What’s wrong with this kid?afterbefore

Different anatomical view

beforeafter

How cute is this baby?!

before after

Which bone of the skull was forming incorrectly?

BEFORE AFTER

Skull of Newborn (which bones are not labeled?)

What would cause the flattening of the occipital bone in infants?

• Before birth:– Multiple births– Baby dropped early or very large– Lack of amniotic fluid

• After birth:– Baby frequently lying or sitting in the same

position– “back to sleep” to prevent SIDS

What are the causes infant skull deformities?

• Deformational plagiocephaly - a condition where an infant has an uneven or irregular shaped head – Can be corrected using a cranial molding

helmet – Best results if used in the first 4-8 months

A more serious condition of skull deformity:

• Craniosynostosis- the premature fusing of two or more of the bony plates that form an infant's skull. – This condition can only be corrected with

surgery

What are the 6 cranial bones that must fuse together? What are

sutures?

• the occipital, the frontal, the two temporal and two parietal

• These bones are separated by crooked lines, called sutures.

Normally, these bony plates grow together during the first few years of life. But sometimes they fuse together before brain growth is complete. This can result in a misshapen skull and can also interfere with normal brain growth and development.

• Continuing after birth, the brain grows very rapidly during the first several years of life.

• This growth is made possible by corresponding growth of the cranial bones along the suture lines.

Purpose of sutures andFontanels…

• The bones and sutures form an almost complete covering for the brain.

• The remaining open places are called soft spots, or fontanels.

• The sutures and fontanels allow the bones of the skull to shift during delivery.

Types of craniosynostosis

• Premature closing of the suture lines, called craniosynostosis, results in a misshapen head.

• The resulting head shape depends on which suture has closed prematurely.

• For instance, if the sagittal suture fuses (the long one running from front to back in the center of the head), the head becomes long and narrow. Sagittal synostosis is the most common form of craniosynostosis

Craniosynostosis is rare and requires surgery.

Most infant skull irregularities are plagiocephaly – no surgery

required.• Because a newborns skull bones are still

moldable, cranial molding helmets help to re-shape the skull painlessly

You make the diagnosis…

• Look at the pictures and determine which skull bones and sutures are forming irregularly

A

B

C

D