Mondal, A;
Rodriguez-Florez, N;
O'Hara, J;
Ong, J;
Jeelani, NUO;
Dunaway, DJ;
James, G;
(2019)
Lack of association of cranial lacunae with intracranial hypertension in children with Crouzon syndrome and Apert syndrome: a 3D morphometric quantitative analysis.
Child's Nervous System
, 35
(3)
pp. 501-507.
10.1007/s00381-019-04059-6.
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Abstract
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.
| Type: | Article |
|---|---|
| Title: | Lack of association of cranial lacunae with intracranial hypertension in children with Crouzon syndrome and Apert syndrome: a 3D morphometric quantitative analysis |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1007/s00381-019-04059-6 |
| Publisher version: | https://doi.org/10.1007/s00381-019-04059-6 |
| Language: | English |
| Additional information: | 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. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Clinical Neurology, Pediatrics, Surgery, Neurosciences & Neurology, Apert, Crouzon, Intracranial pressure, 3D morphometric, SINGLE-SUTURE, PRESSURE, CRANIOSYNOSTOSIS, SURGERY, SCANS |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Biology and Cancer Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10073254 |
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