Head Growth and Fundoscopy as Proxies for Intracranial Pressure in Metopic Synostosis Treated Surgically vs Conservatively

What are the head circumference trajectories and prevalence of signs of increased intracranial pressure (ICP) among patients with metopic synostosis treated conservatively vs surgically?In this cohort study of 209 patients, surgically treated patients showed earlier plateauing of head growth, while conservatively treated patients demonstrated steady head circumference increases over time. Signs of increased ICP were rare (1.4%-1.9%) and did not differ between the 2 groupsThese findings suggest that routine surgery may not be necessary to prevent ICP for most patients with metopic synostosis, supporting close monitoring and individualized treatment decisions.

Corresponding Author: Pauline A. E. Tio, MD, Department of Plastic and Reconstructive Surgery, Erasmus University Medical Center, Sophia’s Children’s Hospital Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands (p.tio@erasmusmc.nl).

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