The impact of age at surgery on long-term neuropsychological outcomes in sagittal craniosynostosis

Anup Patel, Jenny F. Yang, Peter W. Hashim, Roberto Travieso, Jordan Terner, Linda C. Mayes, Paul Kanev, Charles Duncan, John Jane, Ian Pollack, Joseph E. Losee, David J. Bridgett, John A. Persing

Research output: Contribution to journalArticlepeer-review

77 Scopus citations


Background: The relationship between surgical age and long-term neuropsychological outcomes in sagittal-suture craniosynostosis remains equivocal. Wholevault cranioplasty and strip craniectomy are performed at various times in individuals with sagittal-suture craniosynostosis. This study used comprehensive neurological testing to examine the relationship between age at time of surgery and long-term neuropsychological function. Methods: Seventy sagittal-suture craniosynostosis patients who had previously undergone either whole-vault cranioplasty or strip craniectomy were examined divided into three groups: treatment before 6 months (n = 41), between 6 and 12 months (n = 21), and after 12 months (n = 8). To examine long-term cognitive functioning, participants between the ages of 5 and 25 years underwent neurodevelopmental tests to evaluate intelligence, achievement, and learning disabilities. Results: Compared with those treated between 6 and 12 months and after 12 months, patients who underwent surgery before 6 months demonstrated higher full-scale IQ (p < 0.01) and verbal IQ (p < 0.01). Patients who received surgery before 6 months also demonstrated superior abilities in word reading (p < 0.01), reading comprehension (p < 0.01), spelling (p < 0.01), and numerical operations (p < 0.05) relative to those who had surgery between 6 and 12 months old. A statistically significant higher percentage of patients treated after 6 months had one or more reading-related learning disabilities as compared with those undergoing earlier surgery. Conclusions: This study suggests that surgery before 6 months old results in improved long-term neurological outcomes. Future studies should examine how the technique of surgery impacts these neuropsychological measures.

Original languageEnglish (US)
Pages (from-to)608e-617e
JournalPlastic and reconstructive surgery
Issue number4
StatePublished - 2014
Externally publishedYes

ASJC Scopus subject areas

  • Surgery


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