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Developmental changes in the occipital cranial sutures of children less than 2 years of age
Ai Muroi1,2, Takao Enomoto3, Satoshi Ihara4
1Division of Pediatric Neurosurgery, Ibaraki Children's Hospital, Mito, Ibaraki, Japan. a.muroi@md.tsukuba.ac.jp.
Insights
This study analyzed occipital cranial sutures in pediatric patients under two years old using 3D-CT scans. Findings reveal common suture variations and their age distribution, aiding in fracture evaluation.
Area of Science:
- Pediatric Radiology
- Cranial Anatomy
- Developmental Biology
Background:
- The occipital bone, at the junction of membranous and cartilage bone, features numerous accessory sutures.
- Understanding normal cranial suture development is vital for diagnosing pediatric head trauma.
Purpose of the Study:
- To describe the age distribution of occipital cranial sutures in pediatric patients under two years of age.
- To utilize three-dimensional computed tomography (3D-CT) for detailed analysis of these sutures.
Main Methods:
- A retrospective analysis of 167 pediatric patients under two years old who underwent CT for head trauma.
- Detailed examination of occipital bone sutures using 3D-CT imaging.
Main Results:
- Superior median fissures (21%), mendosal sutures (35%), accessory interparietal sutures (9%), and interparietal sutures (6%) were observed.
- Wormian bones in the lambdoid suture were present in 32% of patients.
- Superior median and mendosal sutures were most common in newborns, with superior median fissures absent after five months.
Conclusions:
- Normal cranial anatomy and suture patterns are essential for evaluating potential occipital fractures in children.
- 3D-CT and axial bone window imaging effectively distinguish normal cranial structures from pathology.
Purpose:
The occipital bone is located on the boundary between the membranous and cartilage bones and contains a wide variety of accessory sutures. In this study, we describe the age distribution of pediatric patients who are less than 2 years of age with occipital cranial sutures using a three-dimensional computed tomography (3D-CT).
Methods:
A total of 167 consecutive patients who are less than 2 years of age and underwent computed tomography for head trauma were included in this study.
Results:
Based on the results of this study, various types of sutures were observed among the pediatric participants. In particular, superior median fissures, mendosal sutures, other interparietal segment's accessory sutures, and interparietal sutures were noted in 21%, 35%, 9%, and 6% of the participants, respectively. Additionally, Wormian bones within the lambdoid suture were noted in 32% of the patients. The median age of children with superior median fissure and mendosal suture was 0 month. Meanwhile, superior median fissure was not observed among children older than 5 months of age. In this population, 13 patients (8%) were found to have skull fracture.
Conclusions:
Knowledge of the normal cranial anatomy and developmental patterns of cranial sutures is crucial in the evaluation of questionable fractures in the occipital region. A combination of 3D-CT and axial bone window imaging is useful in differentiating normal structures from pathological changes in the cranium.
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