Each patient is individually evaluated based on the following parameters:
● Age● Health Status and body weight● 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. Brain pressure phenomena.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. 
2. Intracranial hypertensionThe 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). 
3. Progressive premature closure of other suturesEarly 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. 
4. Ophthalmological problemsFrom non syndromic craniosynostosis, the frontal plagiocephaly is accompanied very often by ophthalmological problems. the most common of which are: ● Strabismus, ie the eyes do not see one image, but two, consistently one image to be thwarted causing amblyopia in one eye. The eye that suffers is usually from the healthy side and not from the side of the lesion. This problem is completely curable if diagnosed in time, and is almost exclusively observed in the frontal plagiocephaly.● Swelling of the optic papilla is a sign of intracranial hypertension.It is clear, therefore, how necessary is the regular eye examination of children with early synostosis of cranial sutures.
 5. Cognitive and learning disordersThey 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.

Prognosis of non syndromic craniosynostosis is generally good if the appropriate intervention is performed in time and the child continues to be monitored regularly by the craniofacial team. Children are expected to live normal lives without restrictions, with distribution identical to that of the general population.

● Brachycephaly (short anteroposterior dimension of the head)● Facial hypoplasia● Exophthalmos that could lead, in severe cases, the eyelids not to close● Increased distance between the eyes (hypertelorism) usually in a non-serious degree.● The clinical picture varies from lighter form (which can elude diagnosis) to serious, incompatible with life.

In most cases individuals with Crouzon syndrome have normal intellectual development.

● Increased intracranial pressure due to the reduced capacity of the skull. It’s a common problem and can appear at any time with serious consequences.
● Decrease or loss of vision which is usually caused by increased intracranial pressure.
● Eye irritation due to weakness in the closure of the eyelids. It can create permanent corneal damage.
● Respiratory difficulty, especially during sleep obstructive sleep apnea). In severe form is incompatible with life. Even in the most mild forms it causes significant problems (disturbed sleep, sleepiness during the day, inability to concentrate).

It is diagnosed by physical examination and confirmed by gene identification. Gene identification is a lengthy process and becomes positive only about half of all cases, but that doesn’t matter because the confrontation of problems becomes the basis of the findings of physical examination.

Immediately after birth, clinical exam must be made for:
● Respiratory function. If there is difficulty in breathing which continues after the initial support in the intensive care unit, possibly a tracheostomy is required.
● Closure ability of the eyelids.If the baby cannot close his/her eyelids due to exophthalmos, a temporary tarsorrhaphy may be needed (the upper with the lower eyelid ) in order to protect the cornea until the permanent settlement of the problem.
● Intracranial pressure. It is rarely needed to take immediate measures to correct it. The cases in which urgent surgery is needed are extremely serious and almost incompatible with life.

Because there is almost always a limitation of the capacity of the skull and the brain undergoes pressure, in infancy this pressure must be relieved with expansion (growth) of the cranial cavity. Usually the initial surgery is performed in the back area of the skull in parietal and occipital area (Parietal Decompression). A few months later (if necessary) decompression in anterior part of the skull follows (fronto-orbital advancement). In this intervention the area of ocular conches is formed and exophthalmos is somewhat reduced. Finally, at the age of 10-12 years complete and permanent correction of the deformity and the functional problems are achieved by transferring the anterior part of the skull and face forward with Distraction Osteogenesis (fronto–orbital advancement). This operation can be done at an earlier age, if necessary, due to functional problems that require immediate solution (obstructive apnea, increased intracranial pressure causing decreased vision).

Apert syndrome is caused by two mutations in the FGFR2 gene of chromosome 10. These mutations can be detected in most cases and cause disturbance of the bone and cartilage structure. Mutations can be inherited by parents or can be created without any family history. Most cases are due to new mutations.

From the functional problems the most serious are:
● Obstructive apnea, especially during sleep.● Increased intracranial pressure, which may be presented at any stage and age (see chapter). Increased intracranial pressure can be generalised (and more easily detected) or there might be only topical pressure on the frontal lobes due brachycephaly.● Eye problems which often lead to a decrease in vision.● Mental retardation occurs in all children with Apert syndrome, but the severity varies.● Oily skin and acne.● Frequent episodes of otitis.
Less emphasis has been attributed in the past to abnormalities of the respiratory system. Apart from the narrowness of the throat there may be significant problems in the larynx, the trachea and the bronchi, which can lead to serious respiratory problems.
Finally, characteristic of Apert syndrome is megalocephaly, which occurs in some cases, i.e. the size of the brain is greater than normal.

Surgeries for the treatment of Apert syndrome usually begin from infancy.

Depending on the findings one may need:● Opening in the posterior part of the skull (occipital parietal area) in order to give more space to the brain when there is local pressure points.● Opening and relocation of anterior skull squadron i.e. the area of the eyes and the forehead in order to fully decompress each anterior brain lobes and improve exophthalmos.

At the age of about ten years a bigger surgery is usually needed, the so-called monobloc advancement technique, which is the separation of the anterior part of the skull from the middle third of the face and moving it forward. This surgery aims to correct the short skull and face, but also relieves obstructive apnea, which always exist to some degree. It is possible for this surgery to be done in infancy, on an urgent basis if obstructive apnea is severe and cannot be treated differently.

Simultaneously with the starting of the craniofacial recovery, in the Apert syndrome, the treatment of the hands should start so that the child’s hands become functional. This is done by special hand surgeons. Usually the initial surgeries consist in freeing the thumb and gradually the remaining fingers.