Craniosynostosis Flashcards
What is the most common craniosynostosis post shunting?
dolichocephaly from sagittal synostosis
what is the craniosynostos from sagittal synostosis called?
Dolichocephaly
How often does microcephaly occur after shunting?
6%. If complete synostosis has not occured, it might be reversibel if IC hypertension reoccured.
where is the anterior fontanelle situated?
At the junction of coronal, sagittal and frontal sutures
what fontanelle is located at the junction of coronal, sagittal and frontal sutures
the anterior fontanelle
when does the anterior fontanelle usually fuse?
18-24mo
Where is the posterior fontanelle situated?
At the junction of sagittal and lambdoid suture
what is situated at the junction of sagittal and lambdoid suture
the posterior fontanelle
when does the posterior fontanelle fuse?
at 2-3 mo age.
What is caused by a premature fusion of the sagittal suture?
scaphocephaly
When does normal fusion of the sagittal suture normally occur?
At approximately 22-24 months of age.
what is the most common form of craniosynostosis?
Scaphocephaly = Dolichocephaly
What suture is the most common to give rise to craniocynostosis?
sagittal suture.
What happens to the skulle shape in case of scaphocephaly?
Den växer ffa framför och bakom sutura sagittalis, som ett hundben -narrow elongated skull. (impediment of lateral growth).
How many % of craniosynostosis does scaphoencephaly encount?
50%
What is the Male:female ratio of scaphoencephaly?
3:1
What syndrome is associated to scaphoencephaly?
Marfan syndrome
What is different w scaphoencephaly to other craniocynostosis?
- near normal IQ.
- NOT associated to hydrocephalus.
what does kephale mean in greek?
head.
what does skaphe mean in greek?
a light boat.
what acrocephalosyndactyly types of syndromes are associated to craniosynostosis?
Apert syndrome, carpenter syndrome, crouzon syndrome
What type of anomali is associated to craniosynostosis?
choanal atresia
What syndrome is coronal craniosynostosis correlated to?
Crouzons syndrome and Aperts syndrome.
When does primary craniosynostosis occur?
prenatally
WHat etiologies are there to secondary craniosynososis?
- metabolic ex rickets - D vitaminbrist
- toxic ex valproat, methotrexat
- hematologic - sickle cell, thalassemi
- structural - due to lack of brain growth.
Can craniocynostosis be caused by shunting?
That has never been proven.
How often does increased ICP occur in single suture craniosynostosis?
11%. HIgher in multiple.
Which tyoe of craniosynostosis might cause Amblyopia?
coronal
What to look for clinically in suspected craniosynostosis?
*Bony prominence of the suture
* No ability to cause realtive movement over “the suture” (gently with the thumbs)
* Lack of normal luency over the suture on x-ray or CT.
* CT is the radiology of choice 1st hand.
* MRI if suspected other abnormalities.
– measurements may be very difficult to interpret and be normal even in a odd shaped skull.
What type of skulldeformity does dagittal synostosis cause?
A palpable keel-like sagittal ridge and DOLIDOCHOcephaly OR SCAPHOcephaly
Men kom ihåg. På Beito sade handledaren att de brukar frå förlängt huvud med “bossing” både fram o bak - som ett hundben i axial vy.
What is dolidochencephaly?
An elongated skull frontal and frontal bossing
What is scaphocephaly?
elongated skull with prominent occiput.
How many % of patients with non-syndromic sagittal synostosis have elevated ICP?
44%!
Surgical treatment of Sagittal craniocynostosis?
Longitudinal strip craniectomy from coronal suture to the lambdoid suture. GREAT care not to injure the underlying dura over sinus sagittalis. Within 3-6 mo age….
Usually extensive cranial remodelling is done after 1 yr age.
Under what sensitive period after the longitudinal strip surgery for sagittal craniosynostosis is a redo needed if the opening heals?
up to 6 mo age.
Which is the most common craniosynostosis, with 80% male pt?
sagittal synostosis
