Child's Nervous System

, Volume 34, Issue 9, pp 1725–1733 | Cite as

Quantitative analysis of cranial-orbital changes in infants with anterior synostotic plagiocephaly

  • Rosalinda CalandrelliEmail author
  • Fabio Pilato
  • Luca Massimi
  • Marco Panfili
  • Concezio Di Rocco
  • Cesare Colosimo
Original Paper



The effects of premature fusion of one coronal suture cause skull and orbital alterations in term of side-to-side asymmetry. This study aimed to quantify the cranio-orbital complex changes related to the severity of skull base dysmorphology in patients with unicoronal synostosis.


Twenty-four infants affected by unicoronal synostosis were subdivided in three subgroups according to the severity of skull base deformity and their high-resolution CT images were quantitatively analyzed (groups IIa, IIb, III). Dimensions of cranial fossae, intracranial volume (ICV), ICV synostotic and ICV non synostotic side, whole brain volume (WBV), orbital volumes (OV), ICV/WBV, ICVsynostotic/ICVnon-synostotic, and OVsynostotic/OVnon-synostotic were evaluated.


Asymmetry and reduction in the growth of the anterior and middle fossae were found in all groups while asymmetry of the posterior cranial fossa was found only in IIb and III groups. In all groups, ICV, WBV, and ICV/WBV were not significantly different while ICVsynostotic/ICVnon-synostotic and OVsynostotic/OVnon-synostotic resulted significant difference (p < 0.05). ICVsynostotic side resulted reduction only in group III. OV on the synostotic side was not significantly reduced although a trend in progressively reducing volumes was noted according to the severity of the group.


Skull and orbital changes revealed a side-to-side asymmetry but the effects of the premature synostosis were more severe in group III suggesting an earlier timing of premature unicoronal synostosis in group III with respect to the other groups. The assessment of the skull base deformity might be an indirect parameter of severity of skull orbital changes and it might be useful for surgical planning.


High-resolution CT Craniosynostosis Skull base Intracranial volume Orbital volume 


Compliance with ethical standards

Conflict of interest

Rosalinda Calandrelli declares that she has no conflict of interest. Fabio Pilato declares that he has no conflict of interest. Luca Massimi declares that he has no conflict of interest. Marco Panfili declares that he has no conflict of interest. Di Rocco Concezio declares that he has no conflict of interest. Cesare Colosimo declares that he is scientific consultant for Bracco Diagnostics Inc. and Bayer HealthCare.

Research involving human participants

Ethical approval

We declare that all procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Polo scienze delle immagini, di laboratorio ed infettivologiche Area diagnostica per immagini Università Cattolica del Sacro CuoreFondazione Policlinico Universitario Agostino GemelliRomeItaly
  2. 2.Polo scienze dell’invecchiamento, neurologiche, ortopediche e della testa-collo, Area neuroscienze Università Cattolica del Sacro CuoreFondazione Policlinico Universitario Agostino GemelliRomeItaly

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