Intracranial volume is normal in infants with sagittal synostosis

Abstract

Premature sagittal synostosis results in an elongated, narrow skull shape, scaphocephaly. It has been unclear whether the intracranial volume (ICV) of these children is different from that of normal children. The aim of the present study was to precisely determine the ICV in a large cohort of children with premature sagittal synostosis and to compare it to the ICV of a sex- and age-matched control group. All patients (n = 143) with isolated sagittal synostosis registered in the Göteborg Craniofacial Registry until the end of 2012 with a preoperative CT examination were identified. For each case, a sex- and age- (±30 days) matched control was identified from children who had undergone CT for post-traumatic or neurological reasons. The ICV was measured in a semi-automatic MATLAB program with functions such as region growing, watershed, and thresholding in axial CT slices. The ICV was calculated using the Cavalieri principle. The mean (± SEM) values of ICV for children with sagittal synostosis and for corresponding controls were 866 ± 13 ml and 870 ± 15 ml, respectively. The mean ages of these groups were 173 ± 8 days and 172 ± 8 days, respectively. Subgroup analysis of sex and age at CT (≤180 days and >180 days) did not reveal any differences in ICV between cases and controls. Precise determination of ICV in addition to the use of adequate controls has made it possible to conclude that children with premature isolated sagittal synostosis have a normal ICV.

Key Words:

• Sagittal synostosis
• intracranial volume
• CT

Acknowledgements

This work was supported by the Ester Åsberg-Lindberg Fund, the Centre for Clinical Research in Falun, the Wilhelm and Martina Lundgren Science Research Fund, the Anna and Edwin Berger Foundation, the Gothenburg Medical Society, and H.M. Queen Silvia Jubilee Foundation. The study was conducted according to the principles stated in the Declaration of Helsinki. It was approved by the Göteborg Ethical Committee (no. 784-11).

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.