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Abnormal Skull
Published in Swati Goyal, Neuroradiology, 2020
Normal sutures allow skull growth perpendicular to their long axis, a phenomenon which is restricted in this pathology. The metopic suture closes first, followed by the coronal and lambdoid sutures. The sagittal suture is usually the last one to obliterate.
Clefts and craniofacial
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
The metopic suture normally fuses ~2 years of age. Metopic synostosis leads to trigonocephaly with flattening of the frontal bones, a midline forehead ridge and bitemporal narrowing with flaring of the parietal bones.
Head and Neck
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
Shifting from the base and back of the skull to its front, the frontal bone includes the following landmarks and structures: glabella, the superciliary arch, supraorbital notch (foramen), foramen cecum, orbital surface, lacrimal fossa, and supraorbital margin (Plates 3.7a and c, 3.8a and c, and 3.12). The junction between the frontal bone and the nasal bones is called the nasion. The roof of the skull grows rapidly during fetal stages and, in humans, for several years after birth. This rapid growth is necessary to accommodate the extensive increases in brain size as neurons mature and become myelinated. The frontal suture or metopic suture (meaning “among”) is the suture between the two frontal bones and is usually closed in the adult but palpably open in a newborn human baby, which helps the infant’s head to safely compress to ease its movement through the birth canal.
Early Prenatal Ultrasound and Molecular Diagnosis of Apert Syndrome: Case Report with Postmortem CT-Scan and Chondral Plate Histology
Published in Fetal and Pediatric Pathology, 2022
Gabriele Tonni, Gianpaolo Grisolia, Maurizia Baldi, MariaPaola Bonasoni, Vladimiro Ginocchi, Liliam Cristine Rolo, Edward Araujo Júnior
A 36-year-old mother, gravida 2, para 1, with a previous uneventful pregnancy, underwent routine second trimester scan at 19 weeks of gestation using both a Voluson E6 (GE, Milwaukee, WI) and a Samsung WS80A (Seul, South Corea) apparatuses equipped with a transabdominal 2 D/3D multifrequency 2.5-5.0 MHz probes. A premature closure of the cranial sutures together with a wide metopic suture and bregmatic fontenelle and turribrachicephaly was seen by both 2D and 3D ultrasound in multiplanar mode and using skeleton mode (Figure 1A,B). Using a gradient light 3 D application called Realistic Vue™, an associated syndactyly of the left hand was clearly detected (Figure 2A,B). The scan revealed features consistent with a presumptive prenatal diagnosis of craniosynostosis. Amniocentesis performed at 20 weeks demonstrated a 46, XX karyotype. The amniotic fluid α-FP level was within the normal range. A genetic panel was performed comprising mutations in FGFR1 (fibroblast growth factor receptor)(exon 8), FGFR2 (exons 8,10), FGFR3 (exon 7), Twist (exon 1).
Unilateral Anophthalmia and Congenital Frontal Cranioschisis Associated with Extradural Neuroglial Heterotopia: new Insights into a Possible New Malformative Spectrum
Published in Fetal and Pediatric Pathology, 2023
Javier Arredondo Montero, Mónica Bronte Anaut, Carlos Bardají Pascual
In relation to the etiopathogenesis, we believe that the presence of neuroglial heterotopia in our patient was what conditioned the frontal ossification defect. The closure of the metopic suture begins at 3 months of age and concludes around 8 months of age. Although it is not known exactly when neuroglial heterotopia appears, there is consensus that it is a prenatal defect secondary to aberrant migration of cells of the central nervous system. Like Tanii et al. (9), we consider that this nosological entity may be framed within neural tube defects and that it is probably a form of aborted encephalomyelomeningocele. The integrity of the dura mater and the absence of communication with the subdural space is what establishes the potential distinction with this entity.
Test-retest validation of a cranial deformity index in unilateral coronal craniosynostosis
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
Emilie Robertson, Peter Kwan, Gorman Louie, Pierre Boulanger, Daniel Aalto
The UCS and matched control CT scans are imported into 3D Slicer. Using the transforms function, the images are manually aligned in three dimensions of translation and rotation (anterior-posterior, superior-inferior, right-left). The control skull is assigned as the ‘moving image’ for the alignment and the registration steps. Figure 1 shows the axial, sagittal, and coronal views of the UCS and normal CT scans as they import in 3D Slicer. In panel A, the two images are superimposed. The first step is to translate the skulls in the super-inferior plane, as demonstrated from panel A to panel B. Helpful landmarks for this alignment are the sella turcica and the orbital roof on the non-synostotic side. Next, the normal skull is translated in the anterior-posterior plane to align the contours of the frontal bones. The naso-frontal angle and sella turcica are useful landmarks in the sagittal view to align the cranial vault. Following this step, the normal skull is rotated in the horizontal plane to bring the metopic sutures, as viewed on the axial image, into a parallel relationship. In panels C and D, a dashed white line bisecting the frontal bone at the metopic suture on each skull demonstrates this improvement. After this, the normal skull is translated again in the right-left dimension to align the frontal bones at the metopic suture. The deformity index is a calculation derived from the discrepancy at the frontal bones between a UCS and a normal skull. For this reason, the goal of the manual alignment step is to have the non-synostotic frontal bones line up on the axial and sagittal views as best as possible. Additional rotational and translational adjustments in the aforementioned dimensions can be used as necessary to achieve this goal before progressing to the subsequent registration step.