Learning objectives
This poster will review the normal sutures changes during childhood,
address the characteristic skull shape changes of each type of craniosynostosis and its radiographic features,
mainly on the head CT-scan.
Background
Cranial sutures are synarthrosis,
a type of fibrous joints that exist between the seven cranial bones – paired frontal,
parietal and temporal bones and one occipital bone – and allow the deformation of the skull during birth,
its growth and brain development.[1,2,3]
Craniosynostosis is the premature fusion of one or more cranial sutures.
According to Virchow’s law,
the skull cannot grow perpendicularly to the prematurely fused suture,
so there is a compensatory parallel expansion and growth along patent sutures,
resulting in calvarium deformities.[1,3,4,5,6] Its incidence...
Findings and procedure details
This pictorial review illustrates the different types of craniosynostosis with cases from our institution using different imaging methods,
including head X-ray and CT scans.
Normal cranial sutures
The human skull is composed by four large sutures (sagittal,
coronal,
lambdoid and squamosal) which separate the primary cranial bones (frontal,
parietal,
occipital and temporal) and persist into adulthood.
There are also minor sutures,
namely the metopic,
sphenosquamosal,
sphenofrontal,
and occipitomastoid sutures,
which are opened in infants and toddlers.[2,6,12] The sagittal suture separates both parietal bones; coronal sutures...
Conclusion
Despite its use of ionized radiation,
the CT-3D is the best imaging method to diagnose and plan the treatment of craniosynostosis,
especially the complex or complicated types.
However,
the first approach should be a careful physical examination,
and efforts should be made to avoid unnecessary radiation exposure.
References
1.
Pekcevik,
Y.,
Hasbay,
E.
and Pekcevik,
R.
(2013).
Three-dimensional CT imaging in pediatric calvarial pathologies.
Diagnostic and Interventional Radiology.
2.
Kirmi,
O.,
Lo,
S.,
Johnson,
D.
and Anslow,
P.
(2009).
Craniosynostosis: A Radiological and Surgical Perspective.
Seminars in Ultrasound,
CT and MRI,
30(6),
pp.492-512.
3.
Vargo,
J.,
Hasan,
A.
and Andrews,
B.
(2018).
Identification and Management of Cranial Anomalies in Perinatology.
Clinics in Perinatology,
45(4),
pp.699-715.
4.
Badve,
C.,
K.,
M.,
Iyer,
R.,
Ishak,
G.
and Khanna,
P.
(2013).
Craniosynostosis: imaging review and primer...