Ahluwalia Ranbir, Kiely Chelsea, Foster Jarrett, Gannon Stephen, Wiseman Alyssa L, Shannon Chevis N, Bonfield Christopher M
1Surgical Outcomes Center for Kids, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee.
2Florida State University College of Medicine, Tallahassee, Florida.
J Neurosurg Pediatr. 2020 Jan 31;25(5):514-518. doi: 10.3171/2019.12.PEDS19651. Print 2020 May 1.
The authors sought to assess the prevalence and severity of positional posterior plagiocephaly (PPP) in the pediatric population at a tertiary care center.
The authors conducted a retrospective review of 1429 consecutive patients aged 2 months to 18 years who presented with head trauma and a negative CT scan in 2018. The cohort was stratified by age. The cranial vault asymmetry index (CVAI) was calculated at the superior orbital rim. Asymmetry was categorized according to the following CVAI scores: mild (3.5%-7%), moderate (7%-12%), and severe (> 12%). Patients were grouped by age to assess PPP at different stages of head development: group 1, 2-5 months; group 2, 6-11 months; group 3, 12-23 months; group 4: 2-4 years; group 5, 5-8 years; group 6, 9-12 years; and group 7, 13-18 years. Patients with a history of shunted hydrocephalus, craniosynostosis, skull surgery, or radiographic evidence of intracranial trauma were excluded.
The overall cohort prevalence of PPP was 24.8% (354 patients). PPP prevalence was higher among younger patients from groups 1-3 (40.4%, 33.5%, and 0.8%, respectively). There was a continued decline in PPP by age in groups 4-7 (26.4%, 20%, 20%, and 10.8%, respectively). Mild cranial vault asymmetry was noted most often (78.0%, 276 patients), followed by moderate (19.5%, 69 patients) and severe (2.5%, 9 patients). There were no patients in group 6 or 7 with severe PPP.
PPP is prevalent in pediatric populations and most commonly presents as a case of mild asymmetry. Although there was an overall decline of PPP prevalence with increasing age, moderate asymmetry was seen in all age groups. No patients in the cohort had severe asymmetry that persisted into adolescence.
作者试图评估一家三级医疗中心儿科人群中体位性后斜头畸形（PPP）的患病率和严重程度。
作者对2018年连续收治的1429例年龄在2个月至18岁之间、因头部外伤就诊且CT扫描结果为阴性的患者进行了回顾性研究。该队列按年龄分层。在上眼眶缘计算颅穹不对称指数（CVAI）。根据以下CVAI评分对不对称情况进行分类：轻度（3.5%-7%）、中度（7%-12%）和重度（>12%）。按年龄对患者进行分组，以评估头部发育不同阶段的PPP：第1组，2-5个月；第2组，6-11个月；第3组，12-23个月；第4组：2-4岁；第5组，5-8岁；第6组，9-12岁；第7组，13-18岁。排除有分流性脑积水、颅缝早闭、颅骨手术史或颅内创伤影像学证据的患者。
PPP的总体队列患病率为24.8%（354例患者）。第1-3组较年轻患者中的PPP患病率较高（分别为40.4%、33.5%和0.8%）。在第4-7组中，PPP患病率随年龄持续下降（分别为26.4%、20%、20%和10.8%）。最常观察到轻度颅穹不对称（78.0%，276例患者），其次是中度（19.5%，69例患者）和重度（2.5%，9例患者）。第6组或第7组中没有重度PPP患者。
PPP在儿科人群中很普遍，最常见的表现是轻度不对称。尽管随着年龄增长，PPP患病率总体呈下降趋势，但在所有年龄组中均可见中度不对称。该队列中没有患者存在持续至青春期的重度不对称。
