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Case Reports
. 2020 Sep 17;8(9):e3127.
doi: 10.1097/GOX.0000000000003127. eCollection 2020 Sep.

Abnormal Cranial Shape Preceding Radiographic Evidence of Craniosynostosis

Josie Z Fazzino  1 , Esperanza Mantilla-Rivas  1 , Joseph H Talbet  1 , Elina Kapoor  1 , Monica Manrique  1 , Jennifer L McGrath  1 , Suresh N Magge  2 , Albert K Oh  1 , Gary F Rogers  1
Affiliations
Case Reports

Abnormal Cranial Shape Preceding Radiographic Evidence of Craniosynostosis

Josie Z Fazzino et al. Plast Reconstr Surg Glob Open. .

Abstract

Premature fusion of a cranial suture is known to result in characteristic changes in the head shape, even when the synostosis involves only part of the suture. We report an unusual case of a patient seen at the age of 2 months for an abnormal head shape that was present at birth. The phenotype was consistent with an isolated fusion of the frontosphenoidal suture, but the suture was open on a high-resolution computed tomography scan finding. There was no improvement in cranial form after 6 months of helmet therapy, and a follow-up computed tomography scan image taken at age 10 months showed the development of bilateral isolated frontosphenoidal synostosis. This case highlights that an abnormal head shape may, in some patients, predate radiographic evidence of craniosynostosis.

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Conflict of interest statement

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Figures

Fig. 1.
Fig. 1.
Axial and three-dimensional computed tomographic image at the age of 2 months demonstrating (A) patent but narrow right frontosphenoidal suture (white arrows), and patency of the right sphenosquamosal (black arrowhead) and coronal (black arrow) sutures. B, Patent left fronto-spenoidal suture (white arrow).
Fig. 2.
Fig. 2.
Three-dimensional computed tomographic reconstruction at the age of 2 months: A, patent left frontosphenoidal suture (black arrow), B, narrow but patent sutures of the right hemicranium (black arrow).
Fig. 3.
Fig. 3.
Three-dimensional computed tomographic reconstruction at the age of 10 months: A, Anterior–posterior view showing right frontal flattening and mild deviation of the nasal root. B and C, Lateral views of left and right hemicranium showing isolated fusions of the frontosphenoidal sutures (black arrows).
See this image and copyright information in PMC

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