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Brachycephaly

The Experts below are selected from a list of 327 Experts worldwide ranked by ideXlab platform

K H Nicolaides – 1st expert on this subject based on the ideXlab platform

  • Brachycephaly and frontal lobe hypoplasia in fetuses with trisomy 21 at 11 0 to 13 6 weeks
    Ultrasound in Obstetrics & Gynecology, 2006
    Co-Authors: M Borenstein, T Dagklis, B Csapo, Alexandros Sotiriadis, K H Nicolaides

    Abstract:

    Objective

    To investigate the incidence of Brachycephaly and frontal lobe hypoplasia in fetuses with trisomy 21 at 11 + 0 to 13 + 6 weeks of gestation.

    Methods

    A three-dimensional (3D) volume of the fetal head was obtained before fetal karyotyping at 11 + 0 to 13 + 6 (median, 12 + 5) weeks of gestation in 100 fetuses that were subsequently found to have trisomy 21 and in 300 fetuses subsequently found to be chromosomally normal. The multiplanar mode was used to obtain a sequence of transverse views of the fetal head and to demonstrate the biparietal and suboccipitobregmatic views. We measured the biparietal diameter (BPD), the occipitofrontal diameter (OFD) and the frontothalamic distance (FTD) between the inner table of the frontal bone and the posterior thalami.

    Results

    In the chromosomally normal group the BPD, OFD and FTD increased linearly with crown–rump length (CRL) from 16.7 mm, 19.0 mm and 12.1 mm at a CRL of 45 mm to 26.7 mm, 31.7 mm and 18.7 mm, respectively, at a CRL of 84 mm. In the trisomy 21 fetuses, compared to normal fetuses, there was shorter BPD (mean difference = −0.63 mm; 95% CI, −0.97 to −0.30 mm, P < 0.0001), OFD (mean difference = −1.41 mm; 95% CI, −1.75 to −1.07 mm, P < 0.0001) and FTD (mean difference = −0.77 mm; 95% CI, −1.02 to −0.54 mm; P < 0.0001) and higher BPD to OFD ratio (mean difference = 0.022; 95% CI, 0.012 to 0.032, P < 0.0001) but no significant difference in the FTD to OFD ratio (mean difference = 0.004; 95% CI, −0.006 to 0.013, P = 0.448). Conclusions In fetuses with trisomy 21 at 11 + 0 to 13 + 6 weeks of gestation there is evidence of brachycephaIy but not of frontal lobe hypoplasia. Copyright © 2006 ISUOG. Published by John Wiley & Sons, Ltd.

  • Brachycephaly and frontal lobe hypoplasia in fetuses with trisomy 21 at 11 + 0 to 13 + 6 weeks
    Ultrasound in Obstetrics & Gynecology, 2006
    Co-Authors: M Borenstein, T Dagklis, B Csapo, Alexandros Sotiriadis, K H Nicolaides

    Abstract:

    Objective

    To investigate the incidence of Brachycephaly and frontal lobe hypoplasia in fetuses with trisomy 21 at 11 + 0 to 13 + 6 weeks of gestation.

    Methods

    A three-dimensional (3D) volume of the fetal head was obtained before fetal karyotyping at 11 + 0 to 13 + 6 (median, 12 + 5) weeks of gestation in 100 fetuses that were subsequently found to have trisomy 21 and in 300 fetuses subsequently found to be chromosomally normal. The multiplanar mode was used to obtain a sequence of transverse views of the fetal head and to demonstrate the biparietal and suboccipitobregmatic views. We measured the biparietal diameter (BPD), the occipitofrontal diameter (OFD) and the frontothalamic distance (FTD) between the inner table of the frontal bone and the posterior thalami.

    Results

    In the chromosomally normal group the BPD, OFD and FTD increased linearly with crown–rump length (CRL) from 16.7 mm, 19.0 mm and 12.1 mm at a CRL of 45 mm to 26.7 mm, 31.7 mm and 18.7 mm, respectively, at a CRL of 84 mm. In the trisomy 21 fetuses, compared to normal fetuses, there was shorter BPD (mean difference = −0.63 mm; 95% CI, −0.97 to −0.30 mm, P < 0.0001), OFD (mean difference = −1.41 mm; 95% CI, −1.75 to −1.07 mm, P < 0.0001) and FTD (mean difference = −0.77 mm; 95% CI, −1.02 to −0.54 mm; P < 0.0001) and higher BPD to OFD ratio (mean difference = 0.022; 95% CI, 0.012 to 0.032, P < 0.0001) but no significant difference in the FTD to OFD ratio (mean difference = 0.004; 95% CI, −0.006 to 0.013, P = 0.448). Conclusions In fetuses with trisomy 21 at 11 + 0 to 13 + 6 weeks of gestation there is evidence of brachycephaIy but not of frontal lobe hypoplasia. Copyright © 2006 ISUOG. Published by John Wiley & Sons, Ltd.

Clare Rusbridge – 2nd expert on this subject based on the ideXlab platform

  • use of morphometric mapping to characterise symptomatic chiari like malformation secondary syringomyelia and associated Brachycephaly in the cavalier king charles spaniel
    PLOS ONE, 2017
    Co-Authors: Susan P Knowler, Chloe Cross, Sandra Griffiths, Angus Mcfadyen, Jelena Jovanovik, Anna Tauro, Zoha Kibar, C J Driver, Roberto M La Ragione, Clare Rusbridge

    Abstract:

    Objectives To characterise the symptomatic phenotype of Chiari-like malformation (CM), secondary syringomyelia (SM) and Brachycephaly in the Cavalier King Charles Spaniel using morphometric measurements on mid-sagittal Magnetic Resonance images (MRI) of the brain and craniocervical junction. Methods This retrospective study, based on a previous quantitative analysis in the Griffon Bruxellois (GB), used 24 measurements taken on 130 T1-weighted MRI of hindbrain and cervical region. Associated Brachycephaly was estimated using 26 measurements, including rostral forebrain flattening and olfactory lobe rotation, on 72 T2-weighted MRI of the whole brain. Both study cohorts were divided into three groups; Control, CM pain and SM and their morphometries compared with each other. Results Fourteen significant traits were identified in the hindbrain study and nine traits in the whole brain study, six of which were similar to the GB and suggest a common aetiology. The Control cohort had the most elliptical brain (p = 0.010), least olfactory bulb rotation (p = 0.003) and a protective angle (p = 0.004) compared to the other groups. The CM pain cohort had the greatest rostral forebrain flattening (p = 0.007), shortest basioccipital (p = 0.019), but a greater distance between the atlas and basioccipital (p = 0.002) which was protective for SM. The SM cohort had two conformation anomalies depending on the severity of craniocervical junction incongruities; i) the proximity of the dens (p <0.001) ii) increased airorhynchy with a smaller, more ventrally rotated olfactory bulb (p <0.001). Both generated `concertina' flexures of the brain and craniocervical junction. Conclusion Morphometric mapping provides a diagnostic tool for quantifying symptomatic CM, secondary SM and their relationship with Brachycephaly. It is hypothesized that CM pain is associated with increased Brachycephaly and SM can result from different combinations of abnormalities of the forebrain, caudal fossa and craniocervical junction which compromise the neural parenchyma and impede cerebrospinal fluid flow.

  • Use of Morphometric Mapping to Characterise Symptomatic Chiari-Like Malformation, Secondary Syringomyelia and Associated Brachycephaly in the Cavalier King Charles Spaniel
    PLOS ONE, 2017
    Co-Authors: Susan P Knowler, Chloe Cross, Sandra Griffiths, Angus Mcfadyen, Jelena Jovanovik, Anna Tauro, Zoha Kibar, C J Driver, Roberto M La Ragione, Clare Rusbridge

    Abstract:

    Objectives To characterise the symptomatic phenotype of Chiari-like malformation (CM), secondary syringomyelia (SM) and Brachycephaly in the Cavalier King Charles Spaniel using morphometric measurements on mid-sagittal Magnetic Resonance images (MRI) of the brain and craniocervical junction. Methods This retrospective study, based on a previous quantitative analysis in the Griffon Bruxellois (GB), used 24 measurements taken on 130 T1-weighted MRI of hindbrain and cervical region. Associated Brachycephaly was estimated using 26 measurements, including rostral forebrain flattening and olfactory lobe rotation, on 72 T2-weighted MRI of the whole brain. Both study cohorts were divided into three groups; Control, CM pain and SM and their morphometries compared with each other. Results Fourteen significant traits were identified in the hindbrain study and nine traits in the whole brain study, six of which were similar to the GB and suggest a common aetiology. The Control cohort had the most elliptical brain (p = 0.010), least olfactory bulb rotation (p = 0.003) and a protective angle (p = 0.004) compared to the other groups. The CM pain cohort had the greatest rostral forebrain flattening (p = 0.007), shortest basioccipital (p = 0.019), but a greater distance between the atlas and basioccipital (p = 0.002) which was protective for SM. The SM cohort had two conformation anomalies depending on the severity of craniocervical junction incongruities; i) the proximity of the dens (p

Brent R Collett – 3rd expert on this subject based on the ideXlab platform

  • motor function in school aged children with positional plagiocephaly or Brachycephaly
    Pediatric Physical Therapy, 2020
    Co-Authors: Brent R Collett, Michael L Cunningham, Deborah Kartin, Erin R Wallace, Matthew L Speltz

    Abstract:

    OBJECTIVE: To determine whether children with a history of positional plagiocephaly/Brachycephaly (PPB) show persistent deficits in motor development. METHODS: In a longitudinal cohort study, we completed follow-up assessments with 187 school-aged children with PPB and 149 participants without PPB who were originally enrolled in infancy. Primary outcomes were the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition (BOT-2) composite scores. RESULTS: Children with PPB scored lower than controls on the BOT-2. Stratified analyses indicated that differences were restricted to children who had moderate-severe PPB. No consistent differences were observed in children who had mild PPB. CONCLUSION: Children who had moderate-severe PPB in infancy show persistent differences in motor function. We suggest close developmental monitoring and early intervention to address motor deficits.

  • helmet therapy for positional plagiocephaly and Brachycephaly
    BMJ, 2014
    Co-Authors: Brent R Collett

    Abstract:

    Negligible treatment effects in the first randomized evaluation

    Positional plagiocephaly and Brachycephaly affects approximately 20% of infants and is the most common reason for referral in many craniofacial centers.1 2 This reflects an increase in the incidence of the condition after several countries implemented public health campaigns that encouraged parents to position their babies in a supine position for sleep to prevent sudden infant death syndrome. The advent and marketing of orthotic treatments for positional plagiocephaly and Brachycephaly has also likely increased awareness of plagiocephaly among parents and medical professionals. Although the persistence and implications of infant skull deformities are unclear, often parents are concerned about outcomes for their child and are motivated to participate in treatment. Previous studies showed improvements in head shape after orthotic treatment3; however, until the study by van Wijk and colleagues (doi:10.1136/bmj.g2741) published …

  • longitudinal three dimensional analysis of head shape in children with and without deformational plagiocephaly or Brachycephaly
    The Journal of Pediatrics, 2012
    Co-Authors: Brent R Collett, Carrie L Heike, Indriyati Atmosukarto, Jacqueline R Starr, Michael L Cunningham, Matthew L Speltz

    Abstract:

    Objectives To assess 3-dimensional (3D) changes in head shape in infancy and at age 18 months in children with and without plagiocephaly or Brachycephaly. Study design Using a longitudinal design, we evaluated head shape using 3D surface imaging. We compared the head shapes of children with (1) diagnosed deformational plagiocephaly or Brachycephaly (cases; n = 233); (2) unaffected controls, with no evidence of dysmorphology (n = 167); and (3) affected controls, who despite having no previous diagnosis demonstrated skull dysmorphology on 3D surface imaging (n = 70). Results Cases had greater skull flattening and asymmetry than unaffected controls at both time points, as did controls with skull dysmorphology. In all groups, head shapes became less flat and more symmetric over time. Among cases, symmetry improved slightly more for those who received orthotic treatment. Conclusions Although head shape improves over time for children with deformational plagiocephaly or Brachycephaly, skull dysmorphology persists relative to unaffected controls. Further research is needed to clarify the extent to which these differences are detectable to clinicians and lay observers.