Sagittal Craniosynostosis

Sagittal craniosynostosis—also called scaphocephaly or dolichocephaly—is the most common type of craniosynostosis, occurring when bones in a baby’s head fuse abnormally.

What Is Sagittal Craniosynostosis?

Craniosynostosis occurs when certain bones in a child’s skull join early. At birth, the skull is made of several separate bones with growth plates between them.

Because the skull is not yet solid bone, the brain can grow and expand inside. Normally, sutures close in adulthood.

In some children, skull bones fuse earlier than they should. Sagittal craniosynostosis means early closing of the suture that runs front to back along the top of the head. Babies are usually identified soon after birth by an abnormal head shape.

When this happens, limited room for skull expansion can put pressure on the brain and may interfere with normal brain growth. Scaphocephaly also makes the child’s head look elongated and narrow. For that reason, we recommend early evaluation when parents notice this—preferably before six months of age.

Figure 1. Sagittal craniosynostosis (1)

Figure 2. Sagittal craniosynostosis (1)

How Is Sagittal Craniosynostosis Treated?

When bones fuse early, the only way to separate them is surgery. Depending on the patient’s condition, neurosurgeons may perform endoscopic or open craniosynostosis surgery.

• Endoscopic craniosynostosis repair. In suitable patients, minimally invasive surgery may be considered for scaphocephaly. After endoscopic surgery, helmet therapy is often recommended—both to protect from trauma and to guide ongoing shaping. Helmets are fitted only at CranioWell Orthotics & Prosthetics Centers.
• Open craniosynostosis repair. A traditional technique is used for children who are not candidates for minimally invasive surgery. Bleeding risk and intensive-care stay may be somewhat longer with this approach.

What Causes Sagittal Craniosynostosis?

Sagittal craniosynostosis can appear in an otherwise healthy baby with no known cause, but it is also linked to:

• Apert syndrome
• Beare-Stevenson syndrome
• Crouzon syndrome
• Jackson-Weiss syndrome
• Muenke syndrome
• Pfeiffer syndrome

How Is Sagittal Craniosynostosis Diagnosed?

Diagnosis can usually be made with a simple physical examination. A quick, painless imaging study (X-ray or CT scan) may also be ordered to confirm the diagnosis.

Source: R. Seeberger, J. Hoffmann, C. Freudlsperger, M. Berger, J. Bodem, D. Horn, M. Engel, Intracranial volume (ICV) in isolated sagittal craniosynostosis measured by 3D photocephalometry: A new perspective on a controversial issue, Journal of Cranio-Maxillofacial Surgery, Volume 44, Issue 5, 2016, Pages 626-631, ISSN 1010-5182, https://doi.org/10.1016/j.jcms.2016.01.023.