Pyrexia after transcranial surgery

Pyrexia after transcranial surgery has been observed regularly in clinical practice but does not usually herald any subsequent pathologic process. However, the significance and incidence of this phenomenon remain uncertain. The aim of this study was to evaluate the incidence and timing of any pyrexia after transcranial surgery for craniosynostosis correction and correlate this with the clinical outcome to assess its significance. Retrospective review of sequential case notes collected over a 10 year period identified 136 transcranial operations undertaken for 122 cases of nonsyndromic craniosynostosis. The incidence of postoperative pyrexia of 38 degrees or more in the first 5 days was 76%, whereas that greater than 39 degrees was 11%. Pyrexia was noticed during the first 48 hours and had a bimodal distribution. Only a single case in this series subsequently developed a clinically significant complication, that is, a minor wound infection of the skin, which was treated by antibiotics and dressings. The occurrence of pyrexia did not appear to be related either to sex or to any affected suture but occurred less frequently in those who were under 6 months old. We conclude that this pyrexia should be considered to be a part of the normal physiological response to craniofacial surgery.