Protecting baby Aaron's Brain - Research summary

BACKGROUND: A baby's skull is made up of five bones connected by sutures, or fibrous joints, which allow for brain growth. In a healthy baby, the sutures remain open for as long as the brain grows, but if they close prematurely it is referred to as craniosynostosis. The birth defect affects about one out of every 2,000 babies. According to the National Institute of Neurological Disorders and Stoke (NINDS), closure of one suture is most common. When the brain does grow, the skull responds to the cranial pressure by expanding the areas where the sutures have not fused, leading to a misshapen head, or craniostenosis. Craniosynostosis may be genetic or occur as a result of metabolic diseases like rickets or hyperthyroidism. Other times, it is a result of microcephaly, a condition where the head is abnormally small, or hydrocephalus, where cerebrospinal fluid builds up in the brain. According to Samuel Rhee, M.D., a plastic surgeon and craniofacial surgeon at Weill Medical College of Cornell University in New York, N.Y., if left untreated, it could cause serious brain damage.

TREATMENT: The only treatment for craniosynostosis is surgery. In the traditional technique, a surgeon cuts a baby's skull from one ear, over the top of the head, to the other ear. The tissue is peeled back and almost the entire skull bone is removed. Multiple cuts are made in the bone, which is then reassembled and placed back on the baby to heal. Unfortunately, with this surgery also comes a risk of infection, blood loss, and brain or eye damage. Babies receive a large amount of intensive care. Most of the babies also require blood transfusions, which they may develop reactions to.

Some doctors are now performing a minimally invasive surgery to treat craniosynostosis. The surgery is performed very early in life -- sometimes even in the first month or two. Instead of exposing the skull, a small incision is made on the top of the head and the area that has fused is removed. Following surgery, the baby wears a small helmet for a couple of months to help ensure the head shape will continue to grow normally. The new procedure is significantly shorter compared to the traditional surgery. It takes only about an hour while the traditional can last up to eight hours.

The first long-term study found the minimally invasive technique to be just as successful at treating craniosynostosis. The study, done by a researcher at the University of Missouri, followed 78 patients who had the procedure in the last 10 years and showed the children were developing normally, with good facial features. Because the incision is smaller, Dr. Rhee says recovery is faster. "We are reducing the amount of blood loss tremendously, so none of these patients really have required blood transfusions, and they recover more quickly and go home much faster," he explained.

FOR MORE INFORMATION, PLEASE CONTACT:

Weill Cornell Medical College
http://www.cornellphysicians.com/strhee/index.html
http://www.cornellsurgery.org/patients/healthcraniosynostosis.html