Craniocerebral disproportion

A topical review and proposal toward a new definition, diagnosis, and treatment protocol

Adam L. Sandler, James Tait Goodrich, Lawrence B. Daniels, Arundhati Biswas, Ira Richmond Abbott, III

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Introduction: At some point in their lives, patients previously shunted for hydrocephalus may experience chronic, debilitating headaches, despite the fact that their shunts are functioning properly. Previously published reports have suggested that a subset of these patients may be suffering from an iatrogenic craniocerebral disproportion (CCD) and, therefore, may benefit from procedures that expand the available intracranial space. A unified definition of this disorder, however, is lacking. Discussion: Here, the authors chart the history (including historical terminology) of CCD, review its incidence, describe its signs, symptoms, and associated radiologic findings, and expound upon its pathophysiology. Next, a concise clinical definition of CCD based on the temporal correlation of headaches with the appearance of plateau waves on intracranial pressure (ICP) monitoring is proposed. The authors conclude with a discussion of the various therapeutic strategies employed previously to treat this disorder and present their individualized treatment strategy based upon the simultaneous utilization of ICP monitors and gradual external cranial vault expansion.

Original languageEnglish (US)
Pages (from-to)1997-2010
Number of pages14
JournalChild's Nervous System
Volume29
Issue number11
DOIs
StatePublished - Nov 2013

Fingerprint

Intracranial Pressure
Clinical Protocols
Headache Disorders
Hydrocephalus
Terminology
Signs and Symptoms
Headache
Incidence
Therapeutics

Keywords

  • Craniocephalic disproportion
  • Craniocerebral disproportion
  • Hydrocephalus
  • Shunt
  • Slit ventricle syndrome

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Cite this

Craniocerebral disproportion : A topical review and proposal toward a new definition, diagnosis, and treatment protocol. / Sandler, Adam L.; Goodrich, James Tait; Daniels, Lawrence B.; Biswas, Arundhati; Abbott, III, Ira Richmond.

In: Child's Nervous System, Vol. 29, No. 11, 11.2013, p. 1997-2010.

Research output: Contribution to journalArticle

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