Craniosinostosis

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Babies’ skull consists of 5 bones. These bones connect with immobile joints called sutures and eventually a healthy skull is formed. However, the brain continues to develop after birth. So much so that human brain tissue doubles in size in the first year after birth. For this reason, the joints do not come together immediately. There is a space between the joints, in the front and back of the skull, called the fontanel. The process of joining the bones continues until the baby is 14-18 months old. The fontanel in the back of the skull closes when the baby is 3-6 months old, and the fontanelle in the front part closes when the baby is 14-18 months old. During this period, the baby’s brain grows significantly and the skull closes, taking the shape of the brain. However, sometimes the sutures close early while the baby is in the womb. As a result, the skull becomes deformed and brain development is interrupted. This condition is called craniosynostosis

Craniosynostosis Symptoms

There are no symptoms during pregnancy. It may be possible for a perinatologist to make a diagnosis with detailed ultrasound. Usually, craniosynostosis symptoms appear during or after birth. The family or doctor notices that the child’s head is deformed. This deformity increases rapidly. The shape of the head becomes asymmetrical upward, forward and backward. In addition, deformities are observed in the eyes, nose and ears.

Diagnosis

After observing the deformity in the skull, the neurosurgeon may use head radiography, tomography and MRI for a definitive diagnosis.

Types

Different types of craniosynostoses may develop depending on which suture fused prematurely.

– Sagittal Synostosis: Scaphocele. The skull is elongated from front to back. The forehead is dislocated. The front and back skulls become pointed. The middle part of the head looks hollow. It is the most common type of craniosynostosis.
– Metopic Synostosis: Triganocephaly or triangular head. The suture in the middle of the forehead boils and the skull takes a triangular form towards the forehead and becomes pointed. The distance between the eyes decreases.
– Coronal Synostosis: Brachycephaly. It occurs with premature closure of the coronal suture. Since the skull cannot grow front and back, it grows upward. The height of the head increases. Eyes move away from each other.
– Lambdoid Synostosis: It is the skull tilted to the right or left. It is a rare type of craniosynostosis.

Why Does It Occur?

Many different conditions are thought to cause craniosynostosis:

– Genetic Inheritance
– Drugs used by the mother during pregnancy
– Maternal thyroid disease
– Vitamin D deficiency in the baby

Treatment

The treatment of craniosynostosis is surgery. Depending on the type of disease, the child must be operated on within the first 3 months (sagittal synostosis cases) and the first 6 months (other synostoses) or between 6-9 months (genetic cases). With surgery, high intracranial pressure is reduced and space is given to the brain to grow. The prematurely closed suture is opened and the skull is reshaped. Thus, possible brain damage can be prevented. Neurological and cognitive capacity losses are prevented or kept to a minimum. Additionally, it may be necessary to use a custom-made helmet after the surgery.