Skull base development and craniosynostosis

• Published in: Pediatric radiology Vol. 45; no. Suppl 3; pp. 485 - 496
• Main Authors: Blaser, Susan I., Padfield, Nancy, Chitayat, David, Forrest, Christopher R.
• Format: Journal Article Book Review
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-09-2015; Springer Nature B.V
• Subjects: Advances in Pediatric Neuroradiology; Craniofacial Abnormalities - diagnosis; Diagnosis, Differential; Echoencephalography - methods; Female; Humans; Imaging; Imaging, Three-Dimensional - methods; Magnetic Resonance Imaging - methods; Male; Medicine; Medicine & Public Health; Neuroradiology; Nuclear Medicine; Oncology; Pediatrics; Radiology; Skull Base - abnormalities; Skull Base - pathology; Tomography, X-Ray Computed - methods; Ultrasound; Radiography; Skull base; Magnetic resonance imaging; Computed tomography; Craniosynostosis; Craniofacial deformity; Ultrasonography; Children
• ISSN: 0301-0449; 1432-1998
• DOI: 10.1007/s00247-015-3320-1

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.