gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

Ultrasound in Craniosynostosis

Meeting Abstract

  • Lutz Schreiber - Department of Neurosurgery, Sana-Kliniken Duisburg, Duisburg, Deutschland
  • Ameer Alyeldien - Department of Neurosurgery, Sana-Kliniken Duisburg, Duisburg, Deutschland
  • Catharina Junghans - Department of Neurosurgery, Sana-Kliniken Duisburg, Duisburg, Deutschland
  • Axel Feldkamp - Department of Pediatrics, Sana-Kliniken Duisburg, Duisburg, Deutschland
  • Martin Scholz - Department of Neurosurgery, Sana-Kliniken Duisburg, Duisburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMi.27.05

doi: 10.3205/17dgnc556, urn:nbn:de:0183-17dgnc5561

Published: June 9, 2017

© 2017 Schreiber et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: Craniosynostosis is a premature pathologic ossification of one or several sutures of the skull. The timing of normal closure of the cranial sutures varies according to the anatomical place of the suture. This physiological process ends normally between the 6th and the 18th month of life. A child with a premature ossification of the sutures suffers a pathologic growth of the skull with a restricted growth in some areas and compensatory bossing in other areas. This pathological process leads to abnormal shapes of the skull depending upon the site and timing of the abnormally fused suture. An increasing intracranial pressure is another well-known but rare complication which is discussed in craniosynostosis. A surgical treatment is necessary for functional as well as cosmetic reasons. In the past a CT-scan or an X-ray was mandatory and was considered to be the gold standard examination to establish the diagnosis of a craniosynostosis.

Methods: Since 2013 our standard examination to diagnose a craniosynostosis has been the Ultrasound with a high-frequency Linear Probe (15 MHz, GE Healthcare). Since 2013, 46 children with craniosynostosis were operated in our department of neurosurgery. All the 46 cases underwent an ultrasound examination in the primary assessment of the cases in the out-patient clinic as well as one day preoperative to confirm the diagnosis of craniosynostosis.

Results: In comparison the diagnostic findings of ultrasonography and intraoperative findings, the ultrasonography yielded a very high accurate result. Studying all the ultrasonographic findings of the 46 cases reveals that the ossification always starts at one “trigger-point” and after a while this pathologic ossification increases. It also shows that if there is a sharp angle of the suture the suture tends to be functionally insufficient and the risk of an early ossification is high.

Conclusion: In the pediatric neurosurgery craniosynostosis is a well-known diagnosis. The high-resolution, high-frequency ultrasound is a safe, painless and fast tool that can be used in the primary assessment of the cases in the out-patient clinic. It is possible to establish a diagnosis of craniosynostosis with a high accuracy so it can replace the CT and the X-ray to spare an extra radiation exposure of the children.