Return to Form: Treating Craniosynostosis

Dr. Michael Cunningham, medical director, and Dr. Richard Hopper, surgical director

Dr. Michael Cunningham, medical director,
and Dr. Richard Hopper, surgical director

A baby's brain is a powerful force. After growing explosively during a child's development from fetus to infant, it continues to outgrow the rest of the body for two years before finally slowing down.

The bones of the skull, on the other hand, grow at a less accelerated pace, creating a situation in which the rapidly growing brain could run out of room — and produce dangerous pressure — within the confines of the skull.

Nature, however, devised a clever solution: cranial sutures. These fibrous joints between the five major plates of a newborn's skull enable the skull to expand and make room for the brain's initial growth spurt. The joints then begin to fuse, a gradual process that is not complete until adulthood.

At least that's how it's supposed to work. In a fraction of births, one or more of the sutures is already closed when the baby is born. The result is a condition called craniosynostosis, and it threatens the normal physical and mental development of the infants it afflicts.

The most common — and least severe — form is isolated craniosynostosis, which involves the fusion of only one suture. It occurs in 1 out of 2,500 births.

Making Space for Brain Growth

"Since we can't open up the closed suture, we give a 10-month-old the skull of a 2-year-old so the brain can grow freely," says Dr. Richard Hopper, surgical director of the Craniofacial Center.

Treatment typically requires a delicate operation in which a neurosurgeon and a craniofacial plastic surgeon work together to remove, reshape and then replace pieces of the skull.

The surgeons correct any malformations of the skull and provide space for the brain to grow without distorting the skull or compressing the brain — a situation that could lead to vision loss and brain damage if left untreated.

Olivia Bush

Patient Olivia Bush

If the condition is addressed early enough — ideally within a year of birth — the physical outcomes for isolated craniosynostosis patients can be very positive.

Olivia Bush, the 3-year-old daughter of Todd and Cindy Bush of Seattle, was diagnosed with isolated craniosynostosis at 4 months. She underwent surgery a few weeks later.

Today, it's impossible to tell that her skull was once misshapen. In addition, she shows no apparent signs of any developmental delays.

"She has a huge imagination and she's very smart — too smart for her own good," quips her mother.