{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T13:34:58Z","timestamp":1783776898975,"version":"3.55.0"},"reference-count":64,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECT<\/jats:title>\n                    <jats:p>Patients with syndromic and complex craniosynostosis are characterized by the premature fusion of one or more cranial sutures. These patients are at risk for developing elevated intracranial pressure (ICP). There are several factors known to contribute to elevated ICP in these patients, including craniocerebral disproportion, hydrocephalus, venous hypertension, and obstructive sleep apnea. However, the causal mechanism is unknown, and patients develop elevated ICP even after skull surgery. In clinical practice, the occipitofrontal circumference (OFC) is used as an indirect measure for intracranial volume (ICV), to evaluate skull growth. However, it remains unknown whether OFC is a reliable predictor of ICV in patients with a severe skull deformity. Therefore, in this study the authors evaluated the relation between ICV and OFC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Eighty-four CT scans obtained in 69 patients with syndromic and complex craniosynostosis treated at the Erasmus University Medical Center-Sophia Children\u2019s Hospital were included. The ICV was calculated based on CT scans by using autosegmentation with an HU threshold &lt; 150. The OFC was collected from electronic patient files. The CT scans and OFC measurements were matched based on a maximum amount of the time that was allowed between these examinations, which was dependent on age. A Pearson correlation coefficient was calculated to evaluate the correlations between OFC and ICV. The predictive value of OFC, age, and sex on ICV was then further evaluated using a univariate linear mixed model. The significant factors in the univariate analysis were subsequently entered in a multivariate mixed model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The correlations found between OFC and ICV were r = 0.908 for the total group (p &lt; 0.001), r = 0.981 for Apert (p &lt; 0.001), r = 0.867 for Crouzon-Pfeiffer (p &lt; 0.001), r = 0.989 for Muenke (p &lt; 0.001), r = 0.858 for Saethre- Chotzen syndrome (p = 0.001), and r = 0.917 for complex craniosynostosis (p &lt; 0.001). Age and OFC were significant predictors of ICV in the univariate linear mixed model (p &lt; 0.001 for both factors). The OFC was the only predictor that remained significant in the multivariate analysis (p &lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The OFC is a significant predictor of ICV in patients with syndromic and complex craniosynostosis. Therefore, measuring the OFC during clinical practice is very useful in determining which patients are at risk for impaired skull growth.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2015.2.focus14846","type":"journal-article","created":{"date-parts":[[2015,5,1]],"date-time":"2015-05-01T03:36:59Z","timestamp":1430451419000},"page":"E9","source":"Crossref","is-referenced-by-count":38,"title":["The occipitofrontal circumference: reliable prediction of the intracranial volume in children with syndromic and complex craniosynostosis"],"prefix":"10.3171","volume":"38","author":[{"given":"Bianca Francisca Maria","family":"Rijken","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Craniofacial Center,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca Kelly","family":"den Ottelander","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Craniofacial Center,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Lise Charlotte","family":"van Veelen","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurosurgery, Erasmus University Medical Center\u2013Sophia Children\u2019s Hospital, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten Hans","family":"Lequin","sequence":"additional","affiliation":[{"name":"Department of Pediatric Radiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene Margreet Jacqueline","family":"Mathijssen","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Craniofacial Center,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus14846","series-title":"J Craniofac Surg","first-page":"211","article-title":"CT-determined intracranial volume for a normal population","volume":"11","author":"Abbott","year":"2000"},{"key":"b2-focus14846","series-title":"J Craniofac Surg","first-page":"1014","article-title":"Intracranial volume measurement of metopic craniosynostosis","volume":"15","author":"Anderson","year":"2004"},{"key":"b3-focus14846","series-title":"Pediatr Neurosurg","first-page":"161","article-title":"Analysis of intracranial volume in apert syndrome genotypes","volume":"40","author":"Anderson","year":"2004"},{"key":"b4-focus14846","series-title":"J Clin Neurosci","first-page":"455","article-title":"Intracranial volume measurement of sagittal craniosynostosis","volume":"14","author":"Anderson","year":"2007"},{"key":"b5-focus14846","series-title":"J Craniofac Surg","first-page":"121","article-title":"Papilledema in patients with Apert, Crouzon, and Pfeiffer syndrome: prevalence, efficacy of treatment, and risk factors","volume":"19","author":"Bannink","year":"2008"},{"key":"b6-focus14846","series-title":"J Pediatr","first-page":"303","article-title":"Occipitofrontal head circumference\u2014an accurate measure of intracranial volume","volume":"75","author":"Bray","year":"1969"},{"key":"b7-focus14846","series-title":"Am J Dis Child","first-page":"1171","article-title":"Skull volume in infants. Methodology, normal values, and application","volume":"129","author":"Buda","year":"1975"},{"key":"b8-focus14846","series-title":"Childs Nerv Syst","first-page":"902","article-title":"Hydrocephalus in craniosynostosis: a review","volume":"21","author":"Collmann","year":"2005"},{"key":"b9-focus14846","series-title":"Plast Reconstr Surg","first-page":"1313","article-title":"Progressive postnatal craniosynostosis and increased intracranial pressure","volume":"113","author":"Connolly","year":"2004"},{"key":"b10-focus14846","series-title":"Childs Nerv Syst","first-page":"137","article-title":"Brain and ventricular volume in patients with syndromic and complex craniosynostosis","volume":"28","author":"de Jong","year":"2012"},{"key":"b11-focus14846","series-title":"Arch Dis Child","first-page":"538","article-title":"How does obstructive sleep apnoea evolve in syndromic craniosynostosis? A prospective cohort study","volume":"98","author":"Driessen","year":"2013"},{"key":"b12-focus14846","series-title":"Plast Reconstr Surg","first-page":"377","article-title":"Intracranial pressure and intracranial volume in children with craniosynostosis","volume":"90","author":"Gault","year":"1992"},{"key":"b13-focus14846","series-title":"Plast Reconstr Surg","first-page":"853","article-title":"Phenotypically unusual combined craniosynostoses: presentation and management","volume":"122","author":"Greene","year":"2008"},{"key":"b14-focus14846","series-title":"Childs Nerv Syst","first-page":"880","article-title":"Venous hypertension and craniosynostosis","volume":"21","author":"Hayward","year":"2005"},{"issue":"1 Suppl","key":"b15-focus14846","series-title":"J Neurosurg","first-page":"16","article-title":"How low can you go? Intracranial pressure, cerebral perfusion pressure, and respiratory obstruction in children with complex craniosynostosis","volume":"102","author":"Hayward","year":"2005"},{"key":"b16-focus14846","series-title":"Cleft Palate Craniofac J","first-page":"394","article-title":"Intracranial volume and whole brain volume in infants with unicoronal craniosynostosis","volume":"48","author":"Hill","year":"2011"},{"key":"b17-focus14846","series-title":"Eur J Hum Genet","first-page":"369","article-title":"Craniosynostosis","volume":"19","author":"Johnson","year":"2011"},{"key":"b18-focus14846","series-title":"Eur J Hum Genet","first-page":"39","article-title":"Saethre-Chotzen syndrome caused by TWIST 1 gene mutations: functional differentiation from Muenke coronal synostosis syndrome","volume":"14","author":"Kress","year":"2006"},{"key":"b19-focus14846","series-title":"Eur J Hum Genet","first-page":"289","article-title":"Mutation screening in patients with syndromic craniosynostoses indicates that a limited number of recurrent FGFR2 mutations accounts for severe forms of Pfeiffer syndrome","volume":"14","author":"Lajeunie","year":"2006"},{"key":"b20-focus14846","series-title":"Plast Reconstr Surg","first-page":"187","article-title":"Intracranial compartment volume changes in sagittal craniosynostosis patients: influence of comprehensive cranioplasty","volume":"126","author":"Lee","year":"2010"},{"key":"b21-focus14846","series-title":"Plast Reconstr Surg","first-page":"1162","article-title":"Raised intracranial pressure in Apert syndrome","volume":"122","author":"Marucci","year":"2008"},{"key":"b22-focus14846","series-title":"Plast Reconstr Surg","first-page":"539","article-title":"Crouzon and Apert syndromes: intracranial volume measurements before and after cranio-orbital reshaping in childhood","volume":"96","author":"Posnick","year":"1995"},{"key":"b23-focus14846","series-title":"Plast Reconstr Surg","first-page":"299","article-title":"Metopic and sagittal synostosis: intracranial volume measurements prior to and after cranio-orbital reshaping in childhood","volume":"96","author":"Posnick","year":"1995"},{"key":"b24-focus14846","series-title":"Childs Nerv Syst","first-page":"645","article-title":"Management of craniosynostoses","volume":"16","author":"Renier","year":"2000"},{"key":"b25-focus14846","series-title":"J Neurosurg","first-page":"370","article-title":"Intracranial pressure in craniostenosis","volume":"57","author":"Renier","year":"1982"},{"key":"b26-focus14846","series-title":"Clin Anat","first-page":"479","article-title":"Dependence of computed tomography volume measurements upon section thickness: an application to human dry skulls","volume":"21","author":"Sahin","year":"2008"},{"key":"b27-focus14846","series-title":"Nat Genet","first-page":"304","article-title":"Mutations in TCF12, encoding a basic helix-loop-helix partner of TWIST1, are a frequent cause of coronal craniosynostosis","volume":"45","author":"Sharma","year":"2013"},{"key":"b28-focus14846","series-title":"Plast Reconstr Surg","article-title":"Algorithm for the management of intracranial hypertension in children with syndromic craniosynostosis","author":"Spruijt","year":"2015"},{"key":"b29-focus14846","series-title":"Med Sci Monit","first-page":"MT53","article-title":"Prolonged intracranial pressure (ICP) monitoring in non-traumatic pediatric neurosurgical diseases","volume":"10","author":"Tamburrini","year":"2004"},{"key":"b30-focus14846","series-title":"Childs Nerv Syst","first-page":"269","article-title":"Subdural intracranial pressure monitoring in craniosynostosis: its role in surgical management","volume":"11","author":"Thompson","year":"1995"},{"key":"b31-focus14846","series-title":"Neurosurgery","first-page":"272","article-title":"The effectiveness of papilledema as an indicator of raised intracranial pressure in children with 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Neurosci","first-page":"455","article-title":"Intracranial volume measurement of sagittal craniosynostosis","volume":"14","author":"Anderson","year":"2007"},{"key":"b5-focus14846","series-title":"J Craniofac Surg","first-page":"121","article-title":"Papilledema in patients with Apert, Crouzon, and Pfeiffer syndrome: prevalence, efficacy of treatment, and risk factors","volume":"19","author":"Bannink","year":"2008"},{"key":"b6-focus14846","series-title":"J Pediatr","first-page":"303","article-title":"Occipitofrontal head circumference\u2014an accurate measure of intracranial volume","volume":"75","author":"Bray","year":"1969"},{"key":"b7-focus14846","series-title":"Am J Dis Child","first-page":"1171","article-title":"Skull volume in infants. 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A prospective cohort study","volume":"98","author":"Driessen","year":"2013"},{"key":"b12-focus14846","series-title":"Plast Reconstr Surg","first-page":"377","article-title":"Intracranial pressure and intracranial volume in children with craniosynostosis","volume":"90","author":"Gault","year":"1992"},{"key":"b13-focus14846","series-title":"Plast Reconstr Surg","first-page":"853","article-title":"Phenotypically unusual combined craniosynostoses: presentation and management","volume":"122","author":"Greene","year":"2008"},{"key":"b14-focus14846","series-title":"Childs Nerv Syst","first-page":"880","article-title":"Venous hypertension and craniosynostosis","volume":"21","author":"Hayward","year":"2005"},{"issue":"1 Suppl","key":"b15-focus14846","series-title":"J Neurosurg","first-page":"16","article-title":"How low can you go? Intracranial pressure, cerebral perfusion pressure, and respiratory obstruction in children with complex craniosynostosis","volume":"102","author":"Hayward","year":"2005"},{"key":"b16-focus14846","series-title":"Cleft Palate Craniofac J","first-page":"394","article-title":"Intracranial volume and whole brain volume in infants with unicoronal craniosynostosis","volume":"48","author":"Hill","year":"2011"},{"key":"b17-focus14846","series-title":"Eur J Hum Genet","first-page":"369","article-title":"Craniosynostosis","volume":"19","author":"Johnson","year":"2011"},{"key":"b18-focus14846","series-title":"Eur J Hum Genet","first-page":"39","article-title":"Saethre-Chotzen syndrome caused by TWIST 1 gene mutations: functional differentiation from Muenke coronal synostosis syndrome","volume":"14","author":"Kress","year":"2006"},{"key":"b19-focus14846","series-title":"Eur J Hum Genet","first-page":"289","article-title":"Mutation screening in patients with syndromic craniosynostoses indicates 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craniosynostosis","volume":"45","author":"Sharma","year":"2013"},{"key":"b28-focus14846","series-title":"Plast Reconstr Surg","article-title":"Algorithm for the management of intracranial hypertension in children with syndromic craniosynostosis","author":"Spruijt","year":"2015"},{"key":"b29-focus14846","series-title":"Med Sci Monit","first-page":"MT53","article-title":"Prolonged intracranial pressure (ICP) monitoring in non-traumatic pediatric neurosurgical diseases","volume":"10","author":"Tamburrini","year":"2004"},{"key":"b30-focus14846","series-title":"Childs Nerv Syst","first-page":"269","article-title":"Subdural intracranial pressure monitoring in craniosynostosis: its role in surgical management","volume":"11","author":"Thompson","year":"1995"},{"key":"b31-focus14846","series-title":"Neurosurgery","first-page":"272","article-title":"The effectiveness of papilledema as an indicator of raised intracranial pressure in children with 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