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Craniosynostosis Secondary to Rickets: Manifestations on Computed Tomography
Insights
Rickets can cause craniosynostosis (premature skull fusion) in infants. Early diagnosis and surgical intervention are crucial for infants with abnormal head shape due to rickets.
Area of Science:
- Pediatric Neurosurgery
- Pediatric Orthopedics
- Medical Genetics
Background:
- Rickets, a condition causing bone softening due to vitamin D deficiency, can lead to skeletal deformities.
- Craniosynostosis, the premature fusion of cranial sutures, can result in abnormal head shape and increased intracranial pressure.
- The association between rickets and craniosynostosis is infrequently documented in medical literature.
Observation:
- A 6-month-old infant presented with macrocephaly and signs of rickets.
- Cranial imaging at 2 years old revealed metopic and bilateral coronal craniosynostosis.
- Evidence of increased intracranial pressure was noted on computed tomography (CT).
Findings:
- The infant underwent corrective cranial vault reconstruction surgery.
- This case highlights a rare instance of craniosynostosis secondary to rickets.
- The exact incidence of rickets-induced craniosynostosis is unknown due to lack of mandatory reporting.
Implications:
- Craniosynostosis should be suspected in infants with rickets and abnormal head morphology.
- Craniofacial CT evaluation is recommended for early detection and timely surgical management.
- Prompt surgical intervention can prevent complications associated with increased intracranial pressure.
Abstract:
We present the case of a preterm 6-month-old African American infant who developed craniosynostosis secondary to rickets. This child developed rickets and macrocephaly by the age of 6 months. His head continued to enlarge, and a 3D CT obtained when the child was 2 years old revealed metopic and bilateral coronal craniosynostosis. This CT suggested increased intracranial pressure, and therefore, corrective cranial vault reconstruction was performed. Craniosynostosis secondary to rickets is rarely reported, but since neither rickets nor craniosynostosis is a reportable disease, the exact incidence of both diseases is unknown. Craniosynostosis should be suspected in any rachitic child with an abnormal head circumference or shape and craniofacial CT evaluation should be performed, so that a corrective surgery can be performed at an appropriate age.
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