Premature closure of cranial sutures

Introduction Narrow cranial disease accounts for about 38% of head abnormalities, and its clinical manifestations are mainly manifested in various shapes of skull deformities. Because the cranial suture is closed prematurely, the growth of the skull is restricted, hindering the development of the brain, resulting in an increase in intracranial pressure. Patients may have two eyes protruding, lower vision, ocular dyskinesia, optic disc edema or secondary atrophy, visual impairment or blindness. Some patients may have mental retardation, and symptoms such as headache, nausea, and vomiting may occur in the advanced stage. Some patients may have seizures due to atrophy of the cerebral cortex. The clinical manifestations of narrow cranial disease can be divided into two major categories: head deformity and secondary symptoms.

Cause

So far, the cause of this disease is unknown, and there is no satisfactory explanation. Some scholars have found that the disease is familial, so it is believed that the disease is related to heredity. Most of the lesions are concentrated in the coronal suture or multiple sutures. Some scholars have unknown reasons. The cranial suture ossification that occurs at birth is called primary narrow cranial disease, and the early ossification of the cranial suture secondary to other diseases of the body is called secondary narrow cranial disease. Early cranial ossification of patients with cretinism who overuse thyroid hormone replacement therapy.

As early as 1975, Cohen and Converse et al. in 1976 elaborated on the cause of the narrow cranial disease. It is believed that this disease is a congenital developmental malformation, but in general its cause is still unclear, which may be related to the development of embryonic mesodermal developmental disorders, or it may be due to the occurrence of heterotopic ossification center in the bone-seal tissue. May be related to the lack of certain matrices in the embryo. A few cases have genetic factors. Individual cases can be caused by vitamin D deficiency and hyperthyroidism. The basic reason that Park and Power have suggested is that the skull interstitial bundle is incompletely grown, resulting in a reduction in the skull and premature ossification of the suture tissue.

The starting point of ossification of the cranial suture and how the ossification spreads, the corresponding cranio-sacral humerus, the skull base and the role of the dura mater are not well understood. The development of the skull base plays a leading role in the pathogenesis of the narrow cranial disease with facial deformity changes.

an examination

Related inspection

Intracranial pressure monitoring of skull base MRI examination of intracranial Doppler blood flow map (TCD)

1. Apical deformity: The X-ray skull can be seen on the anterior and posterior slices of the eyelid. The anterior cranial fossa becomes narrow, the anterior cranial fossa becomes narrow, the bone density increases along the coronary seam, and the calcium is calm. There is often a skull finger pressure notch. On the lateral position, the frontal bone was rotated, and the bones behind the frontal bone showed no X-ray protrusion shadows, and the posterior cranial sac was normal.

2. scaphoid deformity: the skull can be seen in the skull with a boat-like deformity. The density of the sagittal suture is increased, the calcareousness is calm, and in severe cases, the suture is not visible, while the coronal suture, herringbone suture, and scaly suture increase. Wide, even separate, if there is an increase in intracranial pressure, it can be seen that the cerebral gyrus is increased.

3. Triangular head deformity: X-ray shows that the frontal bone is short and highly convex. The orthodontic slice shows that the typical eyelid is too short and the inner wall of the ankle is vertical.

4. Oblique head deformity: X-ray manifests as oblique head deformity, that is, the longitudinal direction of the eyelid is skewed upward and outward. The skull image can be seen at the lateral coronal joint, the bone density is increased, the proximal wing point is higher, the diseased anterior cranial fossa is also smaller, and the anterior cranial fossa becomes steeper. The nose cone is skewed and the nose is biased toward the lesion side.

5. Short head deformity: It can be seen that the bone density increases at the coronal sutures on both sides, the skull base changes to the cranial anterior fossa shortened and erects, the sphenoid winglets lift up upwards and backwards, and the wing points are raised. The armpits deepen. The volume of the eyelids becomes smaller.

Differential diagnosis

The disease must be differentiated from the following symptoms:

Small head: It is a microcephaly caused by primary brain development disorder and the head does not increase. It is not the craniosynostosis that limits the development of brain tissue. The cranial suture is also closed, which is the secondary skull closure. disease. Patients often have no increased intracranial pressure, and mental and mental developmental disorders are more obvious. X-ray examination of the bone density can be normal or no brain back pressure traces and other signs of intracranial hypertension.

Cranial suture: Because the child's skull is mostly fibrotic, brain tumors lead to increased intracranial pressure. The cranial suture can be split and the head circumference is enlarged. Parents inadvertently tapping the head of the child can hear the broken pot sound. Therefore, parents should pay attention when they find that their head circumference is significantly larger than that of their children of the same age.

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