How to check the premature closure of cranial suture at home, and the reason of premature closure of cranial suture is not completely clear. In the process of rapid brain development, in order to cooperate with the rapid development of brain tissue in infancy, the suture can not be closed. Let's take a look at how to check premature closure of cranial suture at home.

How to check the premature closure of cranial suture at home 1 Look at the premature closure of cranial suture mainly by looking at the fontanel, which is mainly divided into the anterior fontanel and the posterior fontanel. The posterior fontanel was partially closed at birth, and the latest closing time was 6-8 weeks. The anterior fontanel was not closed at birth, and it began to close at 6 months, and the latest closing time was.

For children suspected of premature closure of cranial suture, the following examination should be done.

1, head circumference measurement:

There is a simple way to measure the forehead and occipital area with a soft ruler, and a more accurate way is to measure under the radiation image. Moreover, through special imaging, the volume of cranial cavity can be calculated, which is more conducive to the formulation of preoperative surgical plan.

2, head ultrasound examination:

Ultrasound has been studied as a low-cost method to replace CT. It has a certain development prospect, but there are also some potential defects. Compared with CT, ultrasound obviously depends more on the technicians who perform the operation. In the case of uncertain results, patients need further examination. CT can not only evaluate the affected bone suture, but also evaluate other parts. It is also necessary to evaluate the secondary cranial suture, brain anatomy and any abnormal vascular structure that may be problematic. Because there is still a lot of work to be done to evaluate cranial cavity stenosis with ultrasound.

3. Skull X-ray:

Craniography was once widely used to observe the closure of cranial suture, whether the cranial suture is symmetrical and the direction of travel, but now it is gradually replaced by cranial CT and reconstruction.

4. Head CT:

Cranial CT examination and three-dimensional reconstruction are the gold standard for the diagnosis of craniosynostosis. One or more bony fused cranial sutures can be clearly displayed, and the situation of ventricular dilatation and hydrocephalus can be evaluated through the diffuse finger compression sign of chronic intracranial hypertension.

Cranial CT can identify bone suture more accurately than X-ray plain film, and can also evaluate the closure range and its influence on the adjacent skull.

CT can also check for brain abnormalities, including hydrocephalus. Asymmetry and deformity of skull base can also be found. CT can also be used to evaluate the spatial and geometric relationship between bony orbit and soft tissue components (eyeball and other extraocular muscles). All these are beneficial to the formulation of preoperative surgical plan.

CT three-dimensional surface reconstruction is helpful to the classification of craniofacial diseases. These images, combined with head measurements and anthropometric data, are helpful to quantify skeletal deformities and make surgical treatment plans for complex craniofacial reconstruction.

The changes of intracranial volume in children with premature closure of cranial suture can be calculated by CT, but these measured values are usually within the normal range.

5.3D printing

Now with the emergence of 3D printing technology, you can make a model of 1: 1 with your child's head, which is more conducive to preoperative planning.

6, head nuclear magnetic resonance:

For syndromic premature closure of cranial suture, MRI examination of skull can know whether it is related to Chiari malformation, and further understand the intracranial situation.

7, genetic testing:

At least 57 gene mutations have been proved to be related to premature closure of cranial suture. Because of the heterogeneity of related gene mutations, exon/whole genome sequencing can help patients with negative results of routine genetic tests find the pathogenic gene mutations.

The affected newborns suspected of having premature closure of cranial suture syndrome can be screened for gene mutation at an early stage. Gene screening includes genes encoding FGFR family members and TWIST. Pathogenic mutation is more common in children with premature closure of unilateral or bilateral coronal suture, but not in children with premature closure of sagittal suture, frontal suture and non-cranial suture syndrome.

8, prenatal testing

It is also an important step to find early cranial cavity stenosis during pregnancy and delivery.

Prenatal examination: fetal ultrasound examination can make morphological analysis of fetal cranial suture. The study of gene mutation in amniotic fluid is helpful to the diagnosis of premature closure of cranial suture and can prompt the prognosis of the disease. Three-dimensional ultrasound can directly display the diseased cranial suture and fontanel. It is more accurate in the discovery and measurement of deformity. Fetal magnetic resonance imaging can evaluate brain development.

How to check premature closure of cranial suture at home 2 How to diagnose premature closure of cranial suture

1. X-ray film of the skull with pointed deformity shows that the medial orbital wall is inclined, the anterior cranial fossa is narrowed, the bone density is increased along the coronal suture, calcium is deposited, and there are often finger pressure notches on the skull. On the lateral radiograph, there is no X-ray projection on the supination of the frontal bone and the posterior bony process of the frontal bone, and the posterior cranial vault is normal.

2. The skull plain film of navicular head malformation showed that the skull was navicular, and the bone density increased and calcified along the sagittal suture. In severe cases, bone seams are not visible, while coronal seams, herringbone seams and squamous seams are widened or even separated. If there is an increase in intracranial pressure, traces of increased brain back pressure can be seen.

3. The X-ray manifestations of tricuspid valve malformation are short and high frontal bone, and the typical short orbit and vertical orbital inner wall can be seen in the frontal film.

4. X-ray manifestations of oblique head deformity are oblique head deformity, that is, the posterior long axis of orbit deviates outward. Cranial images showed that the bone mineral density was higher at the coronal suture, higher near the pterion, smaller anterior cranial fossa and steeper anterior cranial fossa base. The nose cone is skewed and the nose ridge is biased to the affected side.

5. In short head deformity, the bone density at the coronal suture on both sides increases, the change of skull base makes the anterior cranial fossa shorter and upright, the winglet at the pterygoid tip is raised and tilted upward and backward, and the pterygoid tip is raised to deepen the temporal fossa. The volume of the track becomes smaller.

When does the normal cranial suture close?

In the early stage of fetal and infant development, cranial suture is covered by soft fibrous tissue. With the development of the brain and the gradual increase of brain volume, several skulls also grow and expand, which is highly matched with the development speed of the brain. When the brain develops rapidly within 1 year, so does the skull. 1 year-old, the brain capacity is about 80% of that of adults.

Subsequently, the speed of brain development slowed down obviously and the cranial suture gradually closed. After the age of 6, when the brain volume basically stops developing, the skull forms a solid structure through close fiber connection to protect the brain tissue. The long process of human evolution has made this process perfect and finally seamless.

In fact, the closing time of the six main cranial sutures is different, which roughly follows the order of closing from front to back. Frontal suture is mostly closed at birth, sagittal suture and coronal suture begin to close after 1 year old, herringbone suture closes at the latest, and gradually closes after 2 years old, which is called "lazy" zigzag suture. The whole process of cranial suture closure lasts until about 6-7 years old, and it is completely closed at about 12 years old.

The closure of fontanel is not synchronous with the closure of cranial suture. The posterior fontanel is closed about 2-3 months after birth, and the anterior fontanel is closed at 1.5 to 2.5 years old.

How to check premature closure of cranial suture at home 3 What is "premature closure of cranial suture"? Why did you close early?

In the process of rapid brain development, in order to cooperate with the rapid development of baby brain tissue, the suture can not be closed. If one or more cranial sutures are abnormally closed in advance, the development space of brain tissue will be limited. This disease is called "premature closure of cranial suture". The cause of premature closure of cranial suture is not completely clear. During the development of cranial suture, some special genes or factors change, and the dynamic balance of skull cell proliferation, differentiation and apoptosis is unbalanced, which leads to premature closure of cranial suture.

About 80% of premature closure of cranial suture is related to developmental defects during embryonic development, and less than 10% of premature closure of cranial suture has clear genetic factors, that is, family history, which may be passed on to the next generation. In other cases without family history, some related mutant genes can also be found. Some studies have confirmed that premature closure of cranial suture is related to some substances that mothers contact during pregnancy, such as antidepressants and smoking, but the conclusion is not exact. About 7% of children's siblings also suffer from non-syndromic craniosynostosis with no definite mutation.

Is premature closure of cranial suture common?

Premature craniosynostosis is a congenital disease. The incidence rate in Europe is about 1/2500, that is, there will be one premature closure of cranial suture in every 2500 newborns. The newly announced number of newborns in 2020 is 1.2 million. According to the prevalence rate reported abroad, about 5000 children with premature closure of cranial suture are born every year in China.

Generally speaking, boys are more common, but different types of craniosynostosis have different gender advantages, and the overall male-female ratio is about 2: 1. In sagittal suture premature closure, frontal suture premature closure and herringbone suture premature closure, boys are more common, while in coronal suture premature closure, girls are more common.

But this is only based on the incidence rate in Europe, and there is no comprehensive and accurate statistics on the overall incidence rate in China and the differences between different ethnic groups and regions. But at least everyone can understand that premature closure of cranial suture is not a rare disease. For babies with abnormal head shape, don't think that they are "asleep" or "round when they grow up". Go to a specialist hospital for consultation as soon as possible.

What is the manifestation of premature closure of cranial suture?

After the cranial suture is closed in advance, the restriction of local bony structure hinders and oppresses the development of normal brain, and the shape of skull changes accordingly. Skull and brain tissue can only grow in other directions, leading to head deformity, which is manifested as cranial cavity stenosis. The most prominent performance is the abnormality of the head. According to the difference of skull suture closure, there are various head deformities, including navicular head, triangular head, oblique head, short head, tower head and pointed head. There will be a bone deposition bulge at the closed cranial suture, forming a prominent "bone ridge", which can often be touched.

In addition to abnormal head shape, different types of premature closure of cranial suture may also cause or combine other different deformities and nerve injuries. Those involved in coronal suture often cause the ipsilateral forehead and orbit to be abnormally flat, and the eye position, orbit and facial morphology are abnormally asymmetrical, which can affect vision development and even lead to blindness in severe cases.

Premature closure of frontal suture often leads to severe bilateral frontal lobe development restriction, which affects intelligence, and also causes ophthalmic problems such as narrowing of eye distance and decreased vision. Children with narrow skull syndrome often involve multiple cranial sutures, and the neurological function and intelligence are more seriously affected. Children are often accompanied by deformities in the nervous system, maxillofacial region, throat, mouth, limbs and other parts.