Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026
Aplasia cutis congenita of the scalp with skull defect: an individual patient data systematic review of clinical features and treatment approaches.
СтатьяСистематический обзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Agyekum Ruth, Asiedu Kwaku Boadu, Bader Yaw Asante, Patel Krishi, Odame Nana Yaa Amoakosah, Tucker Jane, Agyekum Esther, Achempin-Ansong Percy, Darko Kwadwo, Andani Al-Hassan Dasana
Аннотация
BACKGROUND: Skull defects in aplasia cutis congenita of the scalp are rare but high-risk due to exposed underlying tissues. Because of its rarity, no clear consensus exists regarding optimal management. This study reviews published cases to evaluate clinical features, outcomes, and their relation to treatment strategies.
METHODOLOGY: A systematic review was conducted per PRISMA guidelines, including case reports and series (1970-2024) from PubMed, Scopus, Embase, Web of Science, and PsychINFO. Data were pooled and cases grouped by conservative vs. surgical management for comparison.
RESULTS: Out of 1,230 articles, 83 studies (102 patients) met inclusion. Median age at presentation was the day of birth. Majority of patients were females (51.7%). Spontaneous vaginal delivery occurred in 54.6%, with syndromic associations in 48.6%. Most lesions were solitary (88.8%), vertex-located (78.4%), and averaged 7.9 cm. Dural defects were reported in about 50%; 66.7% had exposed sagittal sinuses. Surgery was performed in 69.6% of cases, and fewer than 30% achieved full skin and bone closure. Hemorrhage and infection were the most common complications; mortality was 10.9%. Overall complications were nearly twice as frequent with surgery, though closure and mortality rates were similar. One-third of surgeries were a combination of failed conservative management, staged procedures or reoperation.
CONCLUSION: Surgical management was common but not clearly linked to better outcomes. Treatment decisions appear to be individualized and influenced by expertise and resources. Standardized reporting and prospective studies are needed to clarify associations between treatment approaches and outcomes.
METHODOLOGY: A systematic review was conducted per PRISMA guidelines, including case reports and series (1970-2024) from PubMed, Scopus, Embase, Web of Science, and PsychINFO. Data were pooled and cases grouped by conservative vs. surgical management for comparison.
RESULTS: Out of 1,230 articles, 83 studies (102 patients) met inclusion. Median age at presentation was the day of birth. Majority of patients were females (51.7%). Spontaneous vaginal delivery occurred in 54.6%, with syndromic associations in 48.6%. Most lesions were solitary (88.8%), vertex-located (78.4%), and averaged 7.9 cm. Dural defects were reported in about 50%; 66.7% had exposed sagittal sinuses. Surgery was performed in 69.6% of cases, and fewer than 30% achieved full skin and bone closure. Hemorrhage and infection were the most common complications; mortality was 10.9%. Overall complications were nearly twice as frequent with surgery, though closure and mortality rates were similar. One-third of surgeries were a combination of failed conservative management, staged procedures or reoperation.
CONCLUSION: Surgical management was common but not clearly linked to better outcomes. Treatment decisions appear to be individualized and influenced by expertise and resources. Standardized reporting and prospective studies are needed to clarify associations between treatment approaches and outcomes.