Neurosurgical Aspects of Craniosynostosis

Federico Di Rocco is full Professor of Neurosurgery and Chairman of the neurosurgical residency program at the University of Lyon 1 (France). He is  Chairman of the Pediatric Neurosurgical Department at the Hôpital Femme Mère Enfant of Lyon and Co-Chairman of the  of the Pediatric Neurosurgical Department at the China International Neuroscience Institute, Beijing . He is member of the Executive Board of International Society for Pediatric Neurosurgery (ISPN),  European Society for Pediatric Neurosurgery (ESPN), the Société de Neurochirurgie de Langue Française (SNCLF) and the Pediatric Committee of the Wolrd Federaion of Neurosurgical Societies (WFNS) and of the European Association of  Neurosurgical Societies  (EANS). He is currently the Director of the French National Referral Center for Craniosynostosis of Lyon, member of the European Rare Disease Network ERN-CRANIO and past Secretary of the European Society of Craniofacial Surgery (ESCFS). Prof Di Rocco is author of more than 250 articles published in peer reviewed international journals and chapters in neurosurgical textbooks. John R. W. Kestle is a pediatric neurosurgeon and clinical researcher in craniosynostosis and pediatric hydrocephalus. He trained in Neurosurgery in Toronto and in Clinical Epidemiology at McMaster University. He began his career at the University of British Columbia in 1992. In 1998, he joined the faculty at the University of Utah and Primary Children’s Hospital in Salt Lake City, where he became Professor of Neurosurgery, Chief of the Division of Pediatric Neurosurgery and Neurosurgery Residency Program Director. He has served as Treasurer and as Scientific Chair of the International Society for Pediatric Neurosurgery, Chair of the Editorial Board for the Journal of Neurosurgery:Pediatrics, and as Chair American Board of Pediatric Neurosurgery. His clinical practice focuses on hydrocephalus and craniosynostosis. His research is in craniosynostosis and hydrocephalus and he founded and Chaired the Hydrocephalus Clinical Research Network (hcrn.org) and the Synostosis Research Group (SynRG). He is currently Professor of Neurosurgery and Vice Chair, Clinical Research in the Department of Neurosurgery at the University of Utah, USA.

• I Introduction.- 1 Historical perspective on the evolution of the techniques and role of the neurosurgeon.- 2 Embryology:  Skull growth, posterior fossa growth: what is important for the neurosurgeon.- 3 Genetics of craniosynostoses : what is important for the neurosurgeon.- 4 Animal models : what is important for the neurosurgeon.- 5 Analysis of postnatal skull shape and brain growth: what is important for the neurosurgeon.- II Clinical aspects.- 6 Clinical diagnosis: what is important for the neurosurgeon.- 7 Sagittal sutures synostosis: key points for the neurosurgeons, management principles (diagnosis, surgical principles and their rationale, timing).- 8 Metopic sutures synostosis: key points for the neurosurgeons, management principles (diagnosis, surgical principles and their rationale, timing).- 9 Coronal sutures synostosis: key points for the neurosurgeons, management principles (diagnosis, surgical principles and their rationale, timing).- 10 Sphenopalatine synostosis: key points for the neurosurgeons, management principles (diagnosis, surgical principles and their rationale, timing).- 11 Lambdoid sutures synostosis: key points for the neurosurgeons, management principles (diagnosis, surgical principles and their rationale, timing).- 12 Multiple sutures synostosis: key points for the neurosurgeons management principles (diagnosis, surgical principles and their rationale, timing).- III CSF and hemodynamics alterations in craniosynostoses.- 13 Hydrocephalus.- 14 Pericerebral effusions.- 15 Cerebral perfusion in craniosynostoses           .- 16 What perfusion explorations ? US, NIRS, TCD, ASL etc.- 17 Venous anomalies and craniosynostosis.- 18 Craniocerebral disproportion and raised ICP in craniosynostoses.- 19 Cerebellar tonsils herniation in craniosynostoses. 20 Syringomyelia in craniosynostoses.- 21 Surgical indications: when is surgery necessary.- 22 Controversies in the indications for surgery (surgery vs no surgery, esthetic indication vs functional indication …).- III The multidisciplinary team and the neurosurgeon.- 23 The role of the neurosurgeon in the multidisciplinary team.- 24 Antenatal diagnosis.- 25 What to ask to the radiologist in craniosynostoses?.- 26 What to ask to the ENT in craniosynostoses?.- 27 What to ask to the ophthalmologist in craniosynostoses?.- 28 What to ask to the maxillofacial surgeon in craniosynostoses?.- 29 What to ask to the orthodontist in craniosynostoses?.- 30 What to ask to the genetist in craniosynostoses?.- 31 What to ask to the pediatrician in craniosynostoses.- 32 What to ask to the psychologist, Psychological aspects.- IV Technical aspects.- 33 Role of 3D volummetry and 3D planning.- 34 Anesthesiological issues: what the neurosurgeon should.- 35 Hemostasis and transfusion in craniosynostoses surgery.- 36 Osteotomy principles, tools and hardware presentation.- 37 Resorbable and non resorbable materials in in craniosynostoses surgery.- V Surgical procedures.- 38 Fixed Posterior vault remodeling.- 39 Posterior vault distraction.- 40 Anterior vault remodeling.- 41 Spring assisted vault remodeling.- 42 Endoscopic approaches.- 43 Role of the post-operative helmet.- 44 technical tips for surgery  in older children.- 45 Controversies in the type of surgery (What technique in which case ? the heterogeneity of the management of craniosynostoses  minimally invasive vs total vault etc ).- VI Surgical  Steps(How I do it).- 46 surgery for sagittal suture synostosis: key points for the neurosurgeons.- 47 Endoscopic.- open vault.- 48 old children.- 49 distraction.- 50 Spring.- VII surgery for metopic suture synostosis: key points for the neurosurgeons.- 51 open vault.- 52 Endoscopic-surgery for coronal suture synostosis: key points for the neurosurgeons.- 53 open vault.- 54 Endoscopic.- 55 distraction.- 56 surgery for lambdoid suture synostosis: key points for the neurosurgeons.- 57 surgery for multiple sutures synostosis: key points for the neurosurgeons (strategy and timing of the procedures).- 58 Foramen magnum decompression in craniosynostosis.- 59 role of ETV in craniosynostoses.- 60 VP shunt in craniosynostoses.- 61 Post-operative management.- VIII RESULTS.- 62 What evaluation tools in craniosynostoses ?.- 63 Mortality, morbidity and complications avoidance.- 64 Cognitive aspects and outcome.- 65 Functional results.- 66 Impact of genetics on the outcome.- 67 Quality of life.- 68 Impact of post-surgical helmet therapy on cognitive outcomes.- 60 Long Follow-up results.