Topic Overview
What is craniosynostosis?
Craniosynostosis (say
"kray-nee-oh-sih-noh-STOH-sus") is a problem with the skull that causes a
baby's head to be oddly shaped. In rare cases it causes pressure on the baby's brain, which can cause damage. It is also called craniostenosis.
A baby's skull is not just one
bowl-shaped piece of bone. It is made up of five thin, bony plates that are
held together by fibrous material called
sutures. The sutures let the skull expand as the
brain grows. Over time, the sutures harden and close the skull bones together.
When a baby has craniosynostosis, one or more of these sutures
close too soon. How the
problem affects your baby depends in part on how many of the sutures
close too soon:
- If only one suture closes too soon, the baby's brain
usually develops normally, but the head has an odd shape. This is what happens in most
cases.
- If more than one suture closes too soon, the
baby's brain may not be able to grow as fast as it should. If severe pressure
builds up around the brain, it may cause brain damage, seizures, blindness, and
developmental delays. But this severe pressure is
rare.
What causes craniosynostosis?
Experts aren't sure
what causes this problem. In some cases, it runs in families. If you've had a baby with craniosynostosis and are planning another pregnancy, you may want to talk to your doctor about genetic counseling.
Craniosynostosis is more likely in:
- Babies who lie in a
breech position while in the
uterus.
- Babies whose mothers smoke or live at a
high altitude during pregnancy.
- Babies who are twins.
What are the symptoms?
The most common sign is an oddly shaped head at birth or by the time the child is a
few months old. For example, the skull may become long and narrow. Or it may be
very flat and broad in front or back or on the sides. The baby may have a misshapen nose or jaw.
An oddly shaped head may be the only sign
of craniosynostosis.
In rare cases, the disease causes pressure to
build up on the baby's brain. This can cause brain damage and can make the baby
develop more slowly than other children. If you know that your baby has this
condition, call your doctor right away if your baby:
- Starts vomiting.
- Becomes
sluggish and sleeps more and plays less.
- Becomes crankier than
usual.
- Has swollen eyes or has problems moving the eyes or
following objects.
- Has problems hearing.
- Breathes
noisily or doesn't breathe for short periods of time.
How is craniosynostosis diagnosed?
You or your
doctor may notice that your baby has an odd-shaped head at birth, shortly after
birth, or later at a well-child checkup.
Just because your baby has an oddly
shaped head doesn't mean that he or she has craniosynostosis. Head shape
may be affected by how your baby was positioned in your uterus, the birth
process, or your baby's sleep position. Talk to your doctor if you are
concerned about the shape of your baby's head.
Your doctor will:
- Look at each side of your baby's face and
head.
- Measure your baby's head.
- Feel the sutures and
soft spots (fontanelles) on the skull.
- Feel the top and sides of the head, where sutures are located, for unusual ridges or
bumps.
Your baby's doctor may also order a skull
X-ray,
CT scan, or
MRI.
How is it treated?
Surgery is the usual treatment to
correct
craniosynostosis. It's usually done in the
first year of life. The surgeon removes strips of bone in the skull
to create artificial
sutures. This surgery prevents or relieves pressure on the brain and allows the skull to expand normally. It also corrects the shape of your baby's head.
The earlier your child has surgery, the better the results. If there is
pressure on the brain, your child needs surgery right away. If your baby
doesn't seem to have pressure on the brain, your doctor may advise you to wait
and see if the head shape returns to normal without surgery. Your child
may wear a special helmet or other device to help reshape the skull. But your
child may still need surgery later.
If your child needs surgery,
talk with your doctor about what to expect.
It may help to see some before-and-after pictures of other children who have had the same type
of surgery so that you are prepared for how your child will look right after
the surgery. There may be a lot of swelling and bruising at first.
Being involved in your baby's care while he or she is in the hospital may help you feel more comfortable when you take your baby home. You'll need to know how to care for your baby's incision and what problems to watch for. Problems after surgery aren't common.
It's normal to feel a wide range of emotions when your child has a problem like craniosynostosis. Counseling or a support group can help.