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Factitious lambdoid perisutural sclerosis: does the "sticky suture" exist?
1Department of Radiology, Children's Medical Center, 1935 Motor Street, Dallas, TX 75235, USA.
Pediatric Radiology
|January 1, 1996
Summary
Perisutural sclerosis is often used to diagnose lambdoid synostosis. However, this case shows the suture was open despite radiographic signs, questioning its diagnostic accuracy.
Area of Science:
- Neurosurgery
- Pediatric Radiology
- Craniofacial Surgery
Background:
- Lambdoid synostosis is a premature fusion of the lambdoid suture, leading to abnormal head shape.
- Perisutural sclerosis, a radiographic finding, is commonly used to indicate impending lambdoid synostosis.
Observation:
- A patient presented with occipital flattening, suspected to be caused by lambdoid synostosis based on perisutural sclerosis observed in radiographs.
- Surgical and histological examination revealed that the lambdoid suture was patent (open).
Findings:
- Radiographs of the surgical specimen did not show perisutural sclerosis.
- The case challenges the reliability of perisutural sclerosis as a sole radiographic indicator for diagnosing or predicting lambdoid synostosis.
Implications:
- Clinical diagnosis of lambdoid synostosis may require a multi-faceted approach beyond relying solely on perisutural sclerosis.
- Further research is needed to validate or refine the diagnostic criteria for lambdoid synostosis.
- This finding may impact surgical decision-making in pediatric craniofacial cases.