Presentation
Abnormal shape of the head. CT was requested to assess the skull sutures and to exclude brain atrophy
Patient Data
Axial and 3D reconstruction of CT scan head showing fused metopic suture with midline frontal bony ridging and triangular head shape. They also show premature closure of the anterior fontanelle with still opened other skull sutures including (coronal, sagittal and lambdoid sutures).
SSD rendering images show some associated facial deformities including: Nasal deformity (right-sided supernumerary nostril), broad nasal bridge and ear deformity (right cupped / lop ear) and bilateral preauricular skin tags.
Case Discussion
Trigonocephaly is the premature fusion of the metopic suture leading to deformation of the anterior calvarium and causing triangular shape of the forehead. In most cases, surgical correction is performed for aesthetic and psychosocial reasons.
The metopic suture is usually open at birth and normally fuses in the first 12 months of life.
In our case trigonocephaly was associated with some facial deformities including; nasal deformity (right sided supernumerary nostril), broad nasal bridge and ear deformity (right cupped / Lop ear) and bilateral preauricular skin tags. Genetic counseling was advised.