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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