Sutures - ridged

Definition

Ridged sutures is caused by an overlap of the bony plates of the skull, with or without premature 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 at which these plates intersect are called sutures or suture lines. In an infant only a few minutes old, the pressure from delivery compresses the head, making the bony plates overlap at the sutures and creating a small ridge.

This is a normal finding of newborns. In the next few days the head expands, the overlapping disappears, and 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 prematurely. When this happens, growth along that particular suture line ceases. Premature closure generally leads to an unusually shaped skull.

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

Common Causes

• Normal ridging due to overlap of bony plates after birth -- resolves spontaneously
• 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.

Call 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 health care provider's office

The medical history will be obtained and a physical examination performed.

Medical history questions documenting ridged sutures in detail may include:

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

Your health care provider will begin with an examination of the skull to determine if ridging exists. If it does, x-rays  or other types of scans of the skull may be obtained, to verify premature closure of the sutures.

After seeing your health care provider:

Although your health care provider keeps records from routine examinations, you may find it helpful to maintain your own records of the development. You will want to bring these records to your health care provider's attention if you notice anything unusual.

You may want to add a diagnosis related to ridged sutures to your personal medical record.

Illustrations

Skull of a newborn

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Ridged sutures