Increased intracranial pressure after coronal suturectomy in craniosynostotic rabbits

It has been suggested that the complications associated with intracranial h ypertension in cranio-synostotic infants may be managed with surgical relea se of the synostosed sutures. However, both postoperative increases and dec reases in intracranial pressure (ICP) have been reported in heterogeneous s amples of infants with syndromic and nonsyndromic craniosynostoses. The pre sent study tvas designed to describe longitudinal changes in ICP in a homog eneous sample of rabbits with uncorrected and corrected familial coronal su ture synostosis and compare them with age-matched normal control rabbits. F ifty-three rabbits were divided into three groups: normal rabbits (n = 28), rabbits with uncorrected bilateral coronal suture synostosis (n = 9), and rabbits with bilateral coronal suture synostosis with coronal suturectomy a t 25 days of age (n = 16). ICP was measured at 25 and 42 days of age using a Codman epidural microtransducer. Results revealed that rabbits with uncor rected craniosynostosis had significantly (P < 0.05) higher ICP at 25 days of age than normal control rabbits by approximately 86%. However, by 42 day s of age, ICP in normal rabbits increased by 75%, whereas ICP in rabbits wi th uncorrected craniosynostosis decreased by 69% over the same time. Synost otic rabbits with coronal suturectomy showed a 50% decrease in ICP immediat ely after surgical release and then followed the normal, age-related ICP pa ttern, which significantly increased by 75% at 42 days of age. Results sugg est that, in the rabbit model, the postsuturectomy rise in ICP may simply b e normal, age-related changes, although a longer follow-up will be needed t o determine the recurrence of pathological ICP. Possible multifactorial exp lanations for intracranial decompression and compensation in the craniosyno stotic rabbit model are also discussed.