Causes of Wıde fontanelles
• Hydrocephalus
• Rickets due to vitamin D deficiency
• Athyrotic hypothyroidism
• Achondroplasia
• Osteogenesis imperfecta
• Cleidocranial dysostosis
• Hypophosphatasia
• Intrauterine growth retardation
• Apert syndrome
• Congenital rubella syndrome • Hallermann - Streiff syndrome • Kenny syndrome
• pycnodysostos
• Russell - Silver syndrome
• Trisomy 13, 18, 21 • Prematurity
Narrow fontanelle causes
• Microcephaly• Craniosynostosis
• Congenital hyperthyroidism
• Presence of Wormian bones
Causes of premature closure of the fontanel
• Craniosynostosis• Microcephaly
• Vitamin D hypervitaminosis
• Variants of the normal
Causes of delayed closure of the fontanelle
• Rickets• Hydrocephalus
• Malnutrition
• Congenital hypothyroidism
• Osteogenesis Imperfecta
• Trisomy 13, 18, 21
Macrocephaly
• Hydrocephalus• Intracranial bleeding
• Congenital toxoplasmosis (when hydrocephalus develops)
• Achondroplasia
• Mucopolysaccharidoses
• Neurofibromatosis
• Gangliosidosis
• Familial cerebral gigantism
• Fragile-X syndrome
• Familial macrocephaly
Microcephaly
• Lissencephaly• Congenital toxoplasmosis (early period)
• Congenital CMV
• Trisomy-13, 21
• Cri-du-Chat syndrome
• Hypoxic ischemic encephalic allopathy
• Craniosynostosis
• Phenylketonuria in the mother
• Mother's radiation and alcohol intake
• Incontinentia pigment
• Familial microcephaly
Craniotabes
• It is normal in the first 3 months.causes:
• Rickets
• Hydrocephalus
• Syphilis
• Cleidocranial dysostosis
• cretinism
• Down syndrome
• Osteogenesis imperfecta • It is seen in hypervitaminosis A.
Cephal hematoma:
It is subperiosteal bleeding, it does not pass the sutures. There may be associated linear skull bone fractures. It resorbs spontaneously within 2-3 months. While it usually does not require treatment. Phototherapy may be required in some cases of hyperbilirubinemia. Infection of the hematoma is very rare.Caput suxadenum:
It crosses the sutures and midline. While it heals spontaneously in 1-2 weeks, excessive bleeding and hyperbilirubinemia may develop.Subgaleal bleeding:
It is common in forceps and vacuum deliveries. Hemophilia may develop. It can lead to hypovolemia, shock and hyperbilirubinemia. The swelling gives fluctuation, crosses the sutures. pushes the ears forward. Consumption coagulopathy may develop due to excessive blood loss.Subdural bleeding:
• It is the least common type of intracranial hemorrhages. They resorb spontaneously. In symptomatic subdural hemorrhages, the subdural collection should be drained from the anterior fontanel with a spinal needle.Subarachnoid hemorrhage:
• Rare and asymptomatic. The most important finding is CSF erythrocyte or gross bleeding.Facial Paralysis:
It is congenital (Mobius syndrome most often: 7th cranial nerve nucleus is absent or hypoplasic).Acquired: unilateral and due to trauma, bilateral very rarely. (most common cause is forceps).