Craniosynostosis is the early fusion of two or more bones of the skull.
Craniosynostosis is the early fusion of two or more bones of the skull. Baby skull consists of bones which have not yet joined to each other but are connected by flexible links called cranial sutures. Since in the early stages of life the brain has particularly strong growth potential, bones, succumbing to the pressure of the developing brain are dissociated from one another, allowing the smooth development of the brain and skull. When the development of the brain stops, cranial sutures lose their functional importance and they no longer have a reason for existence, so they are covered by bone and and bones are joined to each other.
The early synostosis, i.e. the early union of the bones, prevents the normal development of the skull and brain and induces morphological (changes in the normal shape of the head), functional, as well as developmental problems in children. If a suture between two bones fuses prematurely then the skull cannot grow naturally and bones will still have open sutures that will grow more countervailing so as not to limit the growth of the brain. This results in the further development of a malformed skull.
Craniosynostosis may be evident at birth or it might be observed later. It is diagnosed by physical examination, usually in combination with diagnostic imaging. During the examination a complete medical history is taken and the necessary measurements are made.
Each patient is individually evaluated based on the following parameters:
2. Age
3.Type and extent of craniosynostosis
Therefore the plan of each case is completely personalised based on the specific needs of the child. Usually treatment is possible only with surgery. The aim is to correct the shape of the head so as to allow the normal development of the brain and the shape of the skull and the reduction of intracranial pressure if there is any.
Nowadays specialized surgical cranioplasty surgeries are specifically performed to restore the skull and facial skeleton deformities.
These surgical interventions, are performed as a general rule during the first months of life so as the fetal benefits by the increased capacity on the tissue (the periosteum and crestal dura) to form the bone after surgery.
The cranioplasty procedures must be carried out by specialized ΤΕΑΜ in Craniofacial Centers by scientists and doctors with training extensive experience in this type of patients.
1
In the area of craniosynostosis the brain is pressed from lack of space created and thus this area cannot be supplied by adequate blood. The consequence of this may be the incomplete creation of synapses between nerve cells that are necessary for the normal development of the nervous system.
The pressure exerted on the brain from the overlying deformity of the skull may cause increased intracranial pressure, namely generalized intracranial hypertension, or practiced locally only in part of the brain located below the deformed bone. This problem is more frequent than previously thought and the higher rates we observe are in premature closure of the sagittal suture (scaphocephaly).
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Early closure of coronal suture has been observed after surgical correction of scaphocephaly. This problem prevents the simultaneous removal of coronary artery suture in the correction of scaphocephaly.
From non syndromic craniosynostosis, the frontal plagiocephaly is accompanied very often by ophthalmological problems. the most common of which are:
It is clear, therefore, how necessary is the regular eye examination of children with early synostosis of cranial sutures.
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They are observed in increased frequency in children with non syndromic craniosynostosis and they occur during preschool age. It has not been clarified whether they are caused by craniosynostosis or if simply they are due to the same gene that causes them. An evaluation is recommended by a pediatrician once a year from the age of two and thereafter so that if this problem is suspected an early therapeutic intervention is scheduled.