Complex Skull Deformity (Differential Diagnosis Craniosynostosis)

Figure kran_13a_n.jpg to kran_13c_n.jpg: Clinical presentation of an extreme type of a complex skull deformity without a craniosynostosis in a 4-month-old boy. Figure kran_13a_n.jpg: View from the front. The vertical midline axis is bent like a scoliosis concave to right side. Notice the line between the middle of the nasal root and the chin dimple. Figure kran_13b_n.jpg: Oblique view from the top. The right frontal region is more prominent than the left frontal region, which may mask a left coronal synostosis. The lateral angles of the anterior fontanel are not in the same frontal plane, while the left angle lies more posteriorly (in contrast to a left coronal synostosis in which the left angle lies more anteriorly, and the suture is closed). Figure kran_13c_n.jpg: View from the top. There is a plagiocephaly of the right frontal and of the left occipital region; the midline describes a scoliosis concave to the left side. Figure kran_14a_n.jpg and kran_14b_n.jpg: The drawings of a similar but contralateral complex skull deformity describes better the already demonstrated abnormality in the 4-month-old boy. There is an extreme scoliosis of the facial skeleton which is concave to the left. Similar scolioses of varying degrees are often observed in unilateral coronal synostosis. $$kran_7??nr=1££See alternate figure§§. In addition, there is a scoliosis of the basal skull to the right. The basal skull is scoliotic not only in complex skull deformities, but also in unilateral coronal or lambdoid synostoses.