{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T10:52:39Z","timestamp":1787482359175,"version":"build-2736575974"},"reference-count":41,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The exact association between the frequently present anomalous intracranial venous vasculature, emissary collaterals, ventriculomegaly, and increased intracranial pressure (ICP) in children with Apert and Crouzon syndromes remains an enigma. This study aimed to evaluate the association between the aberrant venous system and ventricle size and increased ICP, and to assess the development of the venous structures over time.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>This retrospective cohort study included all patients with Apert or Crouzon syndrome with available CT venography (CTV) scans of the brain. Anomalous venous vasculature was assessed by the total collateral score (TCS), which scored 9 intra- and extracranial venous structures (TCS range 0\u201316). Ventricle size (fronto-occipital horn ratio [FOHR]) was measured on the same scan. The presence of increased ICP, a shunt, tonsillar herniation, and head circumference were extracted from electronic patient records and were used as secondary covariates. Subsequent CTV scans were scored when available.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Ninety patients were included in this study. The mean TCS was 7.5 \u00b1 2.5, and was comparable for patients with Apert and Crouzon syndromes (mean 8.0 and 7.3, respectively). The presence of an extra abnormal venous structure was associated with an increase of the FOHR of 3.2% (p &lt; 0.01). After dividing the venous structures into intra- and extracranial, a similar association between both and the FOHR was found (4.1% and 2.3%, respectively; p &lt; 0.01). The TCS was similar for patients with normal and increased ICP at the time of the scan. Sixteen patients had dual CTV scans. The median time between both scans was 3.2 years. The presence of collaterals remained stable over time (median \u0394TCS = 0.3). Seven patients with functioning shunts also maintained high TCSs (median TCS = 9).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>In patients with Apert and Crouzon syndromes, a close relationship between venous collaterals and ventricle size was observed, in which a more extensive aberrant venous drainage pattern, both intra- and extracranial, was associated with larger ventricles. Preliminary longitudinal data suggested that the presence of venous collaterals remained constant over time despite effective treatment of increased ICP, indicating reliance on these collaterals even in cases of normal ICP. The authors hypothesize that this dependence on collateral drainage is the result of their aberrant internal venous anatomy and predisposes individuals to increased ICP.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.8.peds24111","type":"journal-article","created":{"date-parts":[[2024,11,2]],"date-time":"2024-11-02T02:28:32Z","timestamp":1730514512000},"page":"1-10","source":"Crossref","is-referenced-by-count":4,"title":["Anomalous venous collaterals in Apert and Crouzon syndromes and their relationship to ventricle size and increased intracranial pressure"],"prefix":"10.3171","author":[{"given":"Iris E.","family":"Cuperus","sequence":"first","affiliation":[{"name":"Departments of Plastic and Reconstructive Surgery and Hand Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jip Y.","family":"Mulders","sequence":"additional","affiliation":[{"name":"Departments of Plastic and Reconstructive Surgery and Hand Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjolein H. G.","family":"Dremmen","sequence":"additional","affiliation":[{"name":"Radiology and Nuclear Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine A.","family":"de Planque","sequence":"additional","affiliation":[{"name":"Departments of Plastic and Reconstructive Surgery and Hand Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene M. 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Eur J Hum Genet. 2011;19(4):369\u2013376."},{"issue":"4","key":"b2","series-title":"J Neurosurg Pediatr","first-page":"469","article-title":"Raised intracranial pressure in Crouzon syndrome: incidence, causes, and management","volume":"17","author":"Abu-Sittah GS","year":"2016","unstructured":"Abu-Sittah GS, Jeelani O, Dunaway D, Hayward R. Raised intracranial pressure in Crouzon syndrome: incidence, causes, and management. J Neurosurg Pediatr. 2016;17(4):469\u2013475."},{"issue":"10","key":"b3","series-title":"J Plast Reconstr Aesthet Surg","first-page":"1635","article-title":"Long-term functional outcome in 167 patients with syndromic craniosynostosis; defining a syndrome-specific risk profile","volume":"63","author":"de Jong T","year":"2010","unstructured":"de Jong T, Bannink N, Bredero-Boelhouwer HH,  Long-term functional outcome in 167 patients with syndromic craniosynostosis; defining a syndrome-specific risk profile. J Plast Reconstr Aesthet Surg. 2010;63(10):1635\u20131641."},{"issue":"8","key":"b4","series-title":"Childs Nerv Syst","first-page":"1289","article-title":"Visual field loss in children with craniosynostosis","volume":"27","author":"Liasis A","year":"2011","unstructured":"Liasis A, Walters B, Thompson D, Smith K, Hayward R, Nischal KK. Visual field loss in children with craniosynostosis. Childs Nerv Syst. 2011;27(8):1289\u20131296."},{"issue":"4","key":"b5","series-title":"Plast Reconstr Surg","first-page":"1162","article-title":"Raised intracranial pressure in Apert syndrome","volume":"122","author":"Marucci DD","year":"2008","unstructured":"Marucci DD, Dunaway DJ, Jones BM, Hayward RD. Raised intracranial pressure in Apert syndrome. Plast Reconstr Surg. 2008;122(4):1162\u20131168."},{"issue":"10-11","key":"b6","series-title":"Childs Nerv Syst","first-page":"645","article-title":"Management of craniosynostoses","volume":"16","author":"Renier D","year":"2000","unstructured":"Renier D, Lajeunie E, Arnaud E, Marchac D. Management of craniosynostoses. Childs Nerv Syst. 2000;16(10-11):645\u2013658."},{"issue":"5","key":"b7","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 DN","year":"1995","unstructured":"Thompson DN, Harkness W, Jones B, Gonsalez S, Andar U, Hayward R. Subdural intracranial pressure monitoring in craniosynostosis: its role in surgical management. Childs Nerv Syst. 1995;11(5):269\u2013275."},{"issue":"4","key":"b8","series-title":"J Neurosurg","first-page":"575","article-title":"Chronic tonsillar herniation in Crouzon\u2019s and Apert\u2019s syndromes: the role of premature synostosis of the lambdoid suture","volume":"83","author":"Cinalli G","year":"1995","unstructured":"Cinalli G, Renier D, Sebag G, Sainte-Rose C, Arnaud E, Pierre-Kahn A. Chronic tonsillar herniation in Crouzon\u2019s and Apert\u2019s syndromes: the role of premature synostosis of the lambdoid suture. J Neurosurg. 1995;83(4):575\u2013582."},{"key":"b9","series-title":"Eur J Paediatr Neurol","first-page":"120","article-title":"Neurological deficits are present in syndromic craniosynostosis patients with and without tonsillar herniation","volume":"28","author":"Doerga PN","year":"2020","unstructured":"Doerga PN, Rijken BFM, Bredero-Boelhouwer H,  Neurological deficits are present in syndromic craniosynostosis patients with and without tonsillar herniation. 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Plast Reconstr Surg. 2015;136(2):331\u2013340."},{"issue":"7","key":"b12","series-title":"J Craniofac Surg","first-page":"1903","article-title":"What we know about intracranial hypertension in children with syndromic craniosynostosis","volume":"34","author":"Doerga PN","year":"2023","unstructured":"Doerga PN, Goederen R, van Veelen MC, Joosten KFM, Tasker RC, Mathijssen IMJ. What we know about intracranial hypertension in children with syndromic craniosynostosis. J Craniofac Surg. 2023;34(7):1903\u20131914."},{"issue":"3","key":"b13","series-title":"J Craniomaxillofac Surg","first-page":"312","article-title":"Venous hypertension in syndromic and complex craniosynostosis: the abnormal anatomy of the jugular foramen and collaterals","volume":"43","author":"Florisson JM","year":"2015","unstructured":"Florisson JM, Barmpalios G, Lequin M,  Venous hypertension in syndromic and complex craniosynostosis: the abnormal anatomy of the jugular foramen and collaterals. J Craniomaxillofac Surg. 2015;43(3):312\u2013318."},{"issue":"12","key":"b14","series-title":"Childs Nerv Syst","first-page":"1413","article-title":"Abnormal venous drainage in syndromic craniosynostosis and the role of CT venography","volume":"24","author":"Jeevan DS","year":"2008","unstructured":"Jeevan DS, Anlsow P, Jayamohan J. Abnormal venous drainage in syndromic craniosynostosis and the role of CT venography. Childs Nerv Syst. 2008;24(12):1413\u20131420."},{"issue":"1","key":"b15","series-title":"Plast Reconstr Surg Glob Open","first-page":"e1613","article-title":"Clinical significance of venous anomalies in syndromic craniosynostosis","volume":"6","author":"Copeland AE","year":"2018","unstructured":"Copeland AE, Hoffman CE, Tsitouras V,  Clinical significance of venous anomalies in syndromic craniosynostosis. Plast Reconstr Surg Glob Open. 2018;6(1):e1613."},{"issue":"3","key":"b16","series-title":"J Neurosurg","first-page":"377","article-title":"Enigma of raised intracranial pressure in patients with complex craniosynostosis: the role of abnormal intracranial venous drainage","volume":"94","author":"Taylor WJ","year":"2001","unstructured":"Taylor WJ, Hayward RD, Lasjaunias P,  Enigma of raised intracranial pressure in patients with complex craniosynostosis: the role of abnormal intracranial venous drainage. J Neurosurg. 2001;94(3):377\u2013385."},{"issue":"10","key":"b17","series-title":"Childs Nerv Syst","first-page":"880","article-title":"Venous hypertension and craniosynostosis","volume":"21","author":"Hayward R","year":"2005","unstructured":"Hayward R. Venous hypertension and craniosynostosis. Childs Nerv Syst. 2005;21(10):880\u2013888."},{"issue":"11","key":"b18","series-title":"Childs Nerv Syst","first-page":"3465","article-title":"Craniosynostosis and hydrocephalus: relevance and treatment modalities","volume":"37","author":"Frassanito P","year":"2021","unstructured":"Frassanito P, Palombi D, Tamburrini G. Craniosynostosis and hydrocephalus: relevance and treatment modalities. Childs Nerv Syst. 2021;37(11):3465\u20133473."},{"issue":"2","key":"b19","series-title":"J Neurosurg","first-page":"209","article-title":"Hydrocephalus and craniosynostosis","volume":"88","author":"Cinalli G","year":"1998","unstructured":"Cinalli G, Sainte-Rose C, Kollar EM,  Hydrocephalus and craniosynostosis. J Neurosurg. 1998;88(2):209\u2013214."},{"issue":"5","key":"b20","series-title":"J Neurosurg Pediatr","first-page":"506","article-title":"Dural sinus volume in children with syndromic craniosynostosis and intracranial hypertension","volume":"25","author":"de Goederen R","year":"2020","unstructured":"de Goederen R, Cuperus IE, Tasker RC,  Dural sinus volume in children with syndromic craniosynostosis and intracranial hypertension. J Neurosurg Pediatr. 2020;25(5):506\u2013513."},{"key":"b21","series-title":"StatPearls","article-title":"Anatomy, head and neck, emissary veins","author":"Klein BM","year":"2024","unstructured":"Klein BM, Bordoni B. Anatomy, head and neck, emissary veins. In: StatPearls. StatPearls Publishing; 2024. Accessed August 22, 2024. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK563196\/"},{"key":"b22","series-title":"Anatomy, Imaging and Surgery of the Intracranial Dural Venous Sinuses","first-page":"1","article-title":"The embryology of the dural venous sinus: an overview","author":"McBain L","year":"2020","unstructured":"McBain L, Goren O, Tubbs RS. The embryology of the dural venous sinus: an overview. In: Tubbs RS, ed. Anatomy, Imaging and Surgery of the Intracranial Dural Venous Sinuses. Elsevier; 2020:1-7."},{"key":"b23","series-title":"Anatomy, Imaging and Surgery of the Intracranial Dural Venous Sinuses","first-page":"175","article-title":"The emissary veins","author":"Schumacher M","year":"2020","unstructured":"Schumacher M, Tubbs RS. The emissary veins. In: Tubbs RS, ed. Anatomy, Imaging and Surgery of the Intracranial Dural Venous Sinuses. 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Radiology. 1992;183(2):347\u2013353."},{"key":"b27","series-title":"Am J Ophthalmol","first-page":"38","article-title":"Quantified retinal morphology and its association with papilledema and visual acuity in syndromic and complex craniosynostosis: an optical coherence tomography study","volume":"235","author":"Ottelander BKD","year":"2022","unstructured":"Ottelander BKD, Beeten SDCV, Yang S,  Quantified retinal morphology and its association with papilledema and visual acuity in syndromic and complex craniosynostosis: an optical coherence tomography study. Am J Ophthalmol. 2022;235:38\u201345."},{"issue":"5","key":"b28","series-title":"J Surg Res","first-page":"596","article-title":"FGF-1 affixation stimulates ePTFE endothelialization without intimal hyperplasia","volume":"57","author":"Gray JL","year":"1994","unstructured":"Gray JL, Kang SS, Zenni GC,  FGF-1 affixation stimulates ePTFE endothelialization without intimal hyperplasia. J Surg Res. 1994;57(5):596\u2013612."},{"issue":"1","key":"b29","series-title":"Neurosurg Rev","first-page":"305","article-title":"Transmantle and transvenous pressure gradients in cerebrospinal fluid disorders","volume":"45","author":"Castle-Kirszbaum M","year":"2022","unstructured":"Castle-Kirszbaum M, Goldschlager T. Transmantle and transvenous pressure gradients in cerebrospinal fluid disorders. Neurosurg Rev. 2022;45(1):305\u2013315."},{"issue":"8","key":"b30","series-title":"Childs Nerv Syst","first-page":"1713","article-title":"Hydrocephalus in infants: the unique biomechanics and why they matter","volume":"36","author":"Rekate HL","year":"2020","unstructured":"Rekate HL. Hydrocephalus in infants: the unique biomechanics and why they matter. Childs Nerv Syst. 2020;36(8):1713\u20131728."},{"issue":"5","key":"b31","series-title":"Neurosurgery","first-page":"571","article-title":"Skull base morphology in fibroblast growth factor receptor type 2-related faciocraniosynostosis: a descriptive analysis","volume":"76","author":"Coll G","year":"2015","unstructured":"Coll G, Arnaud E, Collet C, Brunelle F, Sainte-Rose C, Di Rocco F. Skull base morphology in fibroblast growth factor receptor type 2-related faciocraniosynostosis: a descriptive analysis. Neurosurgery. 2015;76(5):571\u2013583."},{"issue":"10","key":"b32","series-title":"Childs Nerv Syst","first-page":"902","article-title":"Hydrocephalus in craniosynostosis: a review","volume":"21","author":"Collmann H","year":"2005","unstructured":"Collmann H, S\u00f6rensen N, Krauss J. Hydrocephalus in craniosynostosis: a review. 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