ARRS 2022 Abstracts


E1377. Walking Fine Lines: An Overview of the Pathophysiology, Radiologic Identification, and Sequelae of Pediatric Craniosynostosis
  1. Natasha McFarlane; Medical College of Wisconsin
  2. Jessie Aw-Zoretic; McGaw Medical Center of Northwestern University
  3. Mariam Kappil; McGaw Medical Center of Northwestern University
  4. Arthur DiPatri; McGaw Medical Center of Northwestern University
  5. Noopur Gangopadhyay; McGaw Medical Center of Northwestern University
Infants impacted by craniosynostosis are predisposed to environmental and genetic triggers that induce the premature fusion of one or more cranial sutures, characteristically resulting in skull deformity. The presentation of craniosynostosis is multifaceted. arising in isolation (primary, non-syndromic) or in association with an existing syndrome (secondary, syndromic). Maternal risk factors such as race, age, and smoking, and fetal risk factors such as male sex, contribute to pathogenesis. Adverse effects of craniosynostosis include increased intracranial pressure, vision defects, and seizures. The complications of this birth defect are complex and potentially permanent. This exhibit will outline the contributing pathophysiology, diagnostic imaging techniques and characteristics, long-term sequelae, and next best steps in correction and management, respectively.

Educational Goals / Teaching Points
Various teaching points will be covered in this exhibit. The educational goals are to review clinical presentation and relevant anatomy; describe pathophysiological and genetic contributions to the development of craniosynostosis; highlight optimal imaging modalities and identifiable characteristics of deformities involving different sutures; and compare approaches to treatment and subsequent outcomes.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Imaging modalities include ultrasound, plain radiography, and CT with 3D reconstruction. A CT with 3D reconstruction is especially useful in assessing the degree of suture involvement and for identifying additional facial and intracranial abnormalities. Image findings are variable and reflect which particular sutures are ossified in the patient.

Craniosynostosis is a common birth defect with potentially lasting neuropsychological effects. Understanding the underlying pathophysiology and using diagnostically sound radiologic methods of identification of craniofacial deformity subtypes is a crucial component of properly characterizing craniosynostosis, and employing the next best steps in surgical correction and management.