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Sutures - ridged

Ridged sutures

 

Ridged sutures refer to an overlap of the bony plates of the skull in an infant, with or without early closure.

Considerations

 

The skull of an infant or young child is made up of bony plates that allow for growth of the skull. The borders where these plates intersect are called sutures or suture lines. In an infant only a few minutes old, the pressure from delivery compresses the head. This makes the bony plates overlap at the sutures and creates a small ridge.

This is normal in newborns. In the next few days the head expands and the overlapping disappears. The edges of the bony plates meet edge to edge. This is the normal position.

Ridging of the suture line can also occur when the bony plates fuse together too early. When this happens, growth along that suture line stops. Premature closure generally leads to an unusually shaped skull.

Premature closing of the suture running the length of the skull (sagittal suture) produces a long, narrow head. Premature closing of the suture that runs from side to side on the skull (coronal suture) leads to a short, wide head.

 

Causes

 

Causes may include:

  • Normal ridging due to overlap of bony plates after birth
  • Congenital craniosynostosis
  • Crouzon's syndrome
  • Apert syndrome
  • Carpenter's syndrome
  • Pfeiffer syndrome

 

Home Care

 

Home care depends on the condition causing the premature closure of sutures.

 

When to Contact a Medical Professional

 

Contact your health care provider if:

  • You notice a ridge along the suture line of your child's head.
  • You think that your child has an abnormal head shape.

 

What to Expect at Your Office Visit

 

Your provider will get a medical history and will do a physical exam .

Medical history questions might include:

  • When did you first notice that the skull seemed to have ridges in it?
  • What do the soft spots (fontanelles) look like?
  • Have the fontanelles closed? At what age did they close?
  • What other symptoms are present?
  • How has your child been developing?

Your provider will examine the skull to see if there is ridging. If there is ridging, the child might need x-rays or other types of scans of the skull to show whether the sutures have closed too early.

Although your provider keeps records from routine checkups, you may find it helpful to keep your own records of your child's development. Bring these records to your provider's attention if you notice anything unusual.

 

 

References

Carlo W. The newborn infant. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics . 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 88.

 
  • Skull of a newborn - illustration

    The "sutures" or anatomical lines where the bony plates of the skull join together can be easily felt in the newborn infant. The diamond shaped space on the top of the skull and the smaller space further to the back are often referred to as the "soft spot" in young infants.

    Skull of a newborn

    illustration

    • Skull of a newborn - illustration

      The "sutures" or anatomical lines where the bony plates of the skull join together can be easily felt in the newborn infant. The diamond shaped space on the top of the skull and the smaller space further to the back are often referred to as the "soft spot" in young infants.

      Skull of a newborn

      illustration

    Talking to your MD

     

      Self Care

       

        Tests for Sutures - ridged

         

           

          Review Date: 2/5/2015

          Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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