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Updated: May 16, 2026

Midface Hypoplasia and Cranial Base Morphology in Syndromic Craniosynostosis: A Comparative Analysis Study Using a Predictive Regression Model
Published on: November 4, 2025
Severe craniosynostosis in an infant with deletion 22q11.2 syndrome
W Al-Hertani1, V A Hastings, J McGowan-Jordan
1Department of Genetics, University of Ottawa, Ottawa, Ontario, Canada.
Insights
This study describes a male infant with 22q11.2 deletion syndrome and severe multi-sutural craniosynostosis, a presentation previously unreported. The findings highlight the syndrome
Area of Science:
- Genetics
- Pediatrics
- Neurosurgery
Background:
- 22q11.2 deletion syndrome is associated with diverse clinical features.
- Craniosynostosis, the premature fusion of skull sutures, is an uncommon manifestation.
- Typical genetic causes for craniosynostosis were excluded in this patient.
Observation:
- A male infant presented with 22q11.2 deletion syndrome.
- The infant exhibited severe multi-sutural craniosynostosis, increased intracranial pressure, and significant brain structure displacement.
- Extensive skull erosion was noted.
Findings:
- This is the first reported case of severe multi-sutural craniosynostosis in 22q11.2 deletion syndrome.
- Standard genetic testing (SNP Microarray) and analysis for common craniosynostosis genes (FGFR2, FGFR3, TWIST) were negative.
- The extreme presentation suggests potential novel genetic factors or co-occurring conditions.
Implications:
- Expands the known phenotypic spectrum of 22q11.2 deletion syndrome.
- Suggests the need for vigilance regarding severe craniosynostosis in affected infants.
- Raises awareness for potential co-occurrence of other genetic disorders contributing to complex phenotypes.
Abstract:
We report a male infant with 22q11.2 deletion syndrome and very severe multi-sutural craniosynostosis associated with increased intracranial pressure, marked displacement of brain structures, and extensive erosion of the skull. While uni- or bi-sultural craniosynostosis is a recognized (though relatively uncommon) feature of 22q11 deletion syndrome, a severe multi-sutural presentation of this nature has never been reported. SNP Microarray was otherwise normal and the patient did not have common mutations in FGFR2, FGFR3, or TWIST associated with craniosynostosis. While markedly variable expressivity is an acknowledged feature of deletion 22q11 syndrome, herein we also consider and discuss the possibility that this infant may have been additionally affected with an undiagnosed single gene disorder.
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