Isolated Post-Shunt Metopic Synostosis and Neural Tube Defects.

Title

Isolated Post-Shunt Metopic Synostosis and Neural Tube Defects.

Creator

Abouhassan William; Chao John Kuang; Murthy Ananth S

Publisher

The Journal of craniofacial surgery

Date

2018
2018-07

Description

BACKGROUND: Craniosynostosis is an uncommon complication after shunting procedures for congenital hydrocephalus. We report a case of a child with myelomeningocele and normocephaly at the time of birth. She underwent ventricular shunting for Chiari malformation and hydrocephalus at 3 days of age. An immediate postoperative CT scan confirmed all sutures were open. Serial CT scans document an open metopic suture at 2 months, closed metopic suture at 5 months, and trigonocephaly at 11 months with concomitant slit ventricle syndrome, and collapsed lateral and third ventricles. METHODS: An Ovid MEDLINE search within the dates of 1948 through 2017, using the keywords "synostosis AND shunt" was carried out. A tabulation of all patients and their respective synostosis patterns were recorded. RESULTS: We identified 8 case series and 2 case reports during 43 years (1966-2017). Seventy-eight patients with 79 suture synostosis patterns were identified (one patient underwent a second cranial reconstruction for identification of a separate, newly formed synostosis). Eighteen (30.5%) cases were associated with a neural tube defect (NTD). Patients with NTD and secondary craniosynostosis had on average earlier age of shunt placement (P = 0.001), craniosynostosis presentation (P = 0.146), and cranioplasty (P = 0.325) than secondary craniosynostosis patients without NTD. CONCLUSIONS: Ventricular shunt drainage in treating hydrocephalus rarely may lead to early synostosis and cranial deformity, especially in patients with NTDs. Early shunt placement poses significant risk in patients with NTD. Close follow-up may be necessary to evaluate overdrainage and cranial deformity after shunting procedures.

Subject

Arnold-Chiari Malformation/complications/*surgery; Craniosynostoses/*etiology; Female; Humans; Hydrocephalus/complications/congenital/*surgery; Infant; Meningomyelocele/complications/*surgery; Newborn; Postoperative Complications/*etiology; Slit Ventricle Syndrome/etiology; Third Ventricle; Ventriculoperitoneal Shunt/*adverse effects

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

e492–e497

Issue

5

Volume

29

Citation

Abouhassan William; Chao John Kuang; Murthy Ananth S, “Isolated Post-Shunt Metopic Synostosis and Neural Tube Defects.,” NEOMED Bibliography Database, accessed May 7, 2021, https://neomed.omeka.net/items/show/4413.

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