Hi, this is Tom, and in this episode I'm going to be going through cranio-cinestosis.

And you can find notes at zero-to-finals.com slash cranio-cinestosis and in the zero-to-finals

pediatrics book. And you can find flashcards and questions to train your knowledge at members.0.0.0.com.

So let's jump straight in.

Craniosinistosis occurs where the skull's sutures or the gaps between the bones of the skull

close prematurely, and this results in abnormal head shapes and restricted

brain growth. This may lead to raised intracranial pressure, cognitive impairment, and neurological

symptoms, for example, seizures. Let's talk about the presentation.

The main presenting feature is an abnormal head shape in an infant,

depending on the affected cranial suture.

Sagital synestosis refers to when the sagittal suture closes early,

and this results in a long and narrow head

from front to back. Coronal synestosis is where the coronal suture closes early, and this leads to

ibsilateral forehead flattening, or flattening of the forehead on the affected side,

and contralateral frontal bulging, where there's bulging of the forehead on the opposite side.

Metopic synestosis is where the metopic suture closes early, and this leads to a pointy triangular forehead.

And lambdaid synestosis is where the lamdoid suture closes early,

and this leads to flattening on the affected side of the osipot at the back of the head,

with bulging behind the ear on the same side.

Next let's go through investigations.

Specialist referral is required for assessment and investigations if craniosynastosis is suspected.

Imaging investigations include a skull x-ray, which used to be the go-to imaging but is less commonly used now,

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