Risk factors for developing recurrent raised intracranial pressure post cranial vault remodelling in nonsyndromic craniosynostosis in children: a systematic review protocol

Abstract

Review question/objective The objective of this review is to identify the factors associated with an increased risk for developing recurrent raised intracranial pressure in nonsyndromic children who have had previous cranial vault remodelling surgery. Inclusion criteria Types of participants This review will consider studies that include: 1. Male and female children up to the age of 18 years old who have had previous cranial vault remodelling surgery for craniosynostosis. 2. Patients diagnosed with primary, nonsyndromic craniosynostosis. 3. Patients who have undergone reoperation for signs and symptoms of raised intracranial pressure. This review will exclude studies that include: 1. Patients with any genetic abnormalities. Types of intervention(s)/phenomena of interest This review will consider studies that evaluate the factors that may be associated with increased risk for developing recurrent raised intracranial pressure, including: 1. Patient's age at the time of first surgery 2. The extent of cranial vault remodelling surgery undertaken. 3. The involvement of single or multiple sutures. 4. The specific suture involved. 5. The timing of initial suture closure (antenatal vs postnatal). Other risk factors identified during the course of the review will also be considered. Types of outcomes Recurrent raised intracranial pressure leading to repeat cranial vault operation. We will consider studies that report raised ICP by objective measures such as papilloedema which is swelling of the optic discs caused by raised ICP and/or 24 hour ICP monitoring via any intracranial pressure monitoring device.