About the operative management and post-operative neural development of patients with cloverleaf skull deformity

作者：Preuss Matthias^*; Stein Marco; Neubauer Bernd A; Schaaf Heidrun; Howaldt Hans Peter; Nestler Ulf; Christophis Petros

来源：Child's Nervous System, 2010, 26(9): 1211-1218.

DOI：10.1007/s00381-010-1114-1

• Kleeblattschadel
• Crouzon syndrome
• Craniosynostosis
• Neural development
• Electrophysiology

We present our treatment concept for cloverleaf skull deformity on the basis of two representative cases that had been presented to our multidisciplinary skull deformity board.
Perioperatively, we monitored electrophysiologic parameters with median nerve somatosensory-evoked potentials (SSEP), tibial nerve (T) SSEP, brainstem acoustic-evoked potential and flush-elicited visual-evoked potential, as well as intracranial pressure. Both patients underwent decompressive bilateral vault craniectomy, frontal and occipital reshaping at an age of four months.
Secondary fronto-orbital advancement and cranial vault reshaping was performed after maximal vault reossification was reached at an age of 8 and 12 months, respectively. Additionally, one of the patients underwent treatment of a Chiari malformation via suboccipital decompressive craniectomy and tonsillary resection, as well as ventriculoperitoneal shunting for hydrocephalus.
The patients showed nearly unrestrained neural and neurophysiological development over a follow-up period of 5 years.

• 出版日期2010-9