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Skull base development and craniosynostosis

  • Advances in Pediatric Neuroradiology
  • Published:
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Abstract

Abnormal skull shape resulting in craniofacial deformity is a relatively common clinical finding, with deformity either positional (positional plagiocephaly) or related to premature ossification and fusion of the skull sutures (craniosynostosis). Growth restriction occurring at a stenosed suture is associated with exaggerated growth at the open sutures, resulting in fairly predictable craniofacial phenotypes in single-suture non-syndromic pathologies. Multi-suture syndromic subtypes are not so easy to understand without imaging. Imaging is performed to define the site and extent of craniosynostosis, to determine the presence or absence of underlying brain anomalies, and to evaluate both pre- and postoperative complications of craniosynostosis. Evidence for intracranial hypertension may be seen both pre- and postoperatively, associated with jugular foraminal stenosis, sinovenous occlusion, hydrocephalus and Chiari 1 malformations. Following clinical assessment, imaging evaluation may include radiographs, high-frequency US of the involved sutures, low-dose (20–30 mAs) CT with three-dimensional reformatted images, MRI and nuclear medicine brain imaging. Anomalous or vigorous collateral venous drainage may be mapped preoperatively with CT or MR venography or catheter angiography.

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Conflicts of interest

Drs. Blaser, Padfield, Chitayat and Forrest have no financial interests, investigational or off-label uses to disclose.

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Authors and Affiliations

  1. Department of Diagnostic Imaging, Division of Neuroradiology, The Hospital for Sick Children and University of Toronto, Toronto, M5G 1X8, Canada

    Susan I. Blaser & Nancy Padfield

  2. Department of Otolaryngology — Head and Neck Surgery, University of Toronto, Toronto, Canada

    Susan I. Blaser

  3. Division of Clinical and Metabolic Genetics, The Hospital for Sick Children and University of Toronto, Toronto, Canada

    David Chitayat

  4. Prenatal Diagnosis and Medical Genetics Program, Mount Sinai Hospital and University of Toronto, Toronto, Canada

    David Chitayat

  5. Centre for Craniofacial Care and Research, Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children and University of Toronto, Toronto, Canada

    Christopher R. Forrest

Authors
  1. Susan I. Blaser
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  2. Nancy Padfield
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  4. Christopher R. Forrest
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Correspondence to Susan I. Blaser.

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Blaser, S.I., Padfield, N., Chitayat, D. et al. Skull base development and craniosynostosis. Pediatr Radiol 45 (Suppl 3), 485–496 (2015). https://doi.org/10.1007/s00247-015-3320-1

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  • DOI: https://doi.org/10.1007/s00247-015-3320-1

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