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

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.

Authors+Show Affiliations

Department of Neurosurgery, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

7674026

Citation

Francel, P C., et al. "Frontal Plagiocephaly Secondary to Synostosis of the Frontosphenoidal Suture. Case Report." Journal of Neurosurgery, vol. 83, no. 4, 1995, pp. 733-6.
Francel PC, Park TS, Marsh JL, et al. Frontal plagiocephaly secondary to synostosis of the frontosphenoidal suture. Case report. J Neurosurg. 1995;83(4):733-6.
Francel, P. C., Park, T. S., Marsh, J. L., & Kaufman, B. A. (1995). Frontal plagiocephaly secondary to synostosis of the frontosphenoidal suture. Case report. Journal of Neurosurgery, 83(4), 733-6.
Francel PC, et al. Frontal Plagiocephaly Secondary to Synostosis of the Frontosphenoidal Suture. Case Report. J Neurosurg. 1995;83(4):733-6. PubMed PMID: 7674026.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Frontal plagiocephaly secondary to synostosis of the frontosphenoidal suture. Case report. AU - Francel,P C, AU - Park,T S, AU - Marsh,J L, AU - Kaufman,B A, PY - 1995/10/1/pubmed PY - 1995/10/1/medline PY - 1995/10/1/entrez SP - 733 EP - 6 JF - Journal of neurosurgery JO - J Neurosurg VL - 83 IS - 4 N2 - 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. SN - 0022-3085 UR - https://www.unboundmedicine.com/medline/citation/7674026/Frontal_plagiocephaly_secondary_to_synostosis_of_the_frontosphenoidal_suture__Case_report_ L2 - https://thejns.org/doi/10.3171/jns.1995.83.4.0733 DB - PRIME DP - Unbound Medicine ER -