Single Suture Craniosynostoses: Physical Traits
Problems caused by sutural fusion:
Does a single sutural synostosis affect a child's development or intelligence?
This is a difficult question to answer. At the current time, we believe
it either does not affect a child's mental development, or if it does,
it cannot be measured by current testing. There are a number of studies
that have been published, which examine the possibility that there may
be raised intracranial pressure in children born with craniosynostosis.
One concern is that if the growing brain is kept from enlarging inside
the skull because a suture has closed prematurely, then as the space inside
the skull gets more crowded, pressure can build up. These studies suggest
that a small percentage of children with a single fused suture will have
raised intracranial pressure. When a group of children who were studied
to measure this raised pressure underwent additional I.Q. testing, it
was noted that those children with the highest pressure had lower I.Q.s.
There are a number of problems with all of these studies. To begin with,
we are not sure what a normal intracranial pressure is in an infant. In
addition, intracranial pressure normally varies up and down, and does
not stay constant. In these studies, the children with the lowest I.Q.s
also had syndromes, which we now know also involve an abnormal brain structure
(in some syndromes, we suspect that the brain may not be wired normally).
Finally, the I.Q. test examines only one form of intelligence. There are
not good tests for creative intelligence, artistic intelligence, musical
intelligence, social intelligence, "common sense", and other areas of
intelligence.
There are also some studies that suggest that children with single sutural
synostosis may have a higher rate of experiencing some minor developmental
or behavioral problems. Once again, it is not clear that these studies
are good ones. One of the many criticisms of these studies is that there
is not a good control group with which to compare children with craniosynostosis.
That is, a certain percentage of children who do not have craniosynostosis
would be expected to have some developmental or behavioral problems, and
perhaps there is the same percentage in children with craniosynostosis.
On the other hand, there may in fact be a higher incidence of developmental
delays or behavioral problems in children with craniosynostosis. We simply
cannot say for sure at this time. A number of questions persist: does
surgery help to prevent developmental problems? Are there different problems
specific to the different fused sutures? Is the brain less affected in
those cases where the skull is less affected? It has been our experience
that the vast majority of children with a single sutural synostosis are
normal children who just have early closure of one of their sutures.
Other common features of all
single sutural synostoses:
Skull | Fusion
of the Suture
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