Early diagnosis and surgical indication in craniosynostosis

9 children, presenting with clinical symptoms of craniosynostosis, and 4 with microcrania underwent calvaria bone scanning and a lumbar subarachnoid constant-infusion manometric test as integrating procedures for the diagnosis and surgical indication. In all the patients with craniosynostosis, calvaria bone scanning revealed the pathological sutures as areas of diminished or absent radionuclide accumulation, while a normal isotope uptake was observed at all the cranial sutures in the children with microcrania. A biphasic response to the infusion test, with an early rapid increase in the intracranial pressure and a late compensation, characterized 8 of the 9 children with craniosynostosis. The response to the infusion test was normal in all the cases with microcrania and in 1 child regarded as affected with coronal synostosis on the grounds of clinical and calvaria bone scanning findings.