Background:
Trigonocephaly is caused by metopic suture synostosis. It is treated by fronto-orbital remodeling, not only to correct the deformity but also to prevent intracranial hypertension, the reported prevalence in trigonocephaly of which ranges from 0 to 33 percent. To support treatment analysis and the design of a treatment protocol for intracranial hypertension in these patients, the authors wished to more accurately quantify the prevalence of preoperative and postoperative intracranial hypertension in a large patient cohort.
Methods:
The authors included all trigonocephaly patients born between 2001 and 2013 who had all been operated on at a single center. During follow-up, the presence of intracranial hypertension was evaluated by funduscopy, and occipitofrontal head circumference was measured. The occipitofrontal head circumference curve was analyzed and its relation to intracranial hypertension assessed.
Results:
In total, 262 patients with trigonocephaly were included. Before surgery, 1.9 percent of them had intracranial hypertension; after surgery, 1.5 percent did (mean age at last follow-up, 4.9 years). Sixteen of 176 patients (9 percent) had occipitofrontal head circumference curve stagnation, which was significantly related to intracranial hypertension (p = 0.001, Fisher’s exact test).
Conclusions:
Intracranial hypertension occurs only sporadically in patients with metopic suture synostosis. Occipitofrontal head circumference measurement should take a prominent place in the postoperative follow-up of metopic suture synostosis patients; stagnation of the occipitofrontal head circumference requires additional screening for intracranial hypertension.

Additional Metadata
Persistent URL dx.doi.org/10.1097/PRS.0000000000002866, hdl.handle.net/1765/95240
Journal Plastic and Reconstructive Surgery
Citation
Cornelissen, M.J, Loudon, S.E, van Doorn, E.C, Muller, R.P.M. (Rogier P.M.), van Veelen-Vincent, M.L.C, & Mathijssen, I.M.J. (2017). Very Low Prevalence of Intracranial Hypertension in Trigonocephaly. Plastic and Reconstructive Surgery, 139(1), 97e–104e. doi:10.1097/PRS.0000000000002866