Craniotabes Flashcards
1
Q
Craniotabes
A
Definition: Very soft skull bones at the Parieto-Occipital area
2
Q
Causes of Craniotabes
A
- Prematurity - 1st 6 months of life
- Bone diseases:
Rickets
Hypohosphatasia
Osteogenesis imperfecta
Hypervitaminosis A - Hydrocephalus
- Congenital Syphilis
3
Q
Causes of delayed closure of Fontanelles
A
- Bone diseases - Rickets, Hypohosphatasia, Achondronplasia; Craniocleidodysostosis
- Increase ICP - Hydrocephalus / SOL
- Metabolic disease (Hypothyroidism, MPS)
- Congenital infections
- Syndromes (Russel-Silver and Down’s / other Trisomies)
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
5
Q
Steps to clinical examination of Craniotabes/ delayed closure/ bulging of anterior fontanelles
A
- Examination of skull for ?Hydrocephalus/ Increase ICP
- Note any Dysmorphism
- Examination of neck for Goitre, limb and chest deformity, skin rash and abdomin for organomegaly
- Look for evidence suggesting:
Rickets: Swollen wrist and knee bowley; Rosary and Hypotonia
Hypothyroidism
Congenital infection
Osteogenesis imperfecta
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:
- Stillbirth in severe cases
- Skull - AF wideand tense with soft skull bone
- Premature fusion of suture
- Features of rickets
- Premature loss of teeth
Investigation -ALP (Very low)
Rx - Calciferol (Vit D2)