Does the incidence of traumatic brain injury in children increase after craniofrontal surgery?

BACKGROUND

Craniofrontal reshaping (CR) for the treatment of craniosynostosis results in a temporary cranial defect due to the advancement and/or expansion of the supraorbital and frontal bones. The goal of the present study was to determine whether the incidence traumatic brain injury (TBI) was increased in patients after CR as a result of this breach in skull integrity.

METHODS

We performed a retrospective chart review of all patients with a diagnosis of craniosynostosis who underwent CR between 1997 and 2007 at our institution. The incidence of TBI (defined as a computed tomography-documented brain or skull injury or loss of consciousness) was determined during a 2-year postoperative follow-up period. Patients older than 1 year at the time of surgery, or those with less than 2 years of follow-up after surgery, were excluded.

RESULTS

A total of 396 patients met the inclusion criteria. The incidence of TBI was zero (95% confidence interval, 0-760/100,000).

CONCLUSIONS

The estimated incidence of TBI after CR surgery is between 0 and 760 per 100,000 patients in our clinic population. These data indicate that although CR may be associated with a slightly increased risk of TBI while the skull is healing, the absolute incidence of such injury remains extremely rare.