Learning objectives
To illustrate the imaging features of various types of idiopathic and syndromic craniosynostosis
To discuss differential diagnosis and the advantages and limitations of imaging methods.
Background
Craniosynostosis is the premature fusion of cranial sutures,
which results in deformity of the skull and may be accompanied by neurological impairment.
This diagram shows the different sutures which can be involved.
The birth incidence of craniosynostosis ranges from 3 to 6 per 10,000 live births [1,2].
In global perspective,
there is really no meaningful differentiation between males and females although coronal synostosis is more frequently seen in girls while sagittal synostosis is more common in boys [3,4].
Simple craniosynostosis is a term applied when...
Imaging findings OR Procedure details
Early diagnosis is then crucial for appropriate management,
avoidance of the aforementioned complications and surgical planning.
After a careful physical examination of the abnormal cranial shape,
plain radiography of the skull is used as a first imaging modality to confirm the suspected diagnosis.
Using anterior-posterior (AP) and lateral views,
prematurely fused sutures are easily identified by the:
absence of sutures
associated bony ridging of the suture line
sclerotic margins
Abnormal cranial and orbital shapes
copper-beaten appearance of the calvarium
In addition to the findings above...
Conclusion
A radiology report is in many respects the single most important factor used to determine patient management namely pre-surgical planning.
It should therefore assess and contain all the information pertinent for treatment purposesincluding:
Endorsement of the diagnosis
Extent (partial versus complete) of suture ossification.
Patency of the other cranial sutures
Measurements,
such as the bitemporal length,
AP dimension,
cephalic index,
intercanthal distance
Areas of calvarial thinning (Luckenschaedel)
Associated anomalies of mid/lower face or midline malformations
Hydrocephalus
Abnormalities of venous drainage.
Craniosynostosis is a common condition...
References
1.
French LR,
Jackson IT,
Melton LJ.,
3rd A population-based study of craniosynostosis.
Journal of Clinical Epidemiology.
1990;43:69–73.
2.
Lajeunie E,
Merrer M,
Bonaïti-Pellie C,
Marchac D,
Renier D.
Genetic study of nonsyndromic coronal craniosynostosis.
American Journal of Medical Genetics 1995;55:500–504.
3.
Khanna PC,
Thapa MM,
Iyer RS,
Prasad SS.
Pictorial essay: The many faces of craniosynostosis.
Indian Journal of Radiology and Imaging.
2011; 21(1):49-56.
4.
Ocal E,
Sun PP,
Persing JA.
Craniosynostosis.
In: Albright AL,
Pollack IF,
Adelson PD,
editors.
Principle and practice of...