Thompson D N, Malcolm G P, Jones B M, Harkness W J, Hayward R D
Craniofacial Centre, Great Ormond Street Hospital for Children, London, UK.
Pediatr Neurosurg. 1995;22(5):235-40. doi: 10.1159/000120907.
The indications for surgical correction of craniosynostosis in which there is involvement of only one of the cranial vault sutures have traditionally been based upon the cosmetic merits of the deformity alone. Whilst it is now appreciated that intracranial hypertension is commonly associated with the more complex forms of craniosynostosis, this aspect has not previously been addressed in detail among cases of single-suture craniosynostosis. This retrospective study reports our experience of overnight subdural intracranial pressure monitoring in 74 children with premature closure of a single cranial suture. A single coronal suture was involved in 37 patients, the sagittal suture in 25 and the metopic suture in 12. Intracranial pressure was raised in 13 (17%), borderline in 28 (38%) and normal in 33 (45%). Elevated intracranial pressure was seen more commonly where a midline suture was involved (sagittal or metopic) than when a single coronal suture was fused. We conclude that intracranial hypertension occurs in a significant proportion of children with single-suture craniosynostosis and suggest that this factor should be borne in mind during the initial assessment of these children so as to enable timely intervention where required and appropriate counselling of parents.
颅骨缝早闭仅累及颅顶一条缝线时，传统上手术矫正的指征仅基于畸形的美容价值。虽然现在人们认识到颅内高压通常与更复杂的颅骨缝早闭形式相关，但在单缝颅骨缝早闭病例中，这一方面以前尚未得到详细探讨。这项回顾性研究报告了我们对74例单颅缝过早闭合儿童进行过夜硬膜下颅内压监测 的经验。37例患者累及单条冠状缝，25例累及矢状缝，12例累及额缝。颅内压升高者13例（17%），临界值者２８例（38%），正常者33例（45%）。与单条冠状缝融合相比，累及中线缝（矢状缝或额缝）时颅内压升高更为常见。我们得出结论，相当一部分单缝颅骨缝早闭儿童存在颅内高压，并建议在对这些儿童进行初步评估时应考虑到这一因素，以便在需要时能够及时干预，并对家长进行适当的咨询。
