Medical Minute 9-6: Stopping the Squeeze: Saving a Baby's Brain

By: Vanessa Welch Email
By: Vanessa Welch Email

Eat, cry, play, sleep, repeat! It's the life of all babies and Dylan's mom is thankful for every repetitive moment. Hard to believe just six months ago Dylan had a part of his skull removed.

"It looked like a triangle on his forehead, like a football shaped head, it was like a very thick stripe almost," said Megan Vandevrede, Dylan's Mom.

It's called craniosynostosis - it impacts one in every three thousand babies, causing the bones of an infant's skull to close prematurely - literally squeezing the baby's brain before it's fully formed. Luckily for Dylan, he was diagnosed at eight weeks old. The perfect age for a new procedure to work.

"Typically for most, you'd wait till they're 6 to 9 months old, when the skull bones are a little bit more rigid and you would do a major surgery," said Richard C. E. Anderson, M.D., St. Joseph's Children's Hospital.

Traditional surgery takes up to eight hours. Surgeons have to open the entire skull, break the bones and remold them, leaving a scar from ear to ear. Now, doctors make a tiny incision on the top of the skull, where they insert a camera to locate and remove the bone that's keeping the skull from growing. Eventually the skull will heal itself.

"Given all of the advantages, there's no question in my mind, it's the right way to go."

One downside, the babies have to wear a helmet for up to one year to help guide the shape of the skull. Dylan's head is 'shaping up' and now he's as healthy as can be.

For more information on other series produced by Ivanhoe Broadcast News contact John Cherry at (407) 691-1500, jcherry@ivanhoe.com.

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BACKGROUND: Immediately following birth, the baby’s brain undergoes an extremely rapid phase of growth and development. In order to accommodate such rapid brain growth, your baby’s skull cap must expand rapidly as well. Rather than being one single large piece of bone, his/her skull is made up of several bones which are held together by fibrous-like hinges called “sutures.” These sutures respond to brain growth by “stretching” and producing new bone, thereby allowing the skull to grow along with the underlying brain. Should any of these sutures close or fuse during early months after birth while the brain is growing, craniosynostosis occurs. The term cranial stenosis or simply synostosis are used to describe this condition. Because the brain is normal, it continues to grow at its programmed rapid rate. However, the closed suture delays proper and parallel bone growth which leads the brain to take the path of least resistance and ultimately the shape of the brain, skull and even face become distorted. ( Source: Craniostenosis.net)

SYMPTOMS: Signs of craniosynostosis include:
• A misshapen skull, with the shape depending on which of the cranial sutures are affected
• Abnormal feeling "soft spot" (fontanel) on your baby's skull
• Early disappearance of the fontanel
• Slow or no growth of head as your baby grows
Development of a raised, hard ridge along affected sutures
Increased pressure within the skull (intracranial pressure) ( Source: Mayo Clinic)

FIXING THE PROBLEM: Traditional approaches typically require a large incision across the top of the head from ear to ear, removal of a much larger amount of bone, and then reshaping and replacement of the removed bone. This surgical approach usually requires 6-8 hours, causes much more pain and swelling, requires a blood transfusion, and children remain in the hospital for about 4-7 days. The key for success using the minimally invasive endoscopic-assisted approach is to intervene early, when the bone is thin. Removal of the prematurely closed suture (the abnormal bone) when the child is between two and six months of age allows the skull to develop a more normal shape as the child grows. The use of a helmet for 6-12 months after surgery helps facilitate this bone remodeling. (Source: New York Presbyterian Hospital)

For More Information, Contact:

Liz Asani/ Public Relations
St. Joseph’s Healthcare System
asanie@sjhmc.org
(973) 754-4500


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