Severity of Skull Malformation is Unrelated to Presurgery Neurobehavioral Status of Infants with Sagittal Synostosis

Abstract

Objective: To examine the association between severity of scaphocephalic skull malformation and neurodevelopmental status prior to cranioplasty. Design and Participants: Seventy-five infants with single-suture sagittal craniosynostosis (median age, 4.5 months) referred to the Infant Learning Project, a prospective, multisite, longitudinal study to evaluate neurocognitive development. Main Outcome Measures: Scaphocephaly severity indices were used to quantify synostotic skull shape from computed tomography scans. Infants were assessed with the mental (MDI) and motor scales (PDI) of the Bayley Scales of Infant Development and the receptive (PLS-AC) and expressive (PLS-EC) language scales of the Preschool Language Scale. Results: No association between skull shape and neurodevelopmental status was found. Conclusions: Lack of association between skull shape and neurodevelopment in infancy may indicate that the presurgical degree of scaphocephaly has little or no direct effect on brain development. Alternatively, such relationships, if they exist, may be evident only at older ages. Finally, it also is possible that aspects of skull malformation not measured in this study may be related to neuropsychological functioning.