Sutures - ridged

Definition

Ridged sutures refer to an overlap of the bony plates of the skull in an infant, with or without early closure.

Alternative Names

Ridged sutures

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 normal in 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 too early. When this happens, growth along that suture line stops. Premature closure generally leads to an unusually shaped skull.

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

Causes

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

When to Contact a Medical Professional

Contact 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 Office Visit

Your health care provider will get a medical history and will do a physical examination.

Medical history questions might include:

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

Your health care provider will begin with an examination of the skull to see if there is ridging. If there is ridging, the child might need x-rays or other types of scans of the skull to show whether the sutures have closed too early.

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

References

Carlo W. Physical Examination of the Infant. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 88.2