Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery最新文献

{"title":"Endoscopic management of unilateral coronal synostosis: impact on the fronto-orbital growth.","authors":"Mark R Proctor, Diya Desai, John G Meara","doi":"10.1007/s00381-026-07397-4","DOIUrl":"10.1007/s00381-026-07397-4","url":null,"abstract":"<p><p>Unilateral coronal synostosis (UCS) is a disorder in which one of the six major cranial sutures are fused and can affect either the left or right side of the skull. Its clinical effects are quite significant, based on the degree of asymmetry it causes both in the cranium as well as the subcranial skull base and facial features, as well as significant ocular concerns. Open cranial vault reconstruction, often referred to as frontal orbital advancement, has long been considered the standard of care for the treatment of this condition. However, most experienced clinicians understand that it is imperfect because its effect on the facial features and ophthalmologic complications is variable, and the forehead symmetry seems to regress over time. Based on the work of Jimenez and Barone endoscopic release of the fused coronal suture has become an alternative treatment option, augmented by adjuvant care in the form of a helmet, springs, or distractors. In this review article, we discuss the relative outcomes on forehead and facial symmetry of the minimally invasive procedure as compared to the open procedure based on our experience with over 130 surgical cases of UCS, our direct detailed analysis of 60 cases, and review of the literature.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurocritical factors associated with mortality and functional recovery in pediatric trauma patients admitted to a tertiary PICU.","authors":"Beyza Nur Mert Bakal, Selman Kesici, Izzet Turkalp Akbasli, Merve Kasikci Cavdar, Benan Bayrakci","doi":"10.1007/s00381-026-07403-9","DOIUrl":"10.1007/s00381-026-07403-9","url":null,"abstract":"<p><strong>Purpose: </strong>To identify early neuroprognostic factors associated with functional neurological outcome in pediatric trauma patients requiring PICU admission. The primary outcome was Glasgow Outcome Scale (GOS) at discharge and 6 months; secondary outcomes were in-hospital mortality and brain death.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 425 consecutive pediatric trauma admissions to a tertiary PICU from June 2014 to December 2021. Demographics, mechanisms of injury, admission severity scores (GCS, PRISM III, PTS), cranial CT findings, early laboratory markers, and key interventions were analyzed. Factors independently associated with mortality were assessed using multivariable logistic regression, and discrimination was evaluated with receiver operating characteristic analyses.</p><p><strong>Results: </strong>Median age was 78 months and 64.2% were male. Falls and traffic accidents were the most common mechanisms. Overall mortality was 7.3% and was predominantly attributable to severe traumatic brain injury (29 of 31 deaths). Brain death occurred in 4.5%. At discharge, 349 of 425 patients (82.1%) had a good neurological outcome (GOS 4-5), whereas 76 (17.9%) had a poor outcome (GOS 1-3), including 31 in-hospital deaths (GOS 1). Among 394 hospital survivors, 6-month follow-up was available for 377 (95.7%); of these, 364 (96.6%) achieved good recovery and 13 (3.4%) had persistent poor outcomes. Among survivors with a poor outcome at discharge and available follow-up, 25 of 38 (65.8%) improved to a good outcome by six months. Seventeen survivors were lost to follow-up. Poor outcome (GOS 1 to 3) was associated with low admission GCS, cerebral edema or midline shift, and early physiologic stress including hyperglycemia and elevated lactate. Factors independently associated with mortality were inotropic support (OR 6.98), blood product administration (OR 6.52), albumin administration (OR 3.69), cerebral edema (OR 3.59), and admission GCS 8 or less (OR 6.82). PRISM III and PTS showed strong discrimination.</p><p><strong>Conclusion: </strong>In critically injured children, early neurological compromise and systemic instability that are identifiable during initial stabilization were the strongest factors associated with mortality and functional recovery, supporting neurofocused risk stratification and timely escalation of care.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148475682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetics versus environment in the pathophysiology of sagittal synostosis.","authors":"Valentina De Gregorio, Domiziano D Tosi, Alessia Vita, Martina Salvati, Luca Massimi, Gianpiero Tamburrini, Federica Tiberio, Wanda Lattanzi","doi":"10.1007/s00381-026-07396-5","DOIUrl":"10.1007/s00381-026-07396-5","url":null,"abstract":"<p><strong>Purpose: </strong>This systematic review aims to provide an updated overview of the relative contribution of germline genetic and environmental factors to the pathophysiology of sagittal craniosynostosis (sCS).</p><p><strong>Methods: </strong>Using the PubMed database in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, relevant studies addressing genetic and/or environmental determinants of sCS in paediatric patients were systematically reviewed.</p><p><strong>Results: </strong>A total of 1238 records were identified, of which 97 studies met inclusion criteria after full-text review. Overall, 25,877 patients were included, with 11,086 diagnosed with sCS (42.8%). Germline genetic variants potentially associated with craniosynostosis were reported in 251 patients, accounting for 12.6% of genetically tested individuals with sCS. Identified variants were distributed across 125 genes, with recurrent findings in 25 genes. Environmental and perinatal factors were more consistently reported across large population-based and case-control studies. Frequently associated factors included male sex, advanced maternal age, maternal smoking, thyroid dysfunction, fertility treatments, foetal constraint, prematurity, and abnormal birth weight, although effect sizes varied across studies.</p><p><strong>Conclusion: </strong>Identifiable germline genetic causes appear to account for only a minority of sCS cases, whereas epidemiological evidence suggests that environmental and perinatal influences may also contribute to disease pathogenesis. Nevertheless, most cases lack identifiable germline mutations in key signalling pathways, and the available evidence does not support either genetic or environmental factors as individually deterministic drivers of disease development. Overall, the evidence synthesized in this review supports a multifactorial model for sCS, in which rare genetic susceptibility and non-genetic influences likely interact in the etiopathogenesis of the condition rather than reflecting a single dominant aetiology. However, heterogeneity across studies, differences in genetic testing methodologies, potential bias in exposure assessment, and the limited availability of integrative analyses restrict definitive conclusions regarding the relative contribution of these factors.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond seizures: understanding adaptive functioning in drug-resistant epilepsy in patients undergoing palliative surgery.","authors":"Ana Valeria Duarte Oliveira, Hélio Rubens Machado, Úrsula Thomé, Geisa de Angelis, João Pereira Leite, Ana Paula Hamad, Américo Ceiki Sakamoto, Tonicarlo Rodrigues Velasco","doi":"10.1007/s00381-026-07398-3","DOIUrl":"10.1007/s00381-026-07398-3","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate clinical predictors of adaptive functioning in pediatric patients with drug-resistant epilepsy (DRE) and the impact of corpus callosotomy and vagus nerve stimulation (VNS) using the Vineland Adaptive Behavior Scales (VABS) during long-term follow-up.</p><p><strong>Methods: </strong>This retrospective observational cohort study included 37 pediatric patients with DRE who underwent callosotomy (n = 24) or VNS (n = 13) at the Ribeirão Preto Epilepsy Surgery Program, University of São Paulo, between 2007 and 2018. Adaptive functioning was assessed using the VABS at three time points: preoperative, postoperative I (mean 25 months), and postoperative II (mean 51 months). Seizure outcomes were classified according to the Engel scale. Statistical analyses included analysis of variance, Pearson correlation, linear regression, and a general linear model for repeated measures.</p><p><strong>Results: </strong>All patients presented adaptive delay preoperatively, with discrepancies between chronological age and age-equivalent scores. Postoperatively, seizure reduction occurred in 70.2% of patients, with most achieving Engel class II-III outcomes. A reduction in antiseizure medication use was observed in 43.2% of patients. Adaptive functioning declined at the first postoperative assessment but gradually improved over time, particularly among patients with better seizure control. Statistical analyses demonstrated significant effects of postoperative time and seizure outcomes on adaptive functioning, with greater improvements in patients with favorable seizure control (F = 4.183; p = 0.024).</p><p><strong>Significance: </strong>Palliative surgical procedures for pediatric DRE are safe and associated with seizure reduction, decreased medication burden, and gradual improvement in adaptive functioning. Early surgical intervention may help minimize developmental decline and improve long-term adaptive outcomes.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148475644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally invasive tubular lumbar microdiscectomy in pediatric patients: a single-center case series.","authors":"Nick De Oliveira, Sam Kavarana, Jim Rogers, Elise Yoon, Stephen Gannon, Christopher M Bonfield","doi":"10.1007/s00381-026-07399-2","DOIUrl":"10.1007/s00381-026-07399-2","url":null,"abstract":"<p><strong>Purpose: </strong>Minimally invasive tubular lumbar microdiscectomy (MIS-MCD) is used for lumbar disc herniation (LDH) in adults, but pediatric data remain limited. This study aimed to evaluate clinical presentation, perioperative outcomes, and recovery patterns after MIS-MCD, and to explore risk factors for reherniation and reoperation in a pediatric cohort.</p><p><strong>Methods: </strong>We performed a retrospective case series of consecutive pediatric patients undergoing primary single-level MIS-MCD for LDH from 2014-2024 at a tertiary center by a single surgeon. Patients with primarily traumatic, neoplastic, or infectious pathology were excluded. Primary outcomes included early symptom improvement, return to activities, reherniation, and reoperation. Risk factors for reherniation were explored using Fisher's exact tests.</p><p><strong>Results: </strong>Thirty-four patients were included (mean age 16.7 ± 1.7 years; 55.9% male; mean BMI 30.6 ± 7.4 kg/m2). Most participated in organized sports (58.9%), with sport/exertional mechanisms being the most common identifiable cause (41.2%). Congenital spinal stenosis (CSS) was present in 20.6%. Mean symptom-to-surgery interval was 9.2 ± 8.3 months. Length of stay was 0.5 ± 0.6 days, median blood loss was 15 mL, and no durotomies occurred. Initial symptom improvement was reported by 94.1%, and 79.4% returned to prior activities. Over a median follow-up of 20.4 months, reherniation occurred in 8 patients (23.5%) and reoperation in 6 (17.6%). Reherniation was significantly associated with CSS (62.5% vs. 7.7%; p < 0.001). All reoperations were repeat MIS-MCD; none required fusion.</p><p><strong>Conclusion: </strong>MIS-MCD is safe and effective in pediatric patients. Reherniation is concentrated in patients with CSS, suggesting preoperative canal narrowing identification may guide counseling and surveillance.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148475668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency repair of neonatal frontoethmoidal encephalocele: controlled mobilization of neonatal frontal bone flaps.","authors":"Muhammet Elveren, Yakup Caglaroglu, Ufuk Temtek, Mehmet Hakan Sahin","doi":"10.1007/s00381-026-07400-y","DOIUrl":"10.1007/s00381-026-07400-y","url":null,"abstract":"<p><strong>Background: </strong>Frontoethmoidal encephalomeningocele (FEEM) is a rare congenital malformation characterized by herniation of intracranial structures through a defect in the anterior skull base. Surgical management in the neonatal period is particularly challenging due to physiological fragility, limited surgical exposure, and the risk of cerebrospinal fluid (CSF) leakage and infection.</p><p><strong>Case report: </strong>We report a female neonate born at 37 weeks of gestation with a large FEEM involving the anterior horns of the lateral ventricles and frontobasal parenchyma herniating through the anterior skull base. Active CSF leakage developed on the first day of life, necessitating urgent surgical intervention. A bicoronal incision and bifrontal craniotomy with inferior frontal bone mobilization were performed. Taking advantage of the elasticity of neonatal bone, the frontal bone flaps were mobilized without segmentation, allowing adequate exposure of the defect. The postoperative course was uneventful, although progressive hydrocephalus required external ventricular drainage followed by ventriculoperitoneal shunt placement. At follow-up, wound healing was complete and the cosmetic outcome was satisfactory.</p><p><strong>Conclusion: </strong>This case highlights that controlled mobilization of elastic frontal bone flaps may provide adequate surgical exposure in neonatal patients requiring urgent repair and may reduce the need for additional bone segmentation.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148475650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of mechanical thrombectomy in pediatric acute ischemic stroke: a case series.","authors":"Lihe Yao, Qiang Wang, Xiaoshan Gao, Lei Li, Wei Zhang, Xuewen He, Yang Luo, Songtian Liu, Youquan Gu, Yaming Xi","doi":"10.1007/s00381-026-07393-8","DOIUrl":"10.1007/s00381-026-07393-8","url":null,"abstract":"<p><strong>Background: </strong>Although ischemic stroke in children is relatively rare, its association with large vessel occlusion (LVO) carries significant clinical consequences. Pediatric ischemic stroke remains one of the leading causes of neurological disability, often resulting in permanent neurological shortfalls of varying severity. These long-term impairments impose a significant burden on affected families and healthcare systems. Currently, no standardized clinical guidelines exist for mechanical thrombectomy in children with acute ischemic stroke due to LVO, highlighting a critical gap in pediatric stroke management.</p><p><strong>Methodology: </strong>A retrospective analysis of four pediatric cases (ages 6-15 years) was conducted, presenting with acute large vessel occlusion (LVO)-induced ischemic stroke, treated with mechanical thrombectomy at the First Hospital of Lanzhou University. Clinical outcomes were assessed using NIH Stroke Scale (NIHSS) and modified Rankin Scale (mRS) scores at 24 h and 90 days' post-procedure.</p><p><strong>Results: </strong>All four cases achieved post-thrombectomy NIHSS scores ≤ 2, indicating significant neurological recovery. At the 90-day follow-up, 100% of patients (4/4) achieved favorable mRS scores (0-2), indicating minimal to no disability and no procedural complications.</p><p><strong>Conclusions: </strong>Mechanical thrombectomy demonstrates both efficiency and safety in treating acute ischemic stroke (AIS) with large vessel occlusion (LVO) in pediatric patients. While our findings align with emerging evidence of positive outcomes, larger, multicenter studies are imperative to establish standardized protocols and expand the application of this intervention in pediatric stroke care.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148475667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient and physician perspectives on large language model generated responses about brain aneurysm.","authors":"Joon Hyeok Choi, Marcella Ruppert-Gomez, Liam M Shanahan, Steven J Staffa, Darren B Orbach, Edward R Smith, Soliman Oushy, Laura Lehman, Anna M Larson, Shivani D Rangwala, Christine Buckley, Grace Hilton, Alfred P See","doi":"10.1007/s00381-026-07392-9","DOIUrl":"10.1007/s00381-026-07392-9","url":null,"abstract":"<p><strong>Purpose: </strong>Large language models (LLMs) are becoming increasingly popular in medicine and neurosurgery. Because LLMs are not trained in specific subspecialties or diagnoses, a better understanding of the implications, effectiveness, and use of LLMs by users and clinicians is necessary. To better understand LLM's effectiveness in neurosurgery and aneurysms, we compared community and physician feedback on ChatGPT 4o and Gemini 1.5 Flash responses to frequently asked questions regarding brain aneurysms.</p><p><strong>Methods: </strong>External surveys were made available on the Brain Aneurysm Foundation page for patients and families to complete and internal surveys were distributed and completed by physicians in the department of neurosurgery at Boston Children's Hospital.</p><p><strong>Results: </strong>In the community survey assessing response usefulness and helpfulness, ChatGPT and Gemini provided different response quality despite similar AI sentiment. Clarity of procedure explanation (p = 0.04), discussion of alternative procedures (p = 0.02), and discussion of procedure risks (p = 0.01) were different. The physician survey, assessing response accuracy, safety, and helpfulness, also found differences in multiple domains. Importantly, differences were found in consistency with current medical knowledge and practice guidelines (p = 0.001), omittance of key points (p < 0.001), and amount of clinically relevant detail included (p < 0.001).</p><p><strong>Conclusion: </strong>LLMs had variable performance across several key domains, consistent with previous research. Despite the apparent advantages of ChatGPT, physician feedback highlighted the continued need for information oversight. Interestingly, community participants consistently found LLM responses to be better than physician ones, while physicians found LLM responses to be similar or somewhat worse than the one they would have provided.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148475665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid response of aggressive cranial Langerhans cell histiocytosis to combined intralesional and perilesional triamcinolone injection: a case report with video.","authors":"Jesús A Sánchez Hernández, Mónica Rivero Garvia, Gloria Moreno Madueño, José I Gutiérrez Carrasco, Javier Márquez Rivas","doi":"10.1007/s00381-026-07402-w","DOIUrl":"10.1007/s00381-026-07402-w","url":null,"abstract":"<p><p>Langerhans cell histiocytosis (LCH) is a rare myeloid neoplasm that predominantly affects bone in the pediatric population, with the skull being one of the most frequent sites of involvement. Local complications following diagnostic procedures in this context are exceptionally rare and poorly described. We report the case of a 14-year-old male with unifocal cranial LCH who developed aggressive local progression after a diagnostic biopsy, characterized by progressive bone destruction, soft tissue involvement, surgical wound dehiscence, and exposure of tumor tissue. Given the rapid evolution of the lesion and the limitations for conventional surgical management, intralesional and perilesional triamcinolone infiltration (40 mg) was performed. A prompt clinical response was observed, with a significant reduction in lesion volume within 4 days. Follow-up magnetic resonance imaging at that time demonstrated a 50-70% decrease in the soft tissue component. During subsequent follow-up, progressive skin healing and early signs of bone repair were noted. This case highlights an uncommon local complication following biopsy of pediatric cranial LCH and suggests that local corticosteroid infiltration may represent a minimally invasive and potentially useful therapeutic alternative in selected cases with aggressive local progression and limited surgical options.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148475697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term subjective patient's satisfaction and aesthetic outcomes in sagittal synostosis: a study of 488 patients operated by early, wide, open strip craniectomy.","authors":"Sapir Sadon, May Brami, Jonathan Roth, David Leshem, Shlomi Constantini","doi":"10.1007/s00381-026-07389-4","DOIUrl":"10.1007/s00381-026-07389-4","url":null,"abstract":"<p><strong>Objective: </strong>Infants with sagittal synostosis (SS) are operated upon mainly for cosmetic reasons. The patient's perception related to head shape and to scar, are mostly subjective. We therefore investigated the long term subjective results of relatively homogeneous group of children who were operated on with an early, open, and wide strip craniectomy.</p><p><strong>Methods: </strong>Single-center, retrospective study with a follow-up of 2 to 25 years. The study cohort included 488 children who underwent early, open, wide, strip craniectomy for SS at the age of 2-4 months and answered the telephone questionnaire. We interviewed the parents, assessing their perception, adding upon the children's related feelings. The questionnaire included both quantitative ratings and qualitative responses \"pearls\", and assessed aesthetic outcomes, including skull shape, scar-related concerns, and overall satisfaction. The cohort was stratified into three age groups (3-6, 6-12, and ≥ 12 years), and a comparative analysis between males and females.</p><p><strong>Results: </strong>488 patients responded to the questionnaire. There is an overall very high satisfaction with the surgery's aesthetic results. Except for one patient (1/488), all responders stated that they would undergo the surgery again. Detailed questions about head shape and the influence of the scar, show mostly minor comments that seem to improve when we compare those between 6 and 12, and those above 12 years of age. Scar-related concerns were generally mild in nature (such as local sensitivity, pruritus, or difficulty with haircuts) and did not translate into overall dissatisfaction.</p><p><strong>Conclusions: </strong>This study confirms that the long-term subjective, aesthetic results of early, wide, open and strip craniectomy of both parents and children are excellent. Despite the presence of minor aesthetic concerns, including scar-related findings, overall satisfaction remains consistently high.</p>","PeriodicalId":520587,"journal":{"name":"Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery","volume":"42 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13369719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}