Craniosynostosis: Treatment, Cost and Side Effects

Craniosynostosis is a condition affecting infants and babies where the brain shape is not normal and subsequently brain development is also not proper. This deformity in brain shape is caused by the fuse of cranial sutures which are basically fibrous joints between the bones of the baby’s skull. It usually involves the fusion of a single cranial sutures, but in rare cases can also include the fusion of more than one suture resulting in complex craniosynostosis.

In a normal baby without craniosynostosis, these cranial sutures do not fuse together until the age of 2 years. A suture is a hinge attached to the bones of the skull by a thin layer of tissue. These sutures intersect with each other in the large soft spot known as fontanel on top of your baby’s head. Moreover, craniosynostosis can be of various types which include-sagittal, the most common type of craniosynostosis where the sagittal sutures fuses prematurely making the head appear long and elongated. In coronal craniosynostosis, there is fusion of two or one coronal sutures making the head appear flattened or short and wide. In metopic craniosynostosis the fusion of metopic sutures gives a triangular appearance to the head. Lastly, the lamboid craniosynostosis is rare among all and leads to flat head and tilting of the head. The cause of craniosynostosis is divided between nonsyndromic and syndromic. Nonsyndromic craniosynostosis does not have any definite cause as doctors have not found why the cranial sutures fuse early in some babies while syndromic craniosynostosis is caused by genetic syndrome like Apert syndrome, Pfeiffer syndrome or crouzon syndrome.

For proper treatment, diagnosis of craniosynostosis is needed which will include physical exam and imaging studies like CT (computerized tomography) scan. Rarely does genetic testing is needed. Moreover, the treatment is done by a multidisciplinary team that may include neurosurgeon, pediatric surgeon or doctor, plastic surgeon and anesthesia specialist. The treatment generally includes surgery and will depend on the type of craniosynostosis and the age of your baby. There are two types of surgeries done that opens the fused sutures to allow brain growth and relieve the intracranial pressure of the brain and also reshape the brain.

Endoscopic surgery is a minimal invasive surgery performed on babies below the age of 6 months. It is generally done in sagittal craniosynotosis or in unicoronal, bicoronal or metopic craniosynotosis. In this surgery, a light along with a camera is fitted at the end of a tube and is inserted through a small scalp incision and used to open the closed sutures to allow normal brain growth. This has minimal blood loss and requires lesser staying at the hospital. On the other hand there is the open surgery which is performed when endoscopic surgery is not suitable and the baby is more than 6 months of age. In this procedure, the surgeon makes an incision in the scalp and removes the bone of the skull and reshapes it and places it inside the brain. The skull position is held in place with plates and screws that are absorbable. This type of surgery requires a longer stay ranging from seven to eight days, at the hospital and also a blood transfusion.

Babies suffering from craniosynotosis display the following symptoms like misshapen skull, depending on the type of fusion of sutures in the brain, an abnormal feeling or disappearing fontanel of your baby’s skull, development of a raised, heard ridge along affected sutures and no development or growth of your baby’s brain. However, it should be noted that the symptoms of craniosynotosis generally appear later in life or until the baby grows to a certain age of 2 years.

Babies who do not show any of the symptoms of craniosynotosis are not eligible for the treatment. Moreover, the regular visit to your pediatrics may help you in identifying the disease.

The surgery done for the treatment of craniosynotosis has various side effects which include swelling of the eyes and face, fever, vomiting, headache, irritability and decreased alertness. Side effects aside, complex craniosynotosis with underlying syndrome causing intracranial pressure can lead to health complications and hazards like developmental delays, cognitive impairment, blindness, eye movement seizures and death in rare cases. However, the side effects and heath complications can vary widely and is treatable if noticed early by your pediatric.

As craniosynotosis occurs among babies and infants, post-treatment guidelines involves extra care and support to your baby. Depending on the surgery whether it is endoscopic or open, your baby is required to stay for 3 or 7 days in hospitals. After bringing your baby home, make sure to lay the baby on his or her back while sleeping because lying in other position may cause damage to the wounds and cause it to bleed. As far as diet is concerned it will mainly involve breast milk or formula if your baby is less than 6 months. However, if he is older than 6 months his or her diet will consist of rice, dal soup or store bought baby food. Make sure to wash the wounds as instructed by the doctor and also bath your baby normally. The most important thing to remember is that to follow up with the doctor to make post-surgery recovery smooth and easier for the baby.

The time for recovery includes hospitaliation and post-surgery revovery at home. Your child will be required to stay at the hospital for 3 to 7 days while his or her post-surgeryrevovery at home may continue for 2 to 3 months.

The surgery cost for craniosynotosis usually range from Rs.2,00,000 to Rs.4,00,000.However, medicianl charges and doctoral consultation starts from Rs.500 and go up to Rs.2000.

Yes, the results of the surgery are permanent and helps in reshaping your baby's head.

Alternative treatment for craniosynotosis usually involves helmet therapy that uses specially molded helmet to help reshape your baby's brain. This method is used only for infants who do not requiere surgery.