Preface

This book about pediatric neurosurgery deals with spina bifida and craniosynostosis. It offers the reader an overview of the diseases with emphasis on the application of new methods and treatment strategies in daily clinical practice.

Spina bifida is a neurodevelopmental disorder and one of the most common congenital malformations. Although patient survival rates have improved over the last decades, neural tube defects are still a substantial cause of morbidity in children. Survival and quality of life are associated with access to proper medical and surgical treatment as well as community support systems. This multidisciplinary approach is the reason for improved patient outcomes in quality of life and life expectancy in the last 50 years. Due to the many complications of this complex health issue, there is an essential need for a multidisciplinary approach to monitor, prevent, and treat possible complications that negatively impact functionality, life quality, and survival. Parents and close caregivers have a crucial role in the entire multidisciplinary team. Raising the child in a caring environment could help them develop into young adults able to go to school and work, find and use transportation, live on their own, and have healthy relationships.

Craniosynostosis is caused by the premature closure of one or more skull sutures. It causes a deformity of the baby's head, which is often visible after birth or in early infancy. The impulse for the growth of a child's head is the growth of the brain. In the case of craniosynostosis, the growth of the skull is limited and deformed, which can negatively affect the growth and development of the brain. Due to this, craniosynostosis cannot be considered only as a cosmetic matter, especially in severe forms or in the case of premature closure of several skull sutures. The diagnosis of craniosynostosis is based on the clinical picture, anthropometric examination with craniometric scan, X-ray, CT, and MRI examination of the skull and brain. The treatment for craniosynostosis is surgical, the aim of which is to modify the shape of the skull. In the case of severe forms, especially syndromological craniosynostosis, the aim is to prevent secondary brain damage. In the past, only open remodeling techniques had been used in the surgical treatment of craniosynostosis. Currently, endoscopic methods with subsequent remodeling treatment with a cranial orthosis are increasingly used.

I believe that this book will be useful for experts from several medical disciplines, especially pediatricians, neonatologists, neurologists, neurosurgeons, maxillofacial surgeons, orthopedists, and urologists.

#### **Branislav Kolarovszki, M.D., Ph.D.**

Associate Professor, Clinic of Neurosurgery, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Slovakia

**Dr. Raffaella Messina and Dr. Valeria Blé**

University of Bari Medical School "Aldo Moro", Bari, Italy

**1**

Section 1

Spina Bifida
