Presentation
Increased head circumference with an elongated skull appearance.
Patient Data
There is a premature and complete closure of the sagittal suture with near total closure of the lambdoid sutures. The coronal and squamosal sutures are patent and normal. There is early inner table scalloping. There is no associated congenital intracranial abnormality and especially there is no obstructive hydrocephalus.
3D reformats confirming sagittal and bilateral lambdoid craniosynostoses. The 3D reformats are often diagnostic and confirmatory of the clinical suspicion.
Case Discussion
CT confirms features consistent with scaphocephaly and pachycephaly.
A classical appearance of an elongated and narrow skull is best appreciated on the 3D reformats. The 3D reformats are dramatic and remarkably assist in confirming craniosynostosis in most instances and are highly recommended to review in all cases of potential craniosynostosis as an axial sutural assessment on bony windows can be difficult to interpret.
Often times the patient is restless, non sedated and motion artefacts will degrade the image acquisition and quality, which may interfere with an accurate assessment. In these instances, sedation and/ or anesthetic assistance can be considered.