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Child's Nervous System
Published in: Child's Nervous System 11/2013

01-11-2013 | Review Paper

Craniocerebral disproportion: a topical review and proposal toward a new definition, diagnosis, and treatment protocol

Authors: Adam L. Sandler, James T. Goodrich, Lawrence B. Daniels III, Arundhati Biswas, Rick Abbott

Published in: Child's Nervous System | Issue 11/2013

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Abstract

Introduction

At some point in their lives, patients previously shunted for hydrocephalus may experience chronic, debilitating headaches, despite the fact that their shunts are functioning properly. Previously published reports have suggested that a subset of these patients may be suffering from an iatrogenic craniocerebral disproportion (CCD) and, therefore, may benefit from procedures that expand the available intracranial space. A unified definition of this disorder, however, is lacking.

Discussion

Here, the authors chart the history (including historical terminology) of CCD, review its incidence, describe its signs, symptoms, and associated radiologic findings, and expound upon its pathophysiology. Next, a concise clinical definition of CCD based on the temporal correlation of headaches with the appearance of plateau waves on intracranial pressure (ICP) monitoring is proposed. The authors conclude with a discussion of the various therapeutic strategies employed previously to treat this disorder and present their individualized treatment strategy based upon the simultaneous utilization of ICP monitors and gradual external cranial vault expansion.
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Metadata
Title
Craniocerebral disproportion: a topical review and proposal toward a new definition, diagnosis, and treatment protocol
Authors
Adam L. Sandler
James T. Goodrich
Lawrence B. Daniels III
Arundhati Biswas
Rick Abbott
Publication date
01-11-2013
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 11/2013
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-013-2257-7

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