FUNCTIONAL OUTCOME AFTER SURGERY FOR TRIGONOCEPHALY

The long-term mental outcome of 76 children operated on for trigonocep haly was assessed, and the factors influencing the prognosis were stud ied. Final assessment of mental development was made on children who w ere more than 3 years old and was based on the occurrence of behaviora l disturbances, learning disability, and school difficulties, and on i ntellectual efficiency. Children were graded into three groups: no abn ormality, mild abnormalities but with normal social function, and gros sly abnormal. Preoperative computed tomography scans were used to meas ure the severity of the frontal stenosis and to identify associated in tracranial abnormalities, such as agenesis of the corpus callosum, dil atation of the subdural spaces, or hydrocephalus. Associated extracran ial malformations and associated family cases were also noted. Lastly, the family setting was studied. Overall, 31.6 percent of patients had evidence of some degree of trouble. Several correlations were identif ied: mental development was worse when the frontal stenosis was severe , when cranial reconstruction was performed after 1 year of age, and w hen there were associated extracranial malformations. In addition, the family environment was found to have a major influence, but the prese nce of intracranial abnormalities did not correlate with mental develo pment.