Syndromic craniosynostosis: sleeping with the enemy

textabstractCraniosynostosis refers to the premature fusion of one or several calvarian sutures. For transient skull distortion during birth, as well as to facilitate growth of the brain, the seven bones of the calvarian are separated by six major calvarian sutures (Figure 1). The sutures function as growth centers. The center of the suture deposits proliferating cells, which gradually undergo osteogenetic differentiation. Migration towards the skull bone results in growth of the cranial vault. This is an important requisite to allow the brain quadrupling its volume during the first two years of life. The posterior fontanel will close first at an age of two months. The metopic suture will close next within the first year of life, followed by closure of the anterior fontanel at the age of two years. Although the other sutures only close in adulthood, they lose their function in skull growth after the age of six years