Craniosynostosis refers to the early (premature) fusion of the sutures of the bones of the skull.  Premature fusing of the sutures deforms the skull shape. This is due to changes of the normal growth directions of the skull bones. Additionally the pressure inside the cranial cavity can get elevated in severe synostosis. There is clinical evidence that some cases can progress to vision impairment. significant intellectual development problems are seen in some non corrected children with craniosynostosis.  In addition, abnormal head shape is associated with low self-esteem and behavioral problems.  Correction of these deformities can relieve cranial pressure and in the long-term, improve the child's self-esteem.

There are several types of craniosynostosis described according to the affected suture or sutures.

When you see a distorted head shape.....

Distortion of head shape could be due to many reasons. To diagnose craniosynostosis it needs to be confirmed by clinical examination and radiological imaging. This could be a simple X-ray or a CT scan.

After diagnosis what will happen?

A craniofacial surgeon would decide what would be the best for the given clinical situation. He could offer surgical correction to parents. If the parents agree on surgery the selecting the exact type of surgery and the timing of the surgery would be the next step.

Diagnosis: A distorted head shape is not always the result of craniosynostosis. The diagnosis of craniosynostosis begins with an examination by a pediatrician, paediatric neurosurgeon or craniofacial surgeon. The initial examination involves questions about gestation and birth, in utero position, neck tightness and post-natal positioning (for example, sleeping position). The physical examination includes inspection of the infant's head and may involve palpation (carefully feeling) of the child's skull for suture ridges and soft spots (the fontanelles) as well as checking for neck tightness and other deformities. The physician may also request x-rays or computerized tomography (a CAT scan, a series of photographic images of the skull). These images provide the most reliable method for diagnosing premature suture fusion (craniosynostosis). In addition, the physician may make (or order) a series of measurements from the child's face and head These measurements will be used to assess severity and monitor treatment.

Treatment

Treatment could start as early as 3 months if the condition is suitable for a spring cranioplasty. If the presentation and the condition is warranting surgery, it is generally done before 2 years of age. Although different techniques have been introduced, ultimate goal remains the normal head shape. With the addition of absorbable plates the speed of the surgery has greatly improved.

Post operative period

Some patients would require a protective helmet. This is to help to mould and protect the brain. He would need to attend regular clinic visits. Few patients may need minor corrective procedures with regards to the outer appearance after puberty.