Elevated intracranial pressure prevalence reaches 38% to 43% in children with single-suture craniosynostosisNew Data Shows Elevated Pressure Risk in Children with Craniosynostosis

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery Published August 16, 2026 Study authors: Gülsuna Beste, Patel Parth, Kharbat Abdurrahman F, Chen Sixia, Machiorlatti Michael, Jea Andrew, Sad… PubMed ↗ DOI ↗ Editorial oversight: Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic

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Key Takeaway

Note that elevated intracranial pressure is prevalent in single-suture craniosynostosis regardless of suture type or timing.

This meta-analysis evaluated the prevalence of elevated intracranial pressure (ICP) in children with isolated single-suture craniosynostosis (SSC). The analysis included 720 children to determine how measurement modalities, suture types, and timing influenced ICP detection.

The study found a pooled prevalence of elevated ICP was 38% when using invasive monitoring (95% CI, 26-51%) and 43% when using optical coherence tomography (OCT) (95% CI, 28-61%). The combined prevalence across modalities was reported as 39% (95% CI, 30-50%). Analysis of suture types showed a range from 33% for metopic to 43% for sagittal sutures, but this difference was not statistically significant (p=0.89). Additionally, intraoperative measurements showed a higher prevalence of 52% compared to 34% for preoperative measurements, though this did not reach statistical significance (p=0.13).

A noted limitation is that meta-regression explained only 11.7% of the between-study variance. Clinically, these findings suggest that noninvasive screening tools like OCT may be useful for identifying patients at risk for elevated ICP before surgery.

How this fits prior evidence

This meta-analysis addresses a gap in understanding the prevalence of intracranial pressure in children with isolated single-suture craniosynostosis. While previous coverage focused on motor delay prevalence in children with craniosynostosis, this study provides specific data on ICP prevalence using both invasive and noninvasive (OCT) methods to identify at-risk patients.

This meta-analysis looked at the prevalence of elevated intracranial pressure (ICP) in 720 children diagnosed with isolated single-suture craniosynostosis. The study used two different ways to check for high pressure: invasive monitoring and a noninvasive method called optical coherence tomography (OCT).

Researchers found that about 38% of children showed elevated pressure during invasive monitoring, while 43% showed it during OCT testing. When looking at the results together, the overall prevalence was about 39%. The study also looked at whether specific suture types or the timing of the test changed these numbers. While some differences were noted between different tests and timings, they were not considered statistically significant.

Because this is a meta-analysis of existing data, it shows a link between the condition and pressure levels rather than proving a direct cause. These findings suggest that noninvasive tools like OCT could help doctors better identify children at risk for high pressure before surgery. You should speak with a specialist to understand what these numbers mean for a specific diagnosis.

What this means for you:

Nearly 40% of children with certain skull suture conditions may have elevated intracranial pressure.

Common questions

How common is high pressure in children with this condition?

The study found a combined prevalence of approximately 39% for elevated intracranial pressure in children with isolated single-suture craniosynostosis. This was based on data from 720 children across different testing methods.

Is there a difference between suture types?

The study compared metopic and sagittal sutures. While the reported numbers were 33% for metopic and 43% for sagittal, the researchers found no statistically significant difference between the two types.

Does the timing of the test change the results?

The study compared preoperative and intraoperative testing. While more cases were identified during surgery (52%) compared to before surgery (34%), this difference was not statistically significant.

Study Details

Study typeMeta analysis

Sample sizen = 720

EvidenceLevel 1

PublishedAug 2026

PMID42570024

View Original Abstract ↓

OBJECTIVE: Elevated intracranial pressure (ICP) in isolated single-suture craniosynostosis (SSC) may contribute to neurodevelopmental impairment, yet reported prevalence varies widely. This systematic review and meta-analysis estimate the pooled prevalence of elevated ICP in isolated SSC and evaluate potential modifiers including suture subtype, measurement timing, and assessment modality. METHODS: PubMed, MEDLINE, Embase, Web of Science, and Scopus were searched (inception to February 2026). Eligible studies reported ICP outcomes in children with isolated SSC using invasive monitoring or optical coherence tomography (OCT). Pooled prevalence was estimated using random-effects meta-analysis with Freeman-Tukey transformation, stratified by measurement modality (invasive vs. OCT). Subgroup analyses evaluated suture type and measurement timing. Heterogeneity was explored through meta-regression and sensitivity analyses. RESULTS: Seventeen studies (720 patients; 1982-2025) met inclusion criteria. All invasive studies applied a uniform ≥ 15 mmHg threshold; OCT studies used four distinct retinal nerve fiber layer algorithms approximating this threshold. Pooled prevalence was 38% (95% CI, 26-51%; I = 77.0%) by invasive monitoring (13 studies; n = 448) and 43% (95% CI, 28-61%; I = 83.8%) by OCT (4 studies; n = 272). The combined estimate was 39% (95% CI, 30-50%). By suture type, prevalence ranged from 33% (metopic) to 43% (sagittal) without significant differences (p = 0.89). Intraoperative studies yielded higher prevalence than preoperative (52% vs. 34%; p = 0.13). Meta-regression explained only 11.7% of between-study variance. CONCLUSIONS: Elevated ICP is reported in a substantial proportion of children with isolated SSC, although prevalence estimates vary considerably based on diagnostic methodology and timing of assessment. Across included studies, pooled estimates ranged between 30-50%. Noninvasive screening, such as OCT, may aid adequate detection in at-risk patients. Standardized ICP thresholds and longitudinal neurocognitive studies are needed to guide management and optimize outcomes.

Elevated intracranial pressure prevalence reaches 38% to 43% in children with single-suture craniosynostosisNew Data Shows Elevated Pressure Risk in Children with Craniosynostosis

How this fits prior evidence

Common questions

Study Details

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Elevated intracranial pressure prevalence reaches 38% to 43% in children with single-suture craniosynostosisNew Data Shows Elevated Pressure Risk in Children with Craniosynostosis

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Common questions

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