Pseudoclosure of anterior fontanelle by wormian bone in isolated sagittal craniosynostosis.
OBJECTIVE
Although syndromic craniosynostosis is one of the causes for early closure of the anterior fontanelle, there is no literature on the incidence and causes of fontanelle closure in isolated single-suture craniosynostosis. The objective of this study was to review the incidence of fontanelle closure by a wormian bone in isolated, nonsyndromic sagittal craniosynostosis.


METHODS
Intraoperative records of 100 consecutive children under 1 year of age, operated for isolated sagittal synostosis over a 14-year period (1987- 2000), were reviewed to identify the presence of a wormian bone closing the anterior fontanelle.


RESULTS
The median age at surgery was 4.2 months with a range of 1.9-11.7 months. Intraoperatively, a wormian bone was seen replacing the anterior fontanelle in 4 cases giving an incidence of 4%.


CONCLUSIONS
A wormian bone can occupy the anterior fontanelle in children with isolated sagittal craniosynostosis giving the appearance of a 'closed fontanelle'.
Agrawal
Deepak
D
Division of Pediatric Neurosurgery, Department of Pediatric Surgery, British Columbia's Children's Hospital, Children's and Women's Health Centre, Vancouver, Canada.
Steinbok
Paul
P
Cochrane
D Douglas
DD
D035262:Cranial Fossa, Anterior / Q000002:abnormalities* / Q000601:surgery; D003393:Cranial Sutures / Q000002:abnormalities* / Q000601:surgery*; D003398:Craniosynostoses / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors