S8A-15 SESSION 8A: METOPIC SYNOSTOSIS CEREBRAL BLOOD FLOW OF THE FRONTAL LOBE IN UNTREATED CHILDREN WITH TRIGONOCEPHALY VERSUS HEALTHY CONTROLS: AN ARTERIAL SPIN LABELING STUDY

Abstract

Introduction: There is an international tendency to be more selective in the indication for surgical correction of trigonocephaly. The choice for surgery is mainly based on the severity of phenotype, with little consensus for the moderate presentation. To date, little is known about cerebral blood flow (CBF) in children with unoperated trigonocephaly. The aim of this study is to determine CBF of the frontal lobe of patients with trigonocephaly to determine whether or not an abnormal CBF can serve as a threshold for surgery. Methods: A prospective cohort study of untreated patients with trigonocephaly using magnetic resonance imaging (MRI) and arterial spin labeling (ASL), determining regional CBF patterns in comparison with a sample of control subjects. These controls showed no cerebral/neurological pathology. Both subjects and controls are at the age of <1 years and sedated using CBF measurements on 3 levels of the frontal lobe bilaterally. Results: Five untreated patients with trigonocephaly and eight control patients with a mean age <1 yearswere included. There was a no difference in CBF between the frontal lobe of untreated patients with trigonocephaly (mean CBF 68.70ml/100g/min; SE 5.42) and the control group (mean CBF 67.34ml/100g/min; SE 4.42; p> 0.10). Conclusion: There is no difference in CBF of the frontal lobe between untreated patients with trigonocephaly and control subjects under the age of 1. As such, a reduced CBF is an unlikely indicator for surgery. Prospectively future studies will be conducted to include more patients with a range of phenotypic severity to further explore the impact of trigonocephaly on CBF.