This happens because the skull bones shift, but the cranial sutures do not fuse. It is different from craniosynostosis. A newborn may have no symptoms or signs, but the condition may become noticeable during the first months of life. They do this to spot this kind of condition. The cause of craniosynostosis depends on the type. The condition can be nonsyndromic, or syndromic.
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A study published in suggested that taking valproic acid — for example, Depakote — for epilepsy during pregnancy may increase the chance of the child being born with craniosynostosis.
According to the CDC , recent research also suggests that there is a higher risk for infants whose mothers:. Imaging tests, such as CT scans and X-rays, can show which sutures have fused. This is important if surgery is likely. A craniofacial surgeon specializes in head and facial surgery and surgery of the jaw. A neurosurgeon specializes in the brain and the nervous system.
The craniofacial surgeon then reforms these sections of the skull and places them back in the head. They then sew up the opening using dissolvable stitches. The process can last several hours, and the child will stay in the hospital for a few days after the surgery. The face is likely to swell, but this not a need for concern. Sometimes a child needs further surgery to reshape the face, or if the craniosynostosis reappears.
This is less invasive. The doctor makes two small incisions in the scalp and cuts the sutures using an endoscope. This allows the brain to grow quickly and protects the brain from minor impacts to the head such as when the infant is learning to hold his head up, roll over, and sit up. Without flexible sutures and fontanelles, the child's brain could not grow enough. The child would develop brain damage.
Feeling the cranial sutures and fontanelles is one way that health care providers follow the child's growth and development. They are able to assess the pressure inside the brain by feeling the tension of the fontanelles. The fontanelles should feel flat and firm. Bulging fontanelles may be a sign of increased pressure within the brain. In this case, providers may need to use imaging techniques to see the brain structure, such as CT scan or MRI scan. Surgery may be needed to relieve the increased pressure.
Surgery usually takes between three to seven hours depending on the case, may require a blood transfusion, and involves a hospital stay of three to seven days. A newer less invasive form of surgery utilizes excision of the affected suture with or without endoscopy, but is only a viable option in specific cases of craniosynostosis.
The preferred age for this surgery is 3 months, but the infant should be no older than 6 months, to obtain optimal results. Using the aid of more limited incision and possibly endoscopes, the surgical correction is performed through one or two small scalp incisions of about an inch each. The point of incision depends on which sutures are affected. The affected suture is opened or removed and the brain is allowed to grow normally.
There is less swelling and blood loss with this method of surgery. This process may be aided through postoperative helmet therapy. Length of surgery is usually about an hour, and most patients can be discharged from the hospital the second day after surgery.
One of the most common reasons for a malformed head shape is plagiocephaly, a condition that is frequently confused with lambdoidal synostosis. In infants with plagiocephaly, the head may be flattened in the back the occiput because the infant lies persistently on the back of the head often with the head turned primarily to one side.
In addition, the ear on that side is often pushed forward, and even the forehead may look a bit prominent compared with the other side. This produces a parallelogram shaped head. Plagiocephaly is not caused by craniosynostosis and usually does not need to be treated surgically. This may cause the skull to be shortened, excessively tall or abnormally wide. The face may have a sunken-in appearance with a thick or beaked nose and bulging eyes.
The upper jaw often has a narrow arch with an open bite and dental crowding. Other possible clinical problems include hydrocephalus, moderate hearing loss, speech impairment and acne. This is characterized by a complex fusion of the skin, soft tissue and bones of the fingers.
Both hands are affected equally, as are the feet. Fontanelles allow for growth of the skull during an infant's first year. Slow or incomplete closure of the skull bones is most often the cause of a wide fontanelle.
If you think that the fontanelles on your baby's head are larger than they should be, talk to your health care provider. Most of the time, this sign will have been seen during the baby's first medical exam. Congenital anomalies of the central nervous system. In: Kliegman RM, St. Nelson Textbook of Pediatrics. Philadelphia, PA: Elsevier; chap Disorders of cranial volume and shape.
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