Craniotabes Flashcards

1
Q

Craniotabes

A

Definition: Very soft skull bones at the Parieto-Occipital area

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2
Q

Causes of Craniotabes

A
  1. Prematurity - 1st 6 months of life
  2. Bone diseases:
    Rickets
    Hypohosphatasia
    Osteogenesis imperfecta
    Hypervitaminosis A
  3. Hydrocephalus
  4. Congenital Syphilis
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3
Q

Causes of delayed closure of Fontanelles

A
  1. Bone diseases - Rickets, Hypohosphatasia, Achondronplasia; Craniocleidodysostosis
  2. Increase ICP - Hydrocephalus / SOL
  3. Metabolic disease (Hypothyroidism, MPS)
  4. Congenital infections
  5. Syndromes (Russel-Silver and Down’s / other Trisomies)
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4
Q

Causes of bulging Anterior Fontanelles

A
Increased ICP
1. Small skull - cranial stenosis
2. Increased intracranial content (SOL; Hydrocephalus)
3. Meningitis; Encephalitis
4. Pseudotumor Cerebri
Idiopathic
Head injury
Venous thrombosis
Galatosaemia
Endocrine: Pregnancy; Hypoparathyroidism
Drugs: Steroid withdrawal; Vit A overdose; Antibiotics (Tetracycline, Nitrofurantoin); OC pills
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5
Q

Steps to clinical examination of Craniotabes/ delayed closure/ bulging of anterior fontanelles

A
  1. Examination of skull for ?Hydrocephalus/ Increase ICP
  2. Note any Dysmorphism
  3. Examination of neck for Goitre, limb and chest deformity, skin rash and abdomin for organomegaly
  4. Look for evidence suggesting:
    Rickets: Swollen wrist and knee bowley; Rosary and Hypotonia
    Hypothyroidism
    Congenital infection
    Osteogenesis imperfecta
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6
Q

Hypophosphatasia

A

AR
Heterozygous carrier state present
Pathogenesis: Inborn error of metabolism with ALP deficiency
Failure of mineralization of bone, abnormal metabolite present in urine (Phosphoeteanolamine)

Clinical features:

  1. Stillbirth in severe cases
  2. Skull - AF wideand tense with soft skull bone
  3. Premature fusion of suture
  4. Features of rickets
  5. Premature loss of teeth

Investigation -ALP (Very low)
Rx - Calciferol (Vit D2)

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