{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:39:21Z","timestamp":1792809561556,"version":"4.5.0"},"reference-count":25,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,2]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Shunting during infancy can precipitate premature closure of one or more cranial suture. Shunt-induced craniosynostosis (SIC) may in turn result in craniocerebral disproportion (CCD). The authors present a single-institution series and offer a pragmatic diagnostic and treatment framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This study was a retrospective case series of patients with SIC-CCD who underwent surgical correction between 2018 and 2025 at a single institution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Eighteen patients were identified. The mean (range) age at initial shunt placement was 2 (0\u20139) months, and the mean age at CCD corrective surgery was 5.6 (1.1\u201318.4) years. Eleven patients (61%) presented with headaches and 14 (78%) had one or more symptoms attributable to CCD. All patients underwent surgery for CCD: 16 underwent cranial vault expansion (12 with distractors), and 2 underwent suturectomy. Three patients required a delayed secondary salvage expansion. The mean follow-up was 3.47 (0.56\u20138.28) years. At the last follow-up, more than two-thirds of patients reported symptom improvement and all had significantly less radiographic intracranial crowding. Emergency department visits for shunt concerns and shunt revisions decreased after vault expansion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Pediatric neurosurgeons, craniofacial plastic surgeons, and neuroradiologists must maintain a high suspicion for SIC-CCD in every child that was shunted early in life. Once CCD is diagnosed, early surgical expansion is recommended. Contemporary craniofacial techniques, aided by computer-assisted surgical planning (CAS), can safely achieve meaningful intracranial volume expansion with symptomatic improvement for most patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.2.peds25547","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:01:21Z","timestamp":1790726481000},"page":"1-11","source":"Crossref","is-referenced-by-count":0,"title":["Shunt-induced craniosynostosis with craniocerebral disproportion: a new way of thinking about an old problem"],"prefix":"10.3171","author":[{"given":"Kendall","family":"Snyder","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Tennessee Health Science Center, Memphis;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Troy","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Tennessee Health Science Center, Memphis;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille","family":"Milton","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Tennessee Health Science Center, Memphis;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nir","family":"Shimony","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Tennessee Health Science Center, Memphis;"},{"name":"Semmes Murphey Clinic, Memphis;"},{"name":"Neuroscience Institute, Le Bonheur Children\u2019s Hospital, Memphis;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asim F.","family":"Choudhri","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Tennessee Health Science Center, Memphis;"},{"name":"Neuroscience Institute, Le Bonheur Children\u2019s Hospital, Memphis;"},{"name":"Department of Radiology, University of Tennessee Health Science Center, Memphis;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Evans","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, University of Tennessee Health Science Center, Memphis; and"},{"name":"Division of Plastic Surgery, Le Bonheur Children\u2019s Hospital, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Klimo","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Tennessee Health Science Center, Memphis;"},{"name":"Semmes Murphey Clinic, Memphis;"},{"name":"Neuroscience Institute, Le Bonheur Children\u2019s Hospital, Memphis;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1-2","key":"b1","series-title":"Acta Neurochir (Wien)","first-page":"89","article-title":"Overdrainage phenomena in shunt treated hydrocephalus","volume":"45","author":"Faulhauer K","year":"1978","unstructured":"Faulhauer K, Schmitz P. 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