Learning objectives
This educational poster highlights normal anatomy of cranial sutures, identifying the characteristic skull shape changes of each type of craniosynostosis and the essential role of imaging in their diagnosis.
Background
Virchow introduced in 1851 the term craniosynostosis.
Craniosynostosis is the premature fusion of one or more of the cranial sutures, restricting cranial growth perpendicular to the affected suture with compensatory overgrowth along the other patent sutures.
The classification craniosynostoses: sagittal,coronal,metopic,lambdoid, multisutural
Ages of normal sutural/fontanelle closure (1)
metopic:3-9 months
anterior fontanelle: 18-24 months
sphenosquamosal: 6-10 years
sphenofrontal: approximately 15 years
occipitomastoid: approximately 16 years
sagittal: approximately 22 years
coronal: approximately 24 years
lambdoid: approximately 26 years
squamosal: approximately 60 years
Findings and procedure details
Anatomy is essential in imaging craniosynostosis. In this article we have depicted various types of craniosynostosis through radiographs and 3D reconstructed images.
Sagittal synostosis
Restriction of growth perpendicular to the sagittal suture results in a narrow and elongated cranium with frontal bossing, occipital protrusion and ridging of the fused, heaped suture. This deformity is characterized by scaphocephaly (inverted boat with a keel), clinocephaly (flat cranium due to loss of cranial convexity), and leptocephaly (tall and narrow cranium)
Coronal synostosis
Coronal synostosis causes restriction of growth...
Conclusion
Despite its use of ionized radiation, the CT-3D is the best imaging method to diagnose and plan the treatment of craniosynostosis.
To avoid unnecessary radiation exposure alternative imaging techniques and protocols including ultrasonography, plain skull radiography and magnetic resonance imaging should be explored.
Personal information and conflict of interest
Dr. I . Gurubharath MD Ph.D
Professor & HOD Department of Radiodiagnosis
Velammal Medical College Hospital & Research Institute
Velammal,Madurai
Tamil Nadu – 625009, India.
E-mail:
[email protected]
Dr. Nikhil Ravooru
Postgraduate resident
Department of Radiodiagnosis
Shri Sathya Sai Medical College and Research Institute
Chennai, Tamil Nadu – 603108
India
E-mail:
[email protected]
Dr. Harshavardhan Balaganesan
Senior resident
Department of Radiodiagnosis
Shri Sathya Sai Medical College and Research Institute
Chennai, Tamil Nadu – 603108
India
E-mail:
[email protected]
References
Idriz S, Patel JH, Ameli Renani S, Allan R, Vlahos I. CT of Normal Developmental and Variant Anatomy of the Pediatric Skull: Distinguishing Trauma from Normality. (2015) Radiographics: a review publication of the Radiological Society of North America, Inc. 35 (5): 1585-601. doi.org/10.1148/rg.2015140177.Pubmed
Kim HJ, Roh HG, Lee IW. Craniosynostosis: Updates in radiologic diagnosis. Journal of Korean Neurosurgical Society. 2016 May;59(3):219.
Netter FH, Dalley AF. Atlas of human anatomy. 2nd ed. East Hanover, NJ: Novartis, 1997.