Single Suture Craniosynostoses: Physical traits
Fusion of the Suture:
What causes these sutures to fuse shut? We know that a number of factors
can lead to early closure of a suture. The two most common causes for
premature closure of a suture are genetic and environmental. For children
affected with one of the single sutural closures, we currently believe
that the most common cause is environmental. We know that it is possible
to cause craniosynostosis in animals by restricting the skull from growing
any larger while the animal is still in the womb. It is very likely that
this is the primary cause for the majority of the single sutural synostoses.
The uterus, or womb, is a relatively small space. We know that sometimes
babies can end up in certain positions in the uterus where they cannot
move around freely. One example would be those children who end up in
a breech position, and can only be delivered by c-section. We theorize
that children with a single sutural synostosis somehow end up positioned
in the uterus so that there is pressure on the skull. This pressure can
restrict the ability of the skull bones to be stretched apart by the growing
brain. If the suture is not stretched apart, it "thinks" it's job is done
and it fuses shut with normal bone. Abnormal skull shapes and single sutural
synostosis is seen more commonly in twins than in single births, further
supporting the theory of inutero constraint. It is also more common in
boys than girls leading some researchers to speculate that testosterone
might make suture closure more likely if there is any restriction of skull
growth inside the uterus. Mothers who have delivered babies with single
sutural synostosis should not feel guilty that they did anything wrong
during their pregnancy to cause this condition. Craniosynostosis occurs
in spite of the mother doing everything "right."
There are reports in the literature, and we have seen cases as well,
of single sutural synostosis that are passed from generation to generation.
This hereditary pattern suggests that the single sutural synostosis is
caused by a problem with a gene and is being passed from one family member
to the next. For example, a specific gene has been identified as causing
plagiocephaly (unilateral coronal suture fused) in the same family, and
this same gene has been identified in a small percentage of other children
In spite of these rare occurrences, the overwhelming majority of single
sutural synostoses appear to be the product of two parents with normal
genes, and a mother who has normal prenatal care. When a child born with
a single sutural synostosis grows up, and decides to have children, the
chance of passing on the condition to his or her offspring is estimated
to be less than 2%. If a couple has a child who is born with a single
sutural synostosis, the chance of this couple having a another child with
a single sutural synostosis is also thought to be about 2%.
Other common features of all
single sutural synostoses:
Skull | Problems
Caused by Sutural Fusion
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