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Papilledema in Isolated Single-Suture Craniosynostosis: Prevalence and Predictive Factors

Florisson, Joyce M.G. MD*; van Veelen, Marie-Lise C. MD†; Bannink, Natalja MD†; van Adrichem, Léon N.A. MD, PhD*; van der Meulen, Jacques J.N.M. MD*; Bartels, Marjolijn C. MD, PhD‡; Mathijssen, Irene M.J. MD, PhD*

Journal of Craniofacial Surgery: January 2010 - Volume 21 - Issue 1 - pp 20-24
doi: 10.1097/SCS.0b013e3181c3465e
Original Articles

The purpose of this retrospective study was to assess the prevalence of papilledema in patients with isolated craniosynostosis. Second, we wanted to assess if the presence of ventricular dilatation on computed tomography (CT) scan is a predictive factor for the occurrence of papilledema.

We included 205 consecutive children with an isolated single-suture craniosynostosis, who had at least 1 fundus examination. Preoperative CT scans of the brain were examined for the presence of ventricular dilatation.

Papilledema developed in 14 of 205 patients: 10 developed papilledema before surgery and 4 during the follow-up period. Ten of the patients with papilledema had a synostosis of the sagittal suture, and 4 of the metopic suture. Prevalence of papilledema in scaphocephaly was 9.7%, and in trigonocephaly, 5.6%. Based on evaluation of all CT scans, ventricular dilatation seemed not to be a predictive factor for papilledema in children with isolated craniosynostosis.

The incidence of papilledema in almost 10% of scaphocephaly patients is remarkably higher than expected. Therefore, we recommend routine preoperative screening, especially for patients with scaphocephaly, but also for patients with trigonocephaly. Postoperative screening is recommended in all patients when there is any uncertainty.

From the Craniofacial Center, Departments of *Plastic and Reconstructive Surgery, †Neurosurgery, and ‡Ophthalmology, Erasmus Medical Center Rotterdam, The Netherlands.

Received May 7, 2009.

Accepted for publication May 30, 2009.

Address correspondence and reprint requests to Joyce M.G. Florisson, MD, Department of Plastic, Reconstructive and Hand Surgery, Erasmus Medical Center Rotterdam, Room Ee 15.91, PO Box 2040, 3000 CA Rotterdam, The Netherlands; E-mail: j.florisson@erasmusmc.nlPlease check correspondence data if correct.

© 2010 Mutaz B. Habal, MD