TY  - JOUR
KW  - Science & Technology
KW  -  Life Sciences & Biomedicine
KW  -  Clinical Neurology
KW  -  Pediatrics
KW  -  Surgery
KW  -  Neurosciences & Neurology
KW  -  Apert
KW  -  Crouzon
KW  -  Intracranial pressure
KW  -  3D morphometric
KW  -  SINGLE-SUTURE
KW  -  PRESSURE
KW  -  CRANIOSYNOSTOSIS
KW  -  SURGERY
KW  -  SCANS
PB  - SPRINGER
ID  - discovery10073254
N2  - Purpose
Cranial lacunae (foci of attenuated calvarial bone) are CT equivalents of ?copper beating? seen on plain skull radiographs in children with craniosynostosis. The qualitative presence of copper beating has not been found to be useful for the diagnosis of intracranial hypertension (IH) in these patients. 3D morphometric analysis (3DMA) allows a more systematic and quantitative assessment of calvarial attenuation. We used 3DMA to examine the relationship between cranial lacunae and IH in children with Crouzon and Apert syndromic craniosynostosis.

Methods
Patients were divided into IH and non-IH groups defined on an intention-to-treat basis. Pre-operative CT scans were converted into 3D skull models and processed to quantify lacunae as a percentage of calvarium surface area (LCP). This was done on individual bone and whole skull basis.

Results
Eighteen consecutive children with Crouzon?s syndrome and 17 with Apert syndrome were identified. Median age at CT scan was 135 days (range 6?1778). Of the 35 children, 21 required surgery for IH at median age of 364 days (range 38?1710). Of these 21 children, 14 had lacunae with mean LCP of 3% (0?28%). Of the 14 non-IH children, 8 had lacunae with mean LCP of 2% (0?8%). LCP was not significantly different between IH and non-IH groups. Parietal bones were most likely to show lacunae (IH 14/21, non-IH 9/14), followed by occipital (IH 8/21, non-IH 3/14), and frontal (IH 6/21, non-IH 2/14).

Conclusion
Results suggest that cranial lacunae, measured using quantitative 3DMA, do not correlate with IH, in agreement with evidence from qualitative plain skull radiograph studies.
EP  - 507
AV  - public
Y1  - 2019/03/01/
TI  - Lack of association of cranial lacunae with intracranial hypertension in children with Crouzon syndrome and Apert syndrome: a 3D morphometric quantitative analysis
A1  - Mondal, A
A1  - Rodriguez-Florez, N
A1  - O'Hara, J
A1  - Ong, J
A1  - Jeelani, NUO
A1  - Dunaway, DJ
A1  - James, G
JF  - Child's Nervous System
SN  - 1433-0350
UR  - https://doi.org/10.1007/s00381-019-04059-6
N1  - This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
IS  - 3
VL  - 35
SP  - 501
ER  -