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      La plaie cranio-cérébrale chez l'oxycéphale: quelle précaution prendre pour le traiter? Translated title: The cranio-cerebral wound in Oxycephaly: what precautions to take to treat it?

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          Abstract

          L'oxycéphalie isolée est une forme non syndromique des craniosténoses d'apparition tardive, elle est responsable d'hypertension intracrânienne insidieuse pouvant aboutir, sinon traitée précocement, à la cécité et à la débilité mentale. En général méconnue, elle peut être révélée par tout phénomène pouvant décompenser l'hypertension intracrânienne latente. Nous présentons un cas rare d'oxycéphalie révélée par un traumatisme crânien. Un jeune garçon de cinq ans s'est présenté avec une tuméfaction pariétale droite non réductible suite à une plaie cranio-cérébrale opérée à deux reprises à l’âge de trois ans puis six mois plus tard. Le bilan neuroradiologique a objectivé une hernie cérébrale avec empreintes digitiformes diffuses et une fusion des sutures crâniennes. Un bilan ophtalmologique a montré un strabisme convergent droit et un fond d’œil normal. Une chirurgie d'expansion crâniennea été réalisée. L’évolution post-opératoire était favorable. L'oxycéphalie harmonieuse peut passer inaperçue et un traumatisme crânien même bénin peut la révéler.

          Most cited references8

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          [Oxycephaly, a severe craniosynostosis. Apropos of a series of 129 cases].

          The authors analyse a series of patients with oxycephaly in order to detail the definition of this craniosynostosis and its functional prognosis. The medical records of 129 oxycephalic patients were reviewed. Skull X-rays, ophthalmologic examination, mental level assessment, intracranial pressure monitoring and CT scan were analysed. The more recent patients were also analysed by MRI. Operated on or not, the patients were followed-up, particularly as far as the mental evolution is concerned. Mean follow-up was 3 years 7 months. One third of the patients came from North Africa, where oxycephaly seems predominant. Mean age at diagnosis was 6 years. Past history of rickets was found in 15% of the patients. On X-rays, the vast majority of the patients presented with multisutural synostosis involving both coronal and sagittal sutures, and diffuse digital prints. At the first mental assessment, one third of the patients had an IQ below 80. Papilledema was found in 17%. The monitoring of intracranial pressure showed an increased pressure in almost two thirds of the patients. Sixty-four percent of the patients with increased intracranial pressure had a normal fundoscopy. Out of 16 patients explored by MRI, 12 had a Chiari I malformation. Postoperatively, all papilledemas disappeared, and the intracranial pressure returned to normal in all cases with preoperative increased intracranial pressure. The mental level seemed to stabilize, the mean postoperative IQ being strongly correlated with the preoperative level. In non-operated patients, the mental level worsened significantly. Oxycephaly is a late-appearing craniosynostosis, with a high risk of ophthalmologic and mental complications. Based on the present series, the operation seemed effective in preventing these complications.
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            Non-syndromic oxycephaly and brachycephaly: a review.

            Non-syndromic coronal synostoses oxycephaly and brachycephaly (NSCSOB) are rare. Their natural history, surgical management, and outcome are debated.
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              The treatment of craniosynostosis: indications and techniques

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                Author and article information

                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                08 October 2015
                2015
                : 22
                : 112
                Affiliations
                [1 ]Department of Neurosurgery, Hôpital des Spécialités ONO, CHU de Rabat, Rabat, Morocco
                [2 ]Mohamed V University, Rabat, Morocco
                [3 ]Medical Department of Neonatology Reanimation, The Reference National Centre of Neonatology and Nutrition of Mother and Child, Sick Child Hospital CHU de Rabat, Rabat, Morocco
                Author notes
                [& ]Corresponding author: Loubna Rifi, Department of Neurosurgery, Hôpital des Spécialités ONO, CHU de Rabat, Rabat, Morocco, Mohamed V University, Rabat, Morocco
                Article
                PAMJ-22-112
                10.11604/pamj.2015.22.112.7366
                4733489
                26848359
                f34cd5dd-dd18-4b11-9df7-657461aa8126
                © Loubna Rifi et al.

                The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 27 June 2015
                : 07 September 2015
                Categories
                Case Report

                Medicine
                oxycéphalie,plaie cranio-cérébrale,craniosténoses,oxycephaly,cranio-cerebral wound,craniosynostosis

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