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Delayed Presentation of Unicoronal Craniosynostosis-Masked by Ipsilateral Posterior Deformational Plagiocephaly
Ian Chow1, Alyssa K Brisbin1, Erin E Anstadt1
1Department of Plastic Surgery, University of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Insights
Pediatricians must consider craniosynostosis even with posterior deformational plagiocephaly. Severe plagiocephaly can mask signs of unicoronal craniosynostosis, delaying diagnosis.
Area of Science:
- Pediatric neurosurgery
- Cranial development
- Medical imaging
Background:
- Head shape abnormalities are common in infants.
- Distinguishing deformational issues from craniosynostosis is clinically important.
- Unicoronal craniosynostosis (UCS) involves premature fusion of one coronal suture.
Observation:
- Two cases of delayed unicoronal craniosynostosis diagnosis are presented.
- Both patients had severe posterior deformational plagiocephaly (PDP).
- The PDP symptoms obscured typical signs of UCS.
Findings:
- Severe posterior deformational plagiocephaly can mimic or mask unicoronal craniosynostosis.
- Diagnostic delays occurred due to the confounding presentation of PDP.
- Calvarial morphology changes in UCS were obscured by PDP.
Implications:
- A high index of suspicion for craniosynostosis is crucial in infants with head shape abnormalities.
- Pediatricians should consider UCS even when PDP is prominent.
- Accurate diagnosis of craniosynostosis requires careful evaluation beyond apparent deformational forces.
Abstract:
Despite a greater awareness of the differential diagnosis of head shape abnormalities among pediatricians, the effect of deformational forces on calvarial morphology can complicate the diagnosis of craniosynostosis. In this report, we describe 2 patients diagnosed with unicoronal craniosynostosis (UCS) in a delayed fashion due to the presence of concomitant posterior deformational plagiocephaly (PDP). In both cases, the severity of each patients' PDP obscured changes typically associated with UCS. This unique presentation underscores the importance of having a high index of suspicion for possible premature suture fusion despite the presence of concomitant PDP.
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