Evidence map›Paper›PMID 41254355›Full record

ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2025

Incidental cranial suture closure in pediatric patients: a rigorous evaluation of suture closure timing in the era of high-resolution CT.

Nicholas A Han, Mark R Halverson, Ashley E Chang, Philip D Tolley, Sara Reis Teixeira, Karuna V Shekdar, Jordan W Swanson, Scott P Bartlett, Erin S Schwartz, Jesse A Taylor

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Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

10 authors.

Nicholas A HanDivision of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Mark R HalversonDivision of Neuroradiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Ashley E ChangDivision of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Philip D TolleyDivision of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Sara Reis TeixeiraDivision of Neuroradiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Karuna V ShekdarDivision of Neuroradiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Jordan W SwansonDivision of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Scott P BartlettDivision of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Erin S SchwartzDivision of Neuroradiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Jesse A TaylorDivision of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA. jataylor@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeClassical teaching suggests that major cranial sutures normally close during the third decade of life. This study investigates the prevalence of incidentally discovered cranial suture closure in healthy pediatric patients and its effects on cranial morphology.

methodsA retrospective review was performed of 1,119 patients (aged 0-18 years) who underwent head CT imaging at our pediatric emergency department from 2014 to 2024. Patients with craniofacial disorders, genetic syndromes, skull fractures, prior skull surgery, or intracranial pathologies were excluded. Three neuroradiologists evaluated the metopic, sagittal, coronal, and lambdoid sutures for patency. Cephalic index was calculated for morphological analysis.

resultsComplete or partial sagittal suture closure was observed in 11.1% of patients, with coronal and lambdoid closure in 2.8% and 1.6%, respectively. Most patients under age three had open sagittal sutures (99.3%), decreasing to 83% by age nine. Metopic suture closure followed established patterns, with over 75% closure rates by 21 months. Multivariable regression revealed sagittal suture closure was associated with decreased cephalic index (β = -0.8, p = 0.026), though 83.1% of these patients remained normocephalic. However, among patients with cephalic index < 70, 86.4% had partial or complete sagittal closure.

conclusionUp to 17% of pediatric patients may experience either partial or complete asymptomatic calvarial suture closure before adulthood. While sagittal suture closure is associated with decreased cephalic index, most patients maintain normocephaly.

Indexed as

Cranial SuturesTomography, X-Ray ComputedAdolescentChildChild, PreschoolFemaleHumansIncidental FindingsInfantInfant, NewbornMaleRetrospective StudiesTime FactorsCalvarial suture closureCephalic indexCranial developmentCraniometricsPediatric CTSagittal suture

Identifiers

PMID41254355

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.