How is Craniosynostosis Diagnosed?

Normally diagnosis of craniosynostosis can be carried out by a pediatrician, they would perform a visual assessment and feel the sutures around the baby's skull to check for ridges. Usually this kind of test is enough to tell if the baby does have the defect, however the pediatrician may request additional tests to confirm this in more detail.

Imaging tests (such as CT scans and X-rays) are an effective way of seeing which sutures have fused this would be highly beneficial if surgery were to be performed.

As craniosynostosis can be caused by hereditary genetic mutations, a sample of the baby's hair, blood or saliva might be taken and the genes tested.

How is Craniosynostosis Treated?

The primary treatment method of craniosynostosis is surgery, which is best done within the first year of the child's life. The main goal of the surgery is to let the cranial vault develop normally. If surgery is not performed the condition can get worse and the skull deformity increase.

Normally the surgery is performed by a team of two surgeons; a craniofacial surgeon and a neurosurgeon. A craniofacial surgeon specializes in head and facial surgery, and also surgery of the jaw. A neurosurgeon specializes in the brain and nervous system.

When undergoing surgery, the child would be under general anesthetic and unconscious, so they would not feel any pain. In the traditional surgical method, the neurosurgeon makes an incision across the top of the infant's scalp and removes the areas of the skull that have become misshapen.

The craniofacial surgeon then reforms these sections of skull and they are then placed back in the head. The opening is then sewn up using dissolvable stitches. The entire process can last several hours.

The child will stay in hospital for a few days after the surgery, their face may swell but this is common and is not a need for concern. Sometimes further surgery is required to reshape their faces or if the craniosynostosis reappears. The child will have regular check-ups after surgery to monitor their skull development.

There is a less invasive method known as endoscopic surgery. This is when a couple of small incisions are made in the scalp and the sutures are cut using an endoscope (a flexible tube that can be used for keyhole surgery). This unfortunately cannot be performed on every child with craniosynostosis due to certain limitations such as location of the fused suture. This type of surgery is much quicker and doesn't lead to as much blood loss or swelling.

What are the Risk Factors of Craniosynostosis?

If not treated a child with craniosynostosis can develop further complications as their skull will continue to grow abnormally and this may affect other functions. An example of this is vision loss on the affected side (amblyopia).

Another risk factor is if the child has a mild case of craniosynostosis, meaning the condition might not be spotted until later. If this is the case, the child may suffer ICP (intercranial pressure) in their skull. This can happen as late as age 8. The symptoms of intercranial pressure include:

• blurry/double vision
• quality of school work may randomly deteriorate
• constant headache

The above symptoms do not necessarily mean the child is suffering intercranial pressure but it is definitely worth taking them to the doctor/pediatrician to get checked out as ICP can cause much greater problems if left untreated.