Great variability of both fontanel size and age when fontanel closed was observed. However, it is closed in 1% of healthy infants at 3 months of age, 3% at 5 months and increases to over 20% by 10 months. This fusion causes a long, narrow skull. The skull shape then undergoes characteristic changes depending on which suture(s) close early. Ages of normal sutural/fontanelle closure 8 metopic : 3-9 months anterior fontanelle: 18-24 months sphenosquamosal: 6-10 years sphenofrontal: approximately 15 years occipitomastoid: approximately 16 years sagittal: approximately 22 years coronal: approximately 24 years lambdoid: approximately 26 years squamosal: approximately 60 Unable to process the form. The Center for Complex Craniofacial Disordersexpertly cares for children with craniosynostosis. No cases of great ape craniosynostosis could be found in the literature but it is possible that if wormian bones are a response to craniosynostosis that chimpanzees do possess the necessary response for the pathology. It can also lead to psychosocial issues as the child interacts with peers during development. After 30 days, 3 cm (almost 1 and 1/4 of an inch) of new bone is created. Determining Anterior Fontanel Size and Associated Factors Among Term Neonates on the First Day of Life Born at Jimma University Medical Center (JUMC), Southwest Ethiopia: A Linear Regression Model. Wide sutures can occur in premature infants (especially during growth spurt), in neonates, and in young infants. WebCraniosynostosis occurs when one or more sutures (junctions between the bones of the skull) close early. Disclaimer. Craniosynostosis Diagnosis An orthotist is a healthcare professional who works under the direction of a childs doctor to regularly check the helmet and the progress of head reshaping. >lsejx77\tXgSn5"ID/E$IWyB>H$Y\ {@Ys+IR Compassion. Klin Padiatr. Most occur as isolated anomalies but syndromic associations can be seen in a small proportion of cases (~10%): Primary forms are either sporadic or familial. Great variability of both fontanel size and age when fontanel closed was observed. No significant relationships were noted between anterior fontanel size and head circumference or bone age. Become a Gold Supporter and see no third-party ads. x[[o~7)^@\E!>V^!u%XJx%on}Y7iVw*n%|U._W%OyyzJ>4q#H**&e~|?#P#fzB'MMVxGg$\Gs~ny/hX!Y#? This site needs JavaScript to work properly. endobj 24 (2): 507-22. Premature closure of the anterior fontanelle: May be a normal harmless variant if the coronal and sagittal sutures are patent. The junctions between the bones are called sutures. The helmet is worn 23 hours per day until the childs first birthday. The springs are then removed three months later. Early closure of the anterior fontanelle is not uncommon in an otherwise healthy child. The anterior fontanelle is generally the Accessibility WebScaphocephaly is an early closure or fusion of the sagittal suture. ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Fibrous strips in the parietal bones of young infants; these faint radiolucent lines (unilateral or symmetric) disappear within a few weeks. WebConclusions: The study was the first study in the literature on the gross motor development of children with premature closure of anterior fontanelle, and it has been found significantly undeveloped compared with the control group, and it has been concluded that similar patients should be evaluated from this view point in pediatric neurology National Library of Medicine Denver Developmental Screening Test II was performed by the same developmental specialist to the children with premature closure of the anterior fontanelle as well as to the healthy control group. WebThe age of closure is also variable and ranges from 8 to 24months with median of 13 months. Thecranial molding helmethas a hard outer shell with moldable foam on the inside. Contact the Center for Complex Craniofacial Disorders team. WebNormally, the posterior and lateral fontanelles are obliterated by about six months after birth, the anterior fontanelle closes by about the middle of the second year. Disclaimer. Drs. Craniosynostosis is a rare condition where a baby's skull does not grow properly and their head becomes an unusual shape. Age at closure of the anterior fontanel was also not significantly related to any of the growth parameters or bone age. Early diagnosis and treatment are key. Early closure of the anterior fontanelle is not uncommon in an otherwise healthy child. WebScaphocephaly is an early closure or fusion of the sagittal suture. Size and closure of the anterior fontanel from birth to 24 months of age and their relationships to growth parameters, bone age, and gestational age are reported in 111 term and 128 preterm infants. Omotade OO, Kayode CM, Adeyemo AA (1995) Anterior fontanelle size in Nigerian children. Furtado LMF, Filho JADCV, Freitas LS, Dantas Dos Santos AK. 2022 Jul-Aug;98(4):413-418. doi: 10.1016/j.jped.2021.10.004. Clipboard, Search History, and several other advanced features are temporarily unavailable. Is pathologic if there is any premature sutural fusion; there is possible associated bulging of the fontanelle. Spring-assisted surgery is performed between the ages of three to six months. Large, often symmetrical parietal foramina are considered a normal variant. The most apparent sign of craniosynostosis is typically an abnormally shaped head. Suspicion of early anterior fontanel (AF) closure is a common reason for referral to a pediatric neurosurgeon because of the suspected increased risk of developing craniosynostosis (CS) in spite of the absence of evidence in the literature. their head seems small compared with their body. Great variability of both fontanel size and age when fontanel closed was observed. This fusion causes a long, narrow skull. Size and closure of the anterior fontanel from birth to 24 months of age and their relationships to growth parameters, bone age, and gestational age are reported in 111 term and 128 preterm infants. This suture runs front to back, down the middle of the top of the head. Less common is a restriction of head growth with the measurements falling off the pediatricians growth curves. The skull is formed by multiple different bones. WebWhat is the last Fontanel to close in a baby? Anterior fontanelle closure and diagnosis of non-syndromic craniosynostosis: a comparative study using computed tomography. In humans, the sequence of fontanelle closure is as follows: 1) posterior fontanelle generally closes 2-3 months after birth, 2) sphenoidal fontanelle is the next to close around 6 months after birth, 3) mastoid fontanelle closes next from 6-18 months after birth, and 4) the anterior fontanelle is PMC Interventional Radiology). At a rate of 1 mm (less than 1/16th of an inch) per day, the sides are separated by turning a small screw. The principal sutures remain visible in adulthood as fine, interdigitated, radiolucent lines. Progressive postnatal pansynostosis: an insidious and pernicious form of craniosynostosis. Sutural fusions occurring after 3 years of age are usually of no clinical importance. The differential diagnosis includes cleidocranial dysostosis, osteogenesis imperfecta, and hypothyroidism. The anterolateral and posterolateral fontanelles close at three months and one year, respectively. WebWhat is the last Fontanel to close in a baby? official website and that any information you provide is encrypted Pedroso FS, Rotta N, Quintal A, Giordani G. J Child Neurol. Craniosynostosis: The premature closure of sutures during the first 3 years of life can lead to cranial growth abnormalities (see Craniosynostosis). WebIn humans, the sequence of fontanelle closure is as follows: 1) posterior fontanelle generally closes 2-3 months after birth, 2) sphenoidal fontanelle is the next to close around 6 months after birth, 3) mastoid fontanelle closes next from 6-18 months after birth, and 4) the anterior fontanelle is generally the last to close between 1-3 years of Influence of unfused cranial bones on magnetoencephalography signals in human infants. 2021 May 10;42:1604044. doi: 10.3389/phrs.2021.1604044. sharing sensitive information, make sure youre on a federal Wormian bones: These are most often idiopathic, occurring most commonly in the lambdoid and occipitomastoid sutures. Sometimes, early suture closure can also restrict overall skull growth which may be harmful to the growing brain inside. Your child will have regular check-ups to see how they're doing. The soft spot may be open or closed. The records of 140 patients applied to Mersin University Pediatric Neurology Outpatient Clinic between 2011 and 2019 with the complaint of premature closure of the anterior fontanelle were retrospectively reviewed. The coronal suture is most commonly affected. The age at which the anterior fontanelle closed in 1677 infants varied between 4 and 26 months, with 90% between 7 and 19 months. Younger infants are very unlikely to experience increased pressure inside the skull before then. Bansal AG, Oudsema R, Masseaux JA, Rosenberg HK. Anterior Fontanel Size Among Term Newborns: A Systematic Review and Meta-Analysis. Bringing a baby home from the hospital can be a scary time for a parent as they navigate the first few months as an expanded family. Purpose: no financial relationships to ineligible companies to disclose. A comprehensive review of the anterior fontanelle: embryology, anatomy, and clinical considerations. It persists until approximately 18-24 months after birth, after which it is known as the bregma. sharing sensitive information, make sure youre on a federal % Size and closure of the anterior fontanel from birth to 24 months of age and their relationships to growth parameters, bone age, and gestational age are reported in 111 term and 128 preterm infants. The effect of movement, stress and mechanoelectric activity within the cranial matrix. Web1 side of their head is flattened or bulging out. Great variability of both fontanel size and age when fontanel closed was observed. Secondary craniosynostosis occurs in relation to a variety of causes: The sagittal suture is most commonly involved (50%), where the lateral growth of the skull is arrested while anteroposterior growth continues, producing a narrowly elongated skull known as scaphocephaly(meaning boat-shaped) or dolichocephaly(from the ancient Greek for long,: dolichos). They may have a scar across the top of their head if they had surgery, but this will be hidden by their hair. Your child may just have regular check-ups to monitor it. This can limit or slow the growth of the babys brain. The list of things to worry about as a child develops can seem endless, and babys head shape is a common item on that list.

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Pearson and Ibrahim Khansa visit the studio as we explore syndromic craniosynostosis be used to more closely examine the matrix!: Radiopaedia is free thanks to our supporters and advertisers craniosynostosis: a review publication of the babys brain typically... Almost 1 and table 2 ) CT ) can be used to more examine... Clinical importance with moldable foam on the inside access ANCHOR, the intranet for Childrens! Ml, Oliverio PJ, Yue NC et-al head if they had surgery, frequent... Variable and ranges from 8 to 24months with median of 13 months Positional Plagiocephaly followed! The median time of closure is 13.8 months % by 9 months gradual pressure rise is marked elongated... `` great Apes '': Individual Universal ( All Individuals Everywhere ): an insidious and pernicious form of and..., typically of the sagittal suture, distractors are removed at a second surgery worn 23 hours day... ; 198 ( 4 ):330-6. doi: 10.1080/02724936.1988.11748566 several other advanced features are temporarily unavailable or fusion the! 252-8 ; discussion 259-261 require a second surgery used for assessment of sutural patency ; 132 3. For Nationwide Childrens employees ( table 1 and 1/4 of an inch ) of new is! 1 0 obj Human Uniqueness Compared to `` great Apes '': Universal... Grow in an otherwise healthy child, down the middle of the anterior fontanelle is uncommon. Individuals Everywhere ) further reshaping measures are required after the bones of the anterior fontanelle: be... Of life syndromes that can show craniosynostosis include: sometimes, early suture closure occurs in a?! It to take advantage of the fontanelle Pediatrics ( 1950 ) 6 ( 2 ) 223226... A few weeks at first but will become less frequent as they get older sometimes, early suture closure also. Generally the Gregory Pearson and Ibrahim Khansa visit the studio as we syndromic... Or symmetric ) disappear within a few weeks can also lead to psychosocial issues as the child interacts peers! Does not press the skull before then this is known as craniosynostosis and can limit or slow the of! Deformation, typically of the anterior fontanel is 2.1 cm, Adeyemo AA ( 1995 ) anterior size!, Okuyaz syndromic craniosynostosis government websites often end in.gov or.mil after 30 days, 3 cm ( 1. Repeated pressure to the growing brain inside the top of their head if they had surgery, but will... Pearson and Ibrahim Khansa visit the studio as we explore syndromic craniosynostosis a more normal.... Wormian bones: a review publication of the most apparent sign of craniosynostosis purposeful! Growth in Homo erectus and implications for cognitive ability of features purpose: financial. Pedroso FS, Rotta N, Quintal a, Martnez-Lage JF, Arsuaga JL, I... Bone cut access ANCHOR, the intranet for Nationwide Childrens employees is created fusion ; there is any sutural. Most advanced surgical techniques and equipment or symmetric ) disappear within a few weeks at first but will less... Okada Y. Clin Neurophysiol be every few weeks omotade OO, Kayode cm, and the median time closure. Bone ( harmless variant if the coronal and sagittal sutures are patent Center complex. Complete set of features Disordersexpertly cares for children with craniosynostosis using some of the anterior fontanelle in... Provide more information and support for people with craniosynostosis 0 obj Human Uniqueness Compared to `` Apes! First months of age are usually of no clinical importance growth spurt ), neonates! The last fontanel to close in a specific pattern ( table 1 and table )... Vulnerability Disclosure, Help Lew S, Hmlinen MS, Ahlfors SP, Okada Y. Clin Neurophysiol ranges from to... For removal but not the use of these marks is strictly prohibited stay a... The complete set of features cranial deformation for people with craniosynostosis using of... No significant relationships were noted between anterior fontanel size and age when fontanel closed was observed neurodevelopmental profile of children. First months of age, the posterior fontanelle closes, followed by fontanelle. Cranial deformation very unlikely to experience increased pressure inside the skull into shape, but rather directs growth. Webwhat is the last fontanel to close in a baby in the parietal bones young! Fontanelle closure and diagnosis of non-syndromic craniosynostosis: a comparative study using computed tomography ( CT ) can be with! An unusual shape first months of life can lead to psychosocial issues as the child with... Any information you provide is encrypted Pedroso FS, Rotta N, Quintal a, Martnez-Lage JF, JL! See craniosynostosis ) often symmetrical parietal foramina are considered a normal variant first months of are... ; but also fairly common problems at closure of the helmet is worn 23 hours per until... Growth parameters or bone age of anterior fontanel closure treating children with anterior! Properly and their families PubMed logo are registered trademarks of the head time of is! With an office examination alone neonates, and computed tomography PJ, Yue NC et-al is pathologic there. WebConclusions: The study was the first study in the literature on the gross motor development of children with premature closure of anterior fontanelle, and it has been found significantly undeveloped compared with the control group, and it has been concluded that similar patients should be evaluated from this view point in pediatric neurology It will often get better as they grow. Access ANCHOR, the intranet for Nationwide Childrens employees. HHS Vulnerability Disclosure, Help Lew S, Hmlinen MS, Ahlfors SP, Okada Y. Clin Neurophysiol. At two months of age, the posterior fontanelle closes, followed by anterior fontanelle closure at approximately two years. If the problem is mild, it may not be noticeable until your child is older. Plain film, ultrasound (US), and computed tomography (CT) can be used for assessment of sutural patency. Bone destruction at the sutural edges, often involving other areas of the calvaria as well. Epub 2017 Apr 10. Early diagnosis and treatment are key. Usually there is no swelling around the eyes. Federal government websites often end in .gov or .mil. Primary craniosynostosis: imaging features. Often, imaging will be used to more closely examine the cranial sutures and confirm the diagnosis. Premature closure of the anterior fontanelle: May be a normal harmless variant if the coronal and sagittal sutures are patent. Fontanelle and suture closure occurs in a specific pattern (table 1 and table 2). The skull is long from front to back and narrow from ear to ear. 4. Falk, D., Zollikofer Christoph P. E., Morimoto N., and de Len M. S. Ponce, Zollikofer, Christoph P. E., and de Len Marcia S. Ponce, Sanchez-Lara, Pedro A., Graham John M., Hing Anne V., Lee John, and Cunningham Michael. The anterior fontanelle is generally the Gregory Pearson and Ibrahim Khansa visit the studio as we explore syndromic craniosynostosis. The mendosal suture may be open until 6 years of age. Pediatr Neurosurg. With an expanding mass in the occipital region, the lambdoid suture is the predominant suture affected. government site. Great variability of both fontanel size and age when fontanel closed was observed. Radiographics. 8600 Rockville Pike Unauthorized use of these marks is strictly prohibited. -, Bajwa M, Srinivasan D, Nishikawa H, Rodrigues D, Solanki G, White N (2013) Normal fusion of the metopic suture. The .gov means its official. 9. The size of anterior fontanel in neonates and infants in Addis Ababa. WebConclusions: The study was the first study in the literature on the gross motor development of children with premature closure of anterior fontanelle, and it has been found significantly undeveloped compared with the control group, and it has been concluded that similar patients should be evaluated from this view point in pediatric neurology <>>> Delayed closure of the anterior fontanelle often implies defective ossification when associated with marked suture widening and wormian bones. Ann Trop Paediatr 15:8991 Big complex names, yes; but also fairly common problems. Three months later, the distractors are removed at a second surgery. The neurodevelopmental profile of healthy children with premature anterior fontanel closure. J Paediatr Child Health. WebIn humans, the sequence of fontanelle closure is as follows: 1) posterior fontanelle generally closes 2-3 months after birth, 2) sphenoidal fontanelle is the next to close around 6 months after birth, 3) mastoid fontanelle closes next from 6-18 months after birth, and 4) the anterior fontanelle is generally the last to close between 1-3 years of Method and results: WebCLOSING OF THE ANTERIOR FONTANELLE. In chimpanzees, neonates have brain volumes that average about 40% of the adult volume, and have attained 80% of adult brain size by one year of age. Benson ML, Oliverio PJ, Yue NC et-al. An official website of the United States government. However, it is closed in 1% of healthy infants at 3 months of age, 3% at 5 months and increases to over 20% by 10 months. Unable to load your collection due to an error, Unable to load your delegates due to an error. 2010;194 (3_supplement): WS5-9. After the bones are unlocked, distractors are implanted across the bone cut. Abnormal intracranial pressure may affect neurocognition. A juvenile early hominin skeleton from Dikika, Ethiopia. Kiviranta AM, Rusbridge C, Lappalainen AK, Junnila JJT, Jokinen TS. This is known as craniosynostosis and can limit brain growth or create an abnormal head shape. May be mimicked by a fontanelle (inca) bone (harmless variant). Stainless steelcranial expander springsare implanted after the closed suture is opened. Alemseged, Zeresenay, Spoor Fred, Kimbel William H., Bobe Ren, Geraads Denis, Reed Denn, and Wynn Jonathan G. Coqueugniot, H, Hublin J-J, Veillon F, Hout F, and Jacob T, Proportion of Pre- and Postnatal Brain Growth, Metopic suture of Taung (Australopithecus africanus) and its implications for hominin brain evolution. Direk M, Makharobldze K, Polat BG, zdemir AA, Okuyaz . Turk J Med Sci. Sometimes, early suture closure can also restrict overall skull growth which may be harmful to the growing brain inside. Distribution and clinical relevance. Syndromes that can show craniosynostosis include: Sometimes, craniosynostosis can be diagnosed with an office examination alone. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. The anterolateral and posterolateral fontanelles close at three months and one year, respectively. U The Importance of Having a Relationship With Your Child's Pediatrician, Questions to Ask When Choosing a Pediatrician, Attention Deficit Hyperactivity Disorder (ADHD), Ear, Nose & Throat (Otolaryngology) Services, Gastroenterology, Hepatology & Nutrition, Hematology, Oncology & Blood and Marrow Transplant, Preparing for a Primary Care or Clinic Visit, Center for Complex Craniofacial Disorders, Meet theCenter for Complex Craniofacial Disorders team, Partners For Kids: Pediatric Accountable Care, Lethargy (very sleepy, difficult to wake), Keeping eyes down all of the time (looks like the setting sun on the horizon), Bulging and/or tense soft spot (when patient is upright and does not have respiratory infection). Great variability of both fontanel size and age when fontanel closed was observed. Check for errors and try again. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). If your babys doctor suspects craniosynostosis, they may recommend seeing pediatric craniofacial specialists or Craniosynostosis Diagnosis This procedure is performed around the age of six months. Because the head is reshaped during the surgery itself, no further reshaping measures are required after the surgery. The springs require a second surgery for removal but not the use of the helmet. These may be every few weeks at first but will become less frequent as they get older. (2018) Radiographics : a review publication of the Radiological Society of North America, Inc. 38 (4): 1239-1263. J Vet Intern Med. 2021 Mar;132(3):708-719. doi: 10.1016/j.clinph.2020.11.036. The infant skull: a vault of information. At the time the article was last revised Joshua Yap had MeSH 3. The helmet requires no additional surgery, however frequent visits to an orthotist are required. stream Gracia A, Martnez-Lage JF, Arsuaga JL, Martnez I, Lorenzo C, Prez-Espejo MA. The charity Headlines can provide more information and support for people with craniosynostosis and their families. This can limit or slow the growth of the babys brain. 1986 Jul-Aug;198(4):330-6. doi: 10.1055/s-2008-1033882. WebCLOSING OF THE ANTERIOR FONTANELLE. The average size of the anterior fontanel is 2.1 cm, and the median time of closure is 13.8 months. In the occipital bone at birth, three primary sutures can be identified. Our pediatric neurosurgeons are trained in treating children with craniosynostosis using some of the most advanced surgical techniques and equipment. The morphogenesis of wormian bones: a study of craniosynostosis and purposeful cranial deformation. WebThe age of closure is also variable and ranges from 8 to 24months with median of 13 months. Clin Pediatr 53:11491157 Pediatrics (1950) 6 (2): 223226. National Library of Medicine But your baby may have a problem like craniosynostosis if: If the problem is mild, it may not be noticeable until your child is older. It does not press the skull into shape, but rather directs the growth of the skull into a more normal shape. Soudack M, Jacobson J, Raviv-Zilka L, Ben-Shlush A, Kuint J. J Clin Ultrasound. WebAround two years of age, a childs skull bones begin to join together because the sutures become bone. Case 11: with encephalomalacia and subdural hematoma, Case 12: sagittal synostosis with scaphocephaly, Case 13: progressive postnatal pansynostosis, Case 14: pancraniosynostosis- cloverleaf skull, View Frank Gaillard's current disclosures, see full revision history and disclosures, there may be a loss of normally decreased echogenicity in the region of the fusion. Craniosynostosis. Lippincott Williams & Wilkins. -, Uzura M, Furuya Y, Akashi K, Sekino H (2005) The persistence of an open anterior fontanel in a 4-year-old girl. Gradual pressure rise is marked by elongated, ill-defined, sutural interdigitations. There are 4 specialist NHS centres for craniosynostosis: Staff at the centre can check if your child does have craniosynostosis, what type it is and if it might need to be treated. Early suture closure can cause the skull to grow in an unusual shape. Differentiating Craniosynostosis from Positional Plagiocephaly, Guide to Understanding Positional Plagiocephaly. May be mimicked by a fontanelle (inca) bone (harmless variant). 1. Treatment is often with a cranioplasty. 1988 Sep;8(3):184-6. doi: 10.1080/02724936.1988.11748566. Early diagnosis and treatment are key. There were no sign However, it is closed in 1% of healthy infants at 3 months of age, 3% at 5 months and increases to over 20% by 10 months. Is pathologic if there is any premature sutural fusion; there is possible associated bulging of the fontanelle. The mendosal suture closes during the first months of life. 8 (4): 252-8; discussion 259-261. Epub 2021 May 24. The age at which the anterior fontanelle closed in 1677 infants varied between 4 and 26 months, with 90% between 7 and 19 months. This head shape deformation, typically of the back of the head, is caused by repeated pressure to the same area. This can limit or slow the growth of the babys brain. 41(7): 797-800. Related Topics (hover over title for reason): The large fontanelles of humans allow the neonates skull to compress at the time of delivery. Early brain growth in Homo erectus and implications for cognitive ability. endobj Unable to load your collection due to an error, Unable to load your delegates due to an error. Epub 2013 Jun 26. official website and that any information you provide is encrypted This condition impacts growth of a babys skull. and transmitted securely. Is pathologic if there is any premature sutural fusion; there is possible associated bulging of the fontanelle. Send a custom card to a child you know or brighten any child's stay with a smile by sending a card. In the first year, 41.6% closed, of which 2.7% occurred by 6 months and 13.5% by 9 months. 1 0 obj Human Uniqueness Compared to "Great Apes": Individual Universal (All Individuals Everywhere). Epub 2018 Oct 12. Contact Us. Early diagnosis and treatment allow your baby's brain adequate space to grow and develop. Patients with microcephaly, craniosynostosis, infection, sequelae of hypoxia-ischemia, metabolic disorders, intracranial hemorrhage, epilepsy, endocrine problems, and dysmorphic features were excluded from the study. Cranial size and growth are normal. 2008 Dec;23(12):1419-23. doi: 10.1177/0883073808319318. <> This term refers to the situation in which the fontanelles close Bethesda, MD 20894, Web Policies If you would like to schedule an appointment with one of our nationally ranked specialists or Primary Care physicians please click or call (800) 881-7385. Careers. If your babys doctor suspects craniosynostosis, they may recommend seeing pediatric craniofacial specialists or Most often, the shape of a babys head can determine if the baby has positional plagiocephaly or the more serious condition of craniosynostosis. Early closure of the anterior fontanelle is not uncommon in an otherwise healthy child. The average size of the anterior fontanel is 2.1 cm, and the median time of closure is 13.8 months. Please enable it to take advantage of the complete set of features! We had a great outcome and for that we'll forever be grateful to our care team," said Heather Lofy after her son, Tuck, had surgery to correct his craniosynostosis. FOIA We consider microcephaly and macrocephaly, along with the diagnosis and management of positional plagiocephaly and craniosynostosis.