Plain X-ray/CT/ICP Measurement (Additional Examinations)

Figure kran_17a_n.jpg to kran_17g_n.jpg: Additional examinations in craniosynostosis include plain x-rays of the skull, CT (if necessary with reconstruction) and pre- and operative measurement of the intracranial pressures. For additional examples see clinical presentation and therapy. Figure kran_17a_n.jpg: Anteroposterior skull roentgenogram of an infant with a left coronal synostosis; notice the harlequin-like displacement of the left lateral border of the orbits in comparison to the right side, and the scoliosis concave to the left of the facial bones. Figure kran_17b_n.jpg: Lateral x-ray of the skull of the same infant with the steep position and narrowness of the left anterior skull base. Figure kran_17c_n.jpg: CT with reconstruction in an infant with functional closure of the lambdoid sutures. Notice the posteriorly tower-shaped skull. Figure kran_17d_n.jpg: CT of the same patient. Notice that mainly the right lambdoid suture is blurred and partially overbridged with bone. Also, the occipital and parietal bony defects of different sizes shown as the radiological equivalent to the palpable craniotabes. Figure kran_17e_n.jpg: Long-term registration of the lumbar CSF pressure in an infant with bilateral lambdoid synostosis; sleep induced by sedation. ICP = Lumbar CSF pressure with the mean values of 5-minute-periods in mm mercury. The basal pressure is increased, and there are episodic pressure rises. Figure kran_17f_n.jpg: One of the episodic pressure rises can be seen on the 48th to 49th minute !£kran_17f_p£!. Figure kran_17g_n.jpg: Operative registration of the subarachnoidal and of the arterial pressure in an infant with bilateral lambdoid synostosis prior to craniectomy and transposition osteotomy (to the left), and at the end of the operation prior to closure of the skin (to the right): While the arterial pressure does not change, the subarachnoidal pressure (in mm mercury) is lower, the pulse amplitude smaller, and the perfusion pressure higher (= arterial pressure minus subarachnoidal pressure).