Page 174 - Demo

172Chapter10GROWTHMAPSThemostimportantgrowthmapis thecomparison at24monthsbetween treatedEACS and OCVRpatients(Figure 4) Themaximum differences are within the -2mmand+2mmrange TypicallyOCVRtreatedpatientshaveamoreelongatedheadwithagrowthfocusaroundthefrontalandoccipitalareasasomewhatnarrowlowertemporalregionandaslightlywiderlowerparietalregionFurthermorethevertexofOCVRpatientsisslightlylowerTwoexamplesofchildrenaging24monthstreatedusingEACSorOCVRareshowninFigure5Themost important findings of the growthmaps arereportedbelow and visualizedinFigure46and7ThegrowthmapsofEACSpatientsfrompretopost-surgeryforagegroups1(3months)and2(6months)bothshowastrongparietalgrowthofupto10mm(Figure6) Thefrontalandoccipitalgrowthforthefirstagegroupwerearound0and 4mmrespectivelyFor thesecond agegroup frontal andoccipitalgrowth waslesscomparedtotheearliersurgerygroupIn OCVRparietal changesup to10mm canbe seenregardless of the age at surgery(Figure6)YetOCVRalsoshoweddifferencesbetweenpreandpost-surgerydependingontheageduringsurgeryIncontrasttoEACSoccipitalgrowthupto7mmispresentbetween6-9months;frontalchangesremainlimitedinallage(OCVR)groupsOccipitalgrowthismorepresentinOCVRforlatersurgeryagesascomparedtotheearliersurgeryagesThepost-surgeryfollow-upforEACSpatientsareshowninFigure7From6-9monthsofageaprominentupperparietalgrowthof5mmisnotedwithlowerparietalgrowtharound3mmFrontalareasgrowupto 4mm Thefrontotemporalregiononlyshows1-2mmofgrowthFrom9-12monthsonly0-1mmfrontotemporalgrowthupto3mmoccipitalgrowthandamidlinegrowthuptoapproximately25mmwasnotedNearlyidenticalgrowthispresentbetween9-18monthsHowever,growth at18monthsismoreprominent around theoccipitaland frontalarea(up to5mm)Between18-24monthsonly frontoparietalgrowthand somelower occipital growthup to25mmispresentBetween24- 48monthssomefrontotemporalgrowth(upto3mm)isdominant