Pseudoclosure of anterior fontanelle by wormian bone in isolated sagittal craniosynostosis

Pediatr Neurosurg. 2006;42(3):135-7. doi: 10.1159/000091854.


Aims and objectives: Although syndromic craniosynostosis is one of the causes for early closure of the anterior fontanelle, there is no literature on the incidence and causes of fontanelle closure in isolated single-suture craniosynostosis. The objective of this study was to review the incidence of fontanelle closure by a wormian bone in isolated, nonsyndromic sagittal craniosynostosis.

Materials and methods: Intraoperative records of 100 consecutive children under 1 year of age, operated for isolated sagittal synostosis over a 14-year period (1987- 2000), were reviewed to identify the presence of a wormian bone closing the anterior fontanelle.

Results: The median age at surgery was 4.2 months with a range of 1.9-11.7 months. Intraoperatively, a wormian bone was seen replacing the anterior fontanelle in 4 cases giving an incidence of 4%.

Conclusions: A wormian bone can occupy the anterior fontanelle in children with isolated sagittal craniosynostosis giving the appearance of a 'closed fontanelle'.

MeSH terms

  • Cranial Fossa, Anterior / abnormalities*
  • Cranial Fossa, Anterior / surgery
  • Cranial Sutures / abnormalities*
  • Cranial Sutures / surgery*
  • Craniosynostoses / etiology
  • Craniosynostoses / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Male
  • Retrospective Studies
  • Risk Factors