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What are the different types of craniosynostosis?
There are multiple classifications of CS. Generally, it is classified based on the cause of the condition, the number of sutures involved, and the sutures that fused prematurely, resulting in a specific head shape.
What are the different types of craniosynostosis?
There are multiple classifications of CS. Generally, it is classified based on the cause of the condition, the number of sutures involved, and the sutures that fused prematurely, resulting in a specific head shape.
This answer is adapted from the Gillette Children’s Healthcare Series book on Craniosynostosis.
Classification by cause
- Nonsyndromic CS: CS that is not associated with a syndrome but is instead its own medical condition that has no known cause. Nonsyndromic CS accounts for about 85% of cases and most are single-suture fusions.
- Syndromic CS: Occurs as part of a genetic syndrome (e.g., Apert, Crouzon, Pfeiffer syndromes). Syndromic CS accounts for about 15% of cases, usually involves multiple sutures and is more complex to treat.
Classification by the number of Sutures Involved
- Single-suture CS: Only one suture fuses prematurely.
- Multisuture CS: More than one suture is fused; commonly syndromic and more severe.
Classification by which suture fused (head shape patterns)
- Sagittal CS (Scaphocephaly): Sagittal suture fuses causing a long, narrow, boat-shaped head.
- Metopic CS (Trigonocephaly): Metopic suture fuses. Creating a triangular forehead, closely spaced eyes.
- Unicoronal CS (Anterior Plagiocephaly): One coronal suture fuses making the forehead asymmetrical with one side flat (eye and nose may shift).
- Bicoronal CS (Brachycephaly): Both coronal sutures fuse creating a short, wide head with tall/flat forehead.
- Lambdoid CS (Posterior Plagiocephaly): One lambdoid suture fuses leading to flattening at the back of the head on one side.
How is craniosynostosis diagnosed?
Craniosynostosis may be suspected when an infant presents with an atypical head shape, usually noticed shortly after birth by parents, family members, or medical professionals familiar with the condition.
How is craniosynostosis diagnosed?
This answer is adapted from section 1.5 of the Gillette Children’s Healthcare Series book on Craniosynostosis.
Craniosynostosis may be suspected when an infant presents with an atypical head shape, usually noticed shortly after birth by parents, family members, or medical professionals familiar with the condition. In rare cases, particularly with syndromic forms, it may be identified before birth by ultrasound, although prenatal diagnosis is uncommon. When craniosynostosis is suspected, the child is referred to a pediatric craniofacial surgeon within a specialized hospital, where diagnosis and management are carried out by a multidisciplinary craniofacial team, often in partnership with a neurosurgeon.
Diagnosis begins with a detailed medical and family history, including information about pregnancy, maternal health or medication use, family history of craniosynostosis, and any feeding or breathing difficulties after birth, which are more typical in syndromic cases. Head growth patterns are also reviewed to identify growth that is unusually fast or slow. This is followed by a thorough physical examination. Clinicians assess facial symmetry, palpate sutures for ridging or flatness, and examine the fontanels for abnormal shape or persistent bulging or sinking. Eye movements and reflexes are checked, with referral to an ophthalmologist recommended for all infants with craniosynostosis. Head circumference is measured and compared with World Health Organization growth charts, though normal circumference does not rule out the condition due to compensatory skull growth. A more accurate indicator is the cranial index, which compares the width and length of the skull. Neurological exams may also be performed if there are concerns about reflexes, movement, or sensation.
If clinical suspicion remains high, imaging is ordered to confirm the diagnosis. Computed tomography (CT) is the most commonly used and reliable imaging technique, providing detailed images of fused sutures and allowing for three-dimensional reconstructions. X-rays can also visualize bone structures but are less comprehensive. Magnetic resonance imaging (MRI) may be used to assess brain tissue and development, offering the advantage of no radiation exposure, though it often requires sedation and is less effective for bone evaluation. Ultrasound, which uses sound waves instead of radiation, may also be used in certain cases to examine sutures.
What does “syndromic” craniosynostosis mean and how is this different from “nonsyndromic” craniosynostosis?
Syndromic craniosynostosis is a form of craniosynostosis that occurs as part of a broader syndrome (a condition defined by a recognizable group of characteristics that consistently appear together). In contrast, nonsyndromic craniosynostosis is not linked to any underlying syndrome and occurs as a standalone condition with no identifiable cause.
What does “syndromic” craniosynostosis mean and how is this different from “nonsyndromic” craniosynostosis?
This answer is adapted from chapter 3 of the Gillette Children’s Healthcare Series book on Craniosynostosis.
Syndromic craniosynostosis is a form of craniosynostosis that occurs as part of a broader syndrome (a condition defined by a recognizable group of characteristics that consistently appear together). It is usually caused by genetic changes and accounts for about 15 percent of all craniosynostosis cases, making it less common than nonsyndromic craniosynostosis.
Because syndromes are diagnosed by recognizing patterns of features rather than a single test (except in cases with a known genetic mutation), individuals with syndromic craniosynostosis may show several, but not necessarily all, traits of the associated syndrome. Importantly, nearly 200 different syndromes have been linked to craniosynostosis, though not all people with those syndromes will necessarily develop craniosynostosis.
In contrast, nonsyndromic craniosynostosis is not linked to any underlying syndrome and occurs as a standalone condition with no identifiable cause. It is the most common type, representing about 85 percent of cases.
What are the common syndromes associated with craniosynostosis?
There are five most prevalent craniosynostosis syndromes: Apert syndrome; Crouzon syndrome; Pfeiffer syndrome; Muenke syndrome; Saethre-Chotzen syndrome.
What are the common syndromes associated with craniosynostosis?
This answer is adapted from section 3.2 of the Gillette Children’s Healthcare Series book on Craniosynostosis.
The five most prevalent CS syndromes are:
- Apert syndrome: Marked by distinctive skull and face shape, and syndactyly (webbed or fused fingers and toes), often with breathing, feeding, and brain development challenges.
- Crouzon syndrome: Characterized by bulging eyes, midface underdevelopment, and hearing loss; severity varies widely, and some individuals are unaware until genetic testing.
- Pfeiffer syndrome: Features high forehead, abnormal hand/foot bones, and possible organ issues; ranges from mild (type 1) to severe (types 2 and 3 with cloverleaf skull, airway obstruction, and cognitive delays).
- Muenke syndrome: Involves wide-set eyes and flattened cheekbones, usually without limb abnormalities; about 20% of cases occur without CS.
- Saethre-Chotzen syndrome: Presents with variable skull, face, hand, and foot differences, sometimes very mild; some individuals remain unaware until genetic testing.
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Plain Language Summaries
Plain language summaries are an effective way of communicating scientific research to a wider audience. By presenting the key findings and significance of a study in easy-to-understand language, the content becomes more accessible to individuals with disabilities, parents, caregivers, and others. Here we present summaries of papers published in Developmental Medicine & Child Neurology (DMCN).
Helpful videos
Here you will find a collection of short videos from authors and editors summarising their work. They cover Developmental Medicine & Child Neurology (DMCN) articles, Mac Keith Press books and e-learning. The aim of the videos is to help viewers get a clear understanding of why the research is important, how it was carried out, and real-world implications.
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