Skull deformities that occur when the cartilages in babies' heads close prematurely are called "craniosynostosis". Craniosynostosis can prevent the growth of the brain, causing developmental problems and loss of function. It is of great importance for the child's mental development to recognize this situation at an early stage and make the necessary interventions.
The skull consists of 5 bones, and these bones are joined by immovable joints called "sutures". In the newborn baby, these bones are separate from each other. The sutures remain open until the age of one so that the brain can grow properly. In this way, during the first year of life and subsequent childhood, when the brain develops most rapidly, the skull takes shape according to the development of the brain.
How is it formed?
As a result of the early fusion of some of the skull bones. In a condition called Craniosynostosis, the growth of the skull is impaired. The side where the prematurely fused bone is located cannot develop. In addition to the resulting deformity, congestion and pressure occurs in the developing brain. This may cause developmental delay. Craniosynostosis, which occurs as a result of premature closure of the baby's skull bones, may differ from fused bones.
What are its effects?
When a suture closes prematurely, a skull deformity occurs. In patients, shape changes occur around the eyes and on their faces due to premature closure of the sutures at the base of the skull. Premature closure of the skull bones, which are normally open at birth and usually remain open until the age of 4 after birth, can negatively affect the baby's brain development. Premature suture closure causes the baby's brain to lose enough space to grow.
How is the diagnosis made?
It is difficult to make a diagnosis in the womb. During this period, detailed ultrasound may be stimulating. The diagnosis is usually made after birth. The family or pediatrician often notices that the child has a head deformity or a premature closure of the fontanel. An asymmetrical appearance is observed on the babies' faces, especially an unusual appearance in the shape of the eyes and skull.
The definitive diagnosis of postnatal craniosynostosis is made by head radiographs and three-dimensional tomography. Magnetic resonance (MR) in syndromic cases imaging and examinations are required.
After diagnosis, it is important whether the disease is isolated or accompanied by a syndrome.
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Baby's hand and foot examination
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Fetal brain MRI examination
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Examination of the baby's intracranial structures
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Genetic specialist consultation
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Examination of the baby's heart
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Consultation of a neurosurgeon
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If there is a family history or syndromic, amniocentesis is required.
Treatment. What are the options?
Treatment in the womb is not possible. However, surgical intervention can be performed after birth after being evaluated by a neurosurgeon.
If there is deformity in the sutures without closure, that is, without the bones boiling, these children can be treated using a personalized helmet.
If the bones are fused after the sutures are closed. Surgical treatment is required. Surgical intervention is generally performed on babies between the ages of 3 months and 1 year. Surgical treatment is performed for both cosmetic reasons and to relieve brain pressure so that development does not retard.
Surgical treatment can be performed in two ways: open and closed (endoscopic). During surgery, the fused bones are separated from each other. In some cases, it is necessary to wear a helmet after surgery. Rarely, repeat surgery may be required during follow-up.
Post-operative follow-up
After the surgery, the patient's vital functions and blood balance should be closely monitored. Patients are usually discharged from the hospital after a one-day stay. If a helmet is to be used after the surgery, it should be used in a way that prevents head growth in the front and back and allows growth to the sides. It should be followed for many years.
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