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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Could Closed Fontenelle And Elongated Head Shape In An Infant Denote?

My son has a closed fontenalle he is 10 months old. It was closed at birth. He has an elongated head shape too.
We had a mri and ct scan last week. Im scared what they will say? will they do operation if the soft spot is closed. or do they monitor him?
Mon, 24 Feb 2014
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Pediatrician 's  Response
Normally, as an infant's brain grows, open borders (known as sutures) between the bones of the skull expand and lead to the development of a normal head shape.

If one or more of these sutures close early, it will cause the skull to expand in the direction of the sutures that remain open, which can result in an abnormal head shape. In dolichocephaly, the sagittal sutures (which run from the front of the head to the back) close together too early. This closure prevents the skull from expanding in width, and the skull begins to expand towards open sutures (such as the coronal sutures that run down the side of the head). The result is that the skull takes on a long, narrow, and boat-shaped appearance. A ridge (raised area) may be noticeable by the closed sagittal sutures. Abnormal skull shapes can occur due to positioning of the developing baby during pregnancy, abnormal sleeping position, or from neck tightness.
Dolichocephaly is not always serious, since the condition ranges from mild to severe. In fact, most children who are treated for dolichocephaly with surgery (see below) go on to lead normal lives. However, dolichocephaly is associated with dozens of developmental disabilities that can result in mental retardation. Psychological problems such as poor self-esteem and depression can also occur as the child gets older. An abnormal skull shape can also lead to difficulties with chewing, swallowing, vision, and breathing. The longer the skull, the greater the risk of serious associated problems.
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What Could Closed Fontenelle And Elongated Head Shape In An Infant Denote?

Normally, as an infant s brain grows, open borders (known as sutures) between the bones of the skull expand and lead to the development of a normal head shape. If one or more of these sutures close early, it will cause the skull to expand in the direction of the sutures that remain open, which can result in an abnormal head shape. In dolichocephaly, the sagittal sutures (which run from the front of the head to the back) close together too early. This closure prevents the skull from expanding in width, and the skull begins to expand towards open sutures (such as the coronal sutures that run down the side of the head). The result is that the skull takes on a long, narrow, and boat-shaped appearance. A ridge (raised area) may be noticeable by the closed sagittal sutures. Abnormal skull shapes can occur due to positioning of the developing baby during pregnancy, abnormal sleeping position, or from neck tightness. Dolichocephaly is not always serious, since the condition ranges from mild to severe. In fact, most children who are treated for dolichocephaly with surgery (see below) go on to lead normal lives. However, dolichocephaly is associated with dozens of developmental disabilities that can result in mental retardation. Psychological problems such as poor self-esteem and depression can also occur as the child gets older. An abnormal skull shape can also lead to difficulties with chewing, swallowing, vision, and breathing. The longer the skull, the greater the risk of serious associated problems.