Faculty Collaboration Database

Frontal plagiocephaly secondary to synostosis of the frontosphenoidal suture. Case report. J Neurosurg 1995 Oct;83(4):733-6

Date

10/01/1995

Pubmed ID

7674026

DOI

10.3171/jns.1995.83.4.0733

Scopus ID

2-s2.0-0029102262 (requires institutional sign-in at Scopus site)   37 Citations

Abstract

Frontal plagiocephaly may arise from either synostotic or deformational forces. Deformational causes of frontal plagiocephaly can be distinguished from synostotic causes by differences seen on physical examination, which can then be confirmed by skull x-ray films and if necessary three-dimensional computerized tomography (CT). Unilateral coronal synostosis is the main synostotic cause of frontal plagiocephaly, although it has also been seen with fusion of the frontozygomatic suture. In several syndromes presenting with bilateral coronal synostosis, fusion of the frontosphenoidal and frontoethmoidal sutures is also present. The authors report, for perhaps the first time, a case showing synostotic frontal plagiocephaly secondary to fusion of the frontosphenoidal suture alone. Although the phenotypic appearance is superficially similar to that seen in unilateral coronal synostosis, analysis of the cranial base shows markedly different effects: angulation of the anterior cranial base with respect to the posterior cranial base away from the synostotic side and angulation of the posterior cranial base with respect to the midpalatal suture also away from the synostotic side. In unilateral coronal synostosis, both angulations are toward the synostotic side. These effects on the cranial base alter its relationship to the cranial vault and the facial skeleton. Most important, frontal plagiocephaly secondary to fusion of the frontosphenoidal suture should not be overlooked as being deformational. Because this fusion is difficult or impossible to visualize by skull x-ray films, three dimensional CT must be obtained in cases that are not clearly identified as deformational plagiocephaly by physical examination.

Author List

Francel PC, Park TS, Marsh JL, Kaufman BA

Author

Bruce A. Kaufman MD Adjunct Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Cranial Sutures
Craniosynostoses
Ethmoid Bone
Frontal Bone
Humans
Infant
Male
Palate
Phenotype
Radiographic Image Enhancement
Skull
Sphenoid Bone
Tomography, X-Ray Computed
Zygoma