Skip to main content
Top
Published in: Child's Nervous System 11/2015

01-11-2015 | Original Paper

Diagnostic features of prematurely fused cranial sutures on plain skull X-rays

Authors: Tilmann Schweitzer, Felix Kunz, Philipp Meyer-Marcotty, Urs Dietmar Achim Müller-Richter, Hartmut Böhm, Clemens Wirth, Ralf-Ingo Ernestus, Christian Linz

Published in: Child's Nervous System | Issue 11/2015

Login to get access

Abstract

Purpose

The characteristic features of prematurely fused craniosynostosis in plain radiographs have already been described in literature, but there is no clinical trial investigating the individual features of every single form of craniosynostosis. We described suture-specific characteristics as well as its frequency of appearance in plain radiographs in every different form of craniosynostosis. Intraoperative findings served as control to confirm the diagnosis.

Methods

One hundred twenty-seven children with prematurely fused cranial sutures who underwent a skull X-ray from 2008 to 2012 were investigated in the present study. In detail, 34 children with frontal, 60 with sagittal, 13 with unilateral and 14 with bilateral coronal synostosis and 3 with unilateral lambdoid craniosynostosis as well as 3 children with a bilateral lambdoid synostosis were included.

Results

Typical radiological characteristics in craniosynostosis exist. These features as well as its frequency in craniosynostosis in plain skull radiographs are presented. In all cases, these typical features enabled a correct diagnosis, which was confirmed by intraoperative findings.

Conclusion

The frequency of the appearance of typical features is listed and may serve as a “mental internal check list” in the radiological approach to craniosynostosis. The study points out the value of plain skull X-rays as it enabled proper diagnosis in all investigated 127 cases.
Literature
1.
go back to reference Collmann H, Soerensen N, Krauss J (1999) Craniosynostosis. Treatment, results and complications. Churchill-Livingstone, London Collmann H, Soerensen N, Krauss J (1999) Craniosynostosis. Treatment, results and complications. Churchill-Livingstone, London
2.
go back to reference David JD, Poswillo D, Simpson D (1982) The craniosynostoses causes, natural history, and management. Springer Verlag, Berlin Heidelberg New York David JD, Poswillo D, Simpson D (1982) The craniosynostoses causes, natural history, and management. Springer Verlag, Berlin Heidelberg New York
3.
go back to reference Thompson DN, R.D. H (1999) Craniosynostosis-pathophysiology, clinical presentation and investigation. Churchill-Livingstone, London Edinburgh New York Philadelphia Sydney Toronto Thompson DN, R.D. H (1999) Craniosynostosis-pathophysiology, clinical presentation and investigation. Churchill-Livingstone, London Edinburgh New York Philadelphia Sydney Toronto
4.
go back to reference Regelsberger J, Delling G, Helmke K, Tsokos M, Kammler G, Kranzlein H, Westphal M (2006) Ultrasound in the diagnosis of craniosynostosis. J Craniofac Surg 17:623–625, discussion 626–628 CrossRefPubMed Regelsberger J, Delling G, Helmke K, Tsokos M, Kammler G, Kranzlein H, Westphal M (2006) Ultrasound in the diagnosis of craniosynostosis. J Craniofac Surg 17:623–625, discussion 626–628 CrossRefPubMed
5.
6.
go back to reference Schweitzer T, Bohm H, Meyer-Marcotty P, Collmann H, Ernestus RI, Krauss J (2012) Avoiding CT scans in children with single-suture craniosynostosis. Child’s Nervous Syst: ChNS: Off J Int Soc Pediatr Neurosurg 28:1077–1082CrossRef Schweitzer T, Bohm H, Meyer-Marcotty P, Collmann H, Ernestus RI, Krauss J (2012) Avoiding CT scans in children with single-suture craniosynostosis. Child’s Nervous Syst: ChNS: Off J Int Soc Pediatr Neurosurg 28:1077–1082CrossRef
7.
go back to reference Bundesärztekammer (2007) Leitlinie der Bundesärztekammer zur Qualitätssicherung in der Röntgendiagnostik. Bundesärztekammer (2007) Leitlinie der Bundesärztekammer zur Qualitätssicherung in der Röntgendiagnostik.
8.
go back to reference Cerovac S, Neil-Dwyer JG, Rich P, Jones BM, Hayward RD (2002) Are routine preoperative CT scans necessary in the management of single suture craniosynostosis? Br J Neurosurg 16:348–354CrossRefPubMed Cerovac S, Neil-Dwyer JG, Rich P, Jones BM, Hayward RD (2002) Are routine preoperative CT scans necessary in the management of single suture craniosynostosis? Br J Neurosurg 16:348–354CrossRefPubMed
9.
go back to reference Wilbrand JF, Szczukowski A, Blecher JC, Pons-Kuehnemann J, Christophis P, Howaldt HP, Schaaf H (2012) Objectification of cranial vault correction for craniosynostosis by three-dimensional photography. J Cranio-Maxillo-Fac Surg: Off Publ Eur Assoc Cranio-Maxillo-Fac Surg 40:726–730CrossRef Wilbrand JF, Szczukowski A, Blecher JC, Pons-Kuehnemann J, Christophis P, Howaldt HP, Schaaf H (2012) Objectification of cranial vault correction for craniosynostosis by three-dimensional photography. J Cranio-Maxillo-Fac Surg: Off Publ Eur Assoc Cranio-Maxillo-Fac Surg 40:726–730CrossRef
10.
go back to reference Lam I, Cunningham M, Speltz M, Shapiro L (2014) Classifying craniosynostosis with a 3D projection-based feature extraction system. Proc / IEEE Int Symp Comput-Based Med Syst IEEE Int Symp Comput-Based Med Syst 2014:215–220 Lam I, Cunningham M, Speltz M, Shapiro L (2014) Classifying craniosynostosis with a 3D projection-based feature extraction system. Proc / IEEE Int Symp Comput-Based Med Syst IEEE Int Symp Comput-Based Med Syst 2014:215–220
12.
go back to reference Zitelli BJDH (2002) Atlas of pediatric physical diagnosis, 4th edn. Mosby, St Louis, pp 803–817 Zitelli BJDH (2002) Atlas of pediatric physical diagnosis, 4th edn. Mosby, St Louis, pp 803–817
13.
go back to reference Kabbani H, Raghuveer TS (2004) Craniosynostosis. Am Fam Phys 69:2863–2870 Kabbani H, Raghuveer TS (2004) Craniosynostosis. Am Fam Phys 69:2863–2870
14.
go back to reference Brenner D, Elliston C, Hall E, Berdon W (2001) Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR Am J Roentgenol 176:289–296CrossRefPubMed Brenner D, Elliston C, Hall E, Berdon W (2001) Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR Am J Roentgenol 176:289–296CrossRefPubMed
15.
go back to reference Brenner DJ, Hall EJ (2007) Computed tomography—an increasing source of radiation exposure. N Engl J Med 357:2277–2284CrossRefPubMed Brenner DJ, Hall EJ (2007) Computed tomography—an increasing source of radiation exposure. N Engl J Med 357:2277–2284CrossRefPubMed
16.
go back to reference Pearce MS, Salotti JA, Little MP, McHugh K, Lee C, Kim KP, Howe NL, Ronckers CM, Rajaraman P, Sir Craft AW, Parker L, Berrington de Gonzalez A (2012) Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet 380:499–505PubMedCentralCrossRefPubMed Pearce MS, Salotti JA, Little MP, McHugh K, Lee C, Kim KP, Howe NL, Ronckers CM, Rajaraman P, Sir Craft AW, Parker L, Berrington de Gonzalez A (2012) Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet 380:499–505PubMedCentralCrossRefPubMed
17.
go back to reference Miglioretti DL, Johnson E, Williams A, Greenlee RT, Weinmann S, Solberg LI, Feigelson HS, Roblin D, Flynn MJ, Vanneman N, Smith-Bindman R (2013) The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk. JAMA Pediatr 167:700–707PubMedCentralCrossRefPubMed Miglioretti DL, Johnson E, Williams A, Greenlee RT, Weinmann S, Solberg LI, Feigelson HS, Roblin D, Flynn MJ, Vanneman N, Smith-Bindman R (2013) The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk. JAMA Pediatr 167:700–707PubMedCentralCrossRefPubMed
18.
go back to reference Bernier MO, Rehel JL, Brisse HJ, Wu-Zhou X, Caer-Lorho S, Jacob S, Chateil JF, Aubert B, Laurier D (2012) Radiation exposure from CT in early childhood: a French large-scale multicentre study. Br J Radiol 85:53–60PubMedCentralCrossRefPubMed Bernier MO, Rehel JL, Brisse HJ, Wu-Zhou X, Caer-Lorho S, Jacob S, Chateil JF, Aubert B, Laurier D (2012) Radiation exposure from CT in early childhood: a French large-scale multicentre study. Br J Radiol 85:53–60PubMedCentralCrossRefPubMed
19.
go back to reference Silverman F, Kuhn J (1993) Caffey’s pediatric x-ray diagnosis: an integrated imaging approach Silverman F, Kuhn J (1993) Caffey’s pediatric x-ray diagnosis: an integrated imaging approach
20.
go back to reference Cohen MM Jr, MacLean ER (2000) Craniosynostosis diagnosis, evaluation, and management. Oxford University Press, New York Cohen MM Jr, MacLean ER (2000) Craniosynostosis diagnosis, evaluation, and management. Oxford University Press, New York
21.
go back to reference van der Meulen J (2012) Metopic synostosis. Child’s Nerv Syst: ChNS: Off J Int Soc Pediatr Neurosurg 28:1359–1367CrossRef van der Meulen J (2012) Metopic synostosis. Child’s Nerv Syst: ChNS: Off J Int Soc Pediatr Neurosurg 28:1359–1367CrossRef
22.
go back to reference Muenke M, Kress W, Collmann H, Solomon BD (2011) Craniosynostosis in monographs in human genetics. Karger Basel Chapter 18: 217 Muenke M, Kress W, Collmann H, Solomon BD (2011) Craniosynostosis in monographs in human genetics. Karger Basel Chapter 18: 217
23.
go back to reference Linz C, Collmann H, Meyer-Marcotty P, Bohm H, Krauss J, Muller-Richter UD, Ernestus RI, Wirbelauer J, Kubler AC, Schweitzer T (2015) Occipital plagiocephaly: unilateral lambdoid synostosis versus positional plagiocephaly. Arch Dis Childhood 100:152–157CrossRef Linz C, Collmann H, Meyer-Marcotty P, Bohm H, Krauss J, Muller-Richter UD, Ernestus RI, Wirbelauer J, Kubler AC, Schweitzer T (2015) Occipital plagiocephaly: unilateral lambdoid synostosis versus positional plagiocephaly. Arch Dis Childhood 100:152–157CrossRef
Metadata
Title
Diagnostic features of prematurely fused cranial sutures on plain skull X-rays
Authors
Tilmann Schweitzer
Felix Kunz
Philipp Meyer-Marcotty
Urs Dietmar Achim Müller-Richter
Hartmut Böhm
Clemens Wirth
Ralf-Ingo Ernestus
Christian Linz
Publication date
01-11-2015
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 11/2015
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-015-2890-4

Other articles of this Issue 11/2015

Child's Nervous System 11/2015 Go to the issue