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Neurocognitive Outcomes In Postoperative Craniosynostosis Patients
Adam H. Junn, BS, Aaron S. Long, BS, Sacha C. Hauc, MPH, Jean C. Rivera, BS, Alexandra Junn, AB, John A. Persing, MD, Michael Alperovich, MD, MSc.
Yale University, New Haven, CT, USA.

PURPOSE: Craniosynostosis has been associated with a variety of neurocognitive deficits. This is the largest cohort of postoperative craniosynostosis patients to undergo formal neurocognitive testing at school age.
METHODS: Patients diagnosed with sagittal, metopic, and coronal synostosis completed age-normalized intelligence quotient (IQ) and visuomotor skills tests between 2016 - 2021. Associations between synostosis sub-type and IQ, VMI scores, age at surgery, age at testing, sex, race, breastfeeding, premature birth, and parental education were evaluated using ANOVA for continuous variables and chi-square tests for categorical variables.
RESULTS: 210 patients completed neurocognitive testing (166 sagittal, 28 metopic, 16 coronal). 118 (56%) of the cohort was male, and 162 (77%) were White. The mean IQ was 107.95 14.53. The mean ages at surgery and testing were 7.49 9.14 months and 172.27 119.83 months, respectively. Sagittal craniosynostosis patients had higher scores in every testing category than metopic craniosynostosis patients, with significant differences in visuomotor integration (100.52 13.19 vs 94.00 12.57, p = 0.015), and visual perception (103.39 12.13 vs 98.25 10.32, p = 0.04). There were no significant differences between groups in terms of age at surgery, age at testing, parental education level, prematurity, and sex.
CONCLUSION: Compared to patients with sagittal synostosis, those with metopic synostosis exhibited lower visuomotor integration and visual perception scores after surgical correction. This suggests that the frontal constriction due to premature fusion of the metopic suture may have lasting impacts on visuomotor function.


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