Pathological and non-pathological alterations in cranial shape: do they relate to impaired cognitive function?
Introduction/Context/Diagnosis
Skull shape is variable in normal humans, but certain pathological and nonpathological conditions modify these genetically programmed shapes. In achondroplasia (FGFR-3 mutation), cranial shape change and modifications to blood and CSF flow result in hindbrain/brainstem impacts, but intelligence is normal. Positional plagiocephaly, due to infants sleeping on their backs, is associated with higher rates of cognitive deficits. No studies are available on cognitive performance in people with intentional cranial deformation. Here we reconstruct arteriovenous blood flow patterns in these three conditions and assess how observed changes may impact the developing brain.
Methods/Treatment Plan
We CT-scanned a series of normal, achondroplastic, plagiocephalic, and intentionally deformed skulls (n=20, ages 1.0 y to adult). Isosurfaces were used to visualize crania, and surface models were constructed to visualize endocranial surfaces and the arteriovenous system.
Results/Outcome
People with achondroplasia have an increased neuron count and decreased apoptosis, resulting in cortical thickening. Paradoxically, arteriovenous inflow/outflow is significantly restricted in the observed cases. Internal carotid artery diameter is reduced on entering the neurocranium but then expands to ≈3-5 times the normal diameter within the cranium. Small jugular foramina restrict venous outflow while the emissary system is substantially increased. In intentional cranial deformation, similar venous changes were found but the arterial system is less impacted. In positional plagiocephaly, the arteriovenous system is impacted, with restriction of arteries entering the cranium and significant disruption of venous outflow.
Significance/Conclusions
Cranial deformations result in blood flow restriction but neurological impacts appear to differ depending on deformation type.
Location
University of the Pacific, Dugoni Dental School, San Francisco, CA
Format
Poster
Poster Session
Faculty, Student, and Staff Presentations
Pathological and non-pathological alterations in cranial shape: do they relate to impaired cognitive function?
University of the Pacific, Dugoni Dental School, San Francisco, CA
Skull shape is variable in normal humans, but certain pathological and nonpathological conditions modify these genetically programmed shapes. In achondroplasia (FGFR-3 mutation), cranial shape change and modifications to blood and CSF flow result in hindbrain/brainstem impacts, but intelligence is normal. Positional plagiocephaly, due to infants sleeping on their backs, is associated with higher rates of cognitive deficits. No studies are available on cognitive performance in people with intentional cranial deformation. Here we reconstruct arteriovenous blood flow patterns in these three conditions and assess how observed changes may impact the developing brain.
