SINGLE SUTURE CRANIOSYNOSTOSIS: in the vast majority of cases the compensatory growth of the normal sutures is generally sufficient to allow the developing brain to grow without causing raised pressure. However, in a certain percentage of cases the restriction is such that the pressure within the skull rises (raised intracranial pressure).
Sagittal synostosis = fusion of the midline sagittal suture; growth fails to occur across the head and excessive growth occurs from front to back leading to Scaphocephaly = boat shaped head.
Metopic synostosis = fusion of the anterior midline suture with failure of adequate transverse growth in the forehead, and compensatory growth posteriorly and laterally leading to Trigonocephaly = triangular skull.
Coronal synostosis = Unicoronal (one suture involved) synostosis: The overall impression is of a skull that has been twisted skew. Plagiocephaly = oblique skull.
Or Bi-coronal synostosis: the skull becomes excessively wide and short from front to back. There may be excessive growth at the upper part of the forehead and both eyebrows and orbital rims are pulled up and flattened. Brachycephaly = short skull.
Lambdoid synostosis (very rare) = a flattening of the skull around the involved suture with compensatory bulging occurring at the forehead on the involved side. Marked bulging of the mastoid bone behind the ear and a significant bulge on the parietal (which is the area above the ear) on the opposite side.
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