Craniostenosis is a deformation of the skull caused by the premature fusion of one or more cranial sutures in the early periods of life, when the growth and development of the brain is not yet complete. This delays the growth of the bones of the skull in a direction perpendicular to the closed suture. The causes of craniostenosis are various factors – violation of bone formation in the bones of the skull when they are laid in the embryonic period, intrauterine infections and birth trauma. In some cases, there is only a change in the shape of the skull without a neurological pathology.
So, with the most common form of premature fusion of sagittal and coronary sutures, the growth of the skull is limited less in the longitudinal and more in the transverse direction, and it acquires a tower- like shape, in which a narrow and symmetrically elongated head is formed. With premature fusion of the coronal suture, the growth of the skull in the anteroposterior direction is limited, it becomes short and wide and takes on a brachiocephalic shape.
Compensation status with preserved disability can be observed throughout life. In other cases, when the compensatory growth of the skull due to the still remaining sutures is insufficient and does not correspond to the growing brain, a progressive syndrome of increased intracranial pressure develops, headaches, stagnant nipples of the optic nerves appear, which quickly turn into secondary optic atrophy with a progressive decrease in visual acuity , mental retardation, seizures are noted. Diagnosis of various types of craniostenosis is specified by x-ray of the skull.
With insufficient compensation of the pathological process and the development of neurological symptoms, indications for surgical intervention arise, the purpose of which is to eliminate the increase in intracranial pressure and compression of the brain by increasing the volume of the skull. This is achieved by fragmentation of the cranial vault with the formation of extensive bone flaps in various areas of the head, depending on the form of craniostenosis, which, under the influence of increased intracranial pressure, rises above the surface of the cranial vault. Linear craniotomy consists in resection of a prematurely closed suture or sutures or the formation of a narrow gap in the bone parallel to these sutures.