S1-10 CLINICAL AND RADIOLOGIC CORRELATION WITH MRI TRACTOGRAPHY IN PRIMARY CRANIOSYNOSTOSIS WITH CRANIAL DECOMPRESSION

Abstract

Introduction: Several microarchitectural alterations have been described in craniosynostosis patients, due to the compresión mecanism of the pathology. We carried out this study with MRI Tractography to evaluate white brain matter and neuropsychological scales were applied before and after primary cranial decompression. Methods: Preoperative MRI Tractography was performed on 15 patients with craniosynostosis. These results were compared to different development neuropsychological tests. At 6-month postoperative tractography controls were made and compared with neupsychology test. Results: 15 patients with craniosynostosis syndromic and nonsyndromic were studied: 6 female and 9 male with average age of 17.25 months. Surgical decompression included Frontorbital advancement and anterior cranial remodeling with or without distraction, posterior decompression with or without distraction, total cranial remodeling and monoblock with distration. Preoperative neuropsychological test show delayed psychomotor development compared to standard normal population, as evidenced in differences in head position and posture, strength and limb tone and thoracic movement. This is specially detected in patients with nonsyndromic plagiocephaly. Tractography shows anisotropy in the cerebral compression sites. Post Operative tests showed better results at posture and delayed psychomotor development and conversion to isotropy of the brain cortex in tractography. Conclusion: In this study we show Tractography as a useful and objective tool to evaluate neuropsychological development and its changes with surgical decompression in craniosynostosis.