Early beaten-copper pattern: its long-term effect on intelligence quotients in 95 children with craniosynostosis

Author:

van der Meulen Jacques1,van der Vlugt Joris1,Okkerse Jolanda2,Hofman Bert3

Affiliation:

1. Departments of Plastic and Reconstructive Surgery and

2. Child and Adolescent Psychiatry; and

3. Netherlands Institute of Health Sciences, Erasmus Medical Center, Rotterdam, The Netherlands

Abstract

Object The aim of this study was to analyze the presence of beaten-copper patterns (BCPs) in children with craniosynostosis before 18 months of age and its association with their IQ at a later age. Methods The authors conducted a retrospective analysis of 538 cephalograms (obtained at a mean patient age of 1.16 years) from 95 patients. The BCP location and percentage of brain surface area covered were related to patient IQ scores obtained by the same psychologist using the Snijders–Oomen Nonverbal Intelligence Test–Revised, 51/2–17, and the Wechsler Preschool and Primary Scale of Intelligence–Revised. Results As much as 71.6% of patients presented with a BCP before 18 months of age (mean surface area of BCP 20.3%, 93% of patients presented with bilateral BCPs). The mean IQ was 95 ± 21.3 (range 50–136) at a mean patient age of 8.4 ± 2.59 years. There was a significant increase in the surface area covered by BCPs in the first 3 years of life (p < 0.001) and a significant difference in IQs between syndromic (30 cases, mean IQ 88.9) and nonsyndromic craniosynostosis cases (54 cases, mean IQ 98.9, p = 0.03). No significant correlation was found between IQ and the appearance of BCPs on presurgery radiographs (Pearson correlation coefficient = 0.143, p = 0.19) or their location (Spearman rank correlation coefficient = 0.091, p = 0.45). The BCPs appeared predominantly in the occipital region (41.1%). Conclusions Although the radiographic appearance of a BCP before the age of 18 months is an uncommon finding in healthy children, a craniosynostosis study group showed a preoperative BCP incidence of 71.6% and an increased incidence during the period of rapid brain expansion in the first 3 years of life. Note, however, that the presence of such a pattern had no significant long-term effect on patient intelligence levels.

Publisher

Journal of Neurosurgery Publishing Group (JNSPG)

Subject

General Medicine

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