Craniosynostosis

Craniosynostosis refers to the premature closing of one or more of the sutures of an infant’s head. The skull is normally composed of bones which are separated by sutures.

As an infant’s brain grows, open sutures allow the skull to expand and develop a relatively normal head shape. If one or more of the sutures has closed early, it can cause the skull to expand in the direction of the open sutures. This dynamic can result in an abnormal head shape. In severe cases, this condition can also cause increased pressure on the child’s growing brain.

Types of Craniosynostosis

In sagittal synostosis (scaphocephaly), the sagittal suture is closed. As a result, the infant’s head does not expand in width but grows long and narrow, accommodating the baby’s growing brain. The sagittal suture is the most common single suture involved in craniosynostosis. The incidence of sagittal synostosis in the population is approximately 1 in 4200 births. Males are affected about three times more often than females.

When the metopic suture is closed, this condition is called metopic synostosis. The term trigonocephaly is used to describe your child’s head shape. This deformity can vary from mild to severe. There is usually a ridge down the forehead that can be seen or felt and the eyebrows may appear “pinched” on either side. The eyes may also appear unnaturally close together.

The coronal suture goes from ear to ear on the top of the head. Early closure of one side, unilateral coronal synostosis (Plagiocephaly) results in the forehead and orbital rim (eyebrow) having a flattened appearance on that side. This can create a “winking” effect. These features may also be more apparent when looking at the child in the mirror.

Both sides are fused in bicoronal synostosis (brachycephaly). In these cases, the child may have a an extremely flat, recessed forehead. This suture fusion is most often found in Crouzon’s and Apert’s Syndromes.

Diagnosis of Craniosynostosis

There are several known signs that may have caused you or your doctor to suspect that your child has craniosynostosis. In most cases, naturally the misshapen head is the first clue of such a condition. The anterior fontanelle, or soft spot, may or may not be open. The suspected diagnosis is confirmed by x-rays. A CT scan is also done to make sure there are no underlying abnormalities in the brain.


How is Plagiocephaly different from Craniosynostosis?

In deformational Plagiocephaly, the skull bones are all formed normally; there is no premature fusion of skull bones. Craniosynostosis is known to be present when one or more of the skull bones have fused together too soon. X-rays Skull or a CT scan of the head is often performed to confirm such a diagnosis.

Surgical treatment options for craniosynostosis should only be determined after a thorough and careful evaluation by a craniofacial team.