Thread by @MollyCarnahan

1 of 3 infants has a misshaped skull & 1/2500 have craniosynostosis. This new @RadioGraphics Fundamentals presentation reviews CT findings of craniosynostosis & common syndromic causes. #RGphx #radres
Craniosynostosis: Understanding the Misshaped Head bit.ly/30aRqDY

Before 9 months of age, only the metopic suture can be fused normally. Sagittal, coronal & lamboid sutures narrow during childhood but should not fuse. CT is imaging modality of choice- describe shape/synostosis, ICP & vascular anatomy

2/11 #RGphx

In non-syndromic patients, usually 1 suture is involved: sagittal > coronal > metopic > lamboid.

Let’s review the key CT features of each.

3/11 #RGphx

Sagittal synostosis (scaphocephaly) is most common. On 3D reconstructions, the head looks long, like an inverted boat with a keel.

4/11 #RGphx

Coronal synostosis can be unilateral (anterior plagiocephaly) or bilateral (brachycephaly).

5/11 #RGphx

Bilateral coronal synostosis (brachycephaly)) has increased biparietal distance, hypertelorism, exorbitism & harlequin deformity.

6/11 #RGphx

Trigoncephaly, which can be seen in Jacobsen syndrome or Opitz C syndrome, has a triangular or pearlike shape.

7/11 #RGphx

Differentiating lamboid synostosis (posterior plagiocephaly) vs positional plagiocephaly is important for management. Posterior plagiocephaly is characterized by trapezoidal skull & posterior displacement of the ear.

8/11 #RGphx

15% of cases are syndromic. Most common causes: Apert, Crouzon & Pfeiffer syndromes. All 3 are AD inheritance.

9/11 #RGphx

In summary, low-dose CT is imaging modality of choice to evaluate which (if any) sutures have prematurely closed. Need to describe the head shape, confirm synostosis & vascular anatomy.

10/11 #RGphx

Thanks for following along and don’t forget to check out the full presentation in this excellent @Radiographics Fundamentals guide.

bit.ly/30aRqDY

And keep an eye out for more #RGphx #tweetorials

#Radres #RadEd