports and/or operative records were available for 108 (94.7%) children and were confirmatory for sagittal craniosynostosis in all. CONCLUSIONS: Accurate diagnosis of isolated sagittal synostosis can be made clinically, and operative correction can proceed without a need for radiological investigations, unless the clinical features are not completely typical. This approach could result in significantly reduced radiation exposure for the developing brain and could provide economic benefits to health care providers.
Authors: James E Baumgartner; Kelly Seymour-Dempsey; John F Teichgraeber; James J Xia; Amy L Waller; Jaime Gateno Journal: J Neurosurg Date: 2004-08 Impact factor: 5.115
Authors: Per Hall; Hans-Olov Adami; Dimitrios Trichopoulos; Nancy L Pedersen; Pagona Lagiou; Anders Ekbom; Martin Ingvar; Marie Lundell; Fredrik Granath Journal: BMJ Date: 2004-01-03
Authors: Kathleen A Kapp-Simon; Matthew L Speltz; Michael L Cunningham; Pravin K Patel; Tadanori Tomita Journal: Childs Nerv Syst Date: 2006-12-21 Impact factor: 1.475
Authors: Matthieu Vinchon; Philippe Pellerin; Pierre Guerreschi; Marc Baroncini; Patrick Dhellemmes Journal: Childs Nerv Syst Date: 2012-08-08 Impact factor: 1.475