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Craniosynostosis

I was searching for some information about the process and progression of infant skull growth when I came across a condition called craniosynostosis. According to NHS Choices it is a condition which causes abnormal shaped heads in babies due to the premature fusing of some of the sutures in the skull. This means that growth may be compensated in the affected areas.

It is a rare condition affecting 1 in 1,800 – 3,000 and of that number 3 out of 4 are boys. There are two types of craniosynotosis 80-95% of which are non-syndomic, which means there are no other birth defects. The remaining cases are syndomic and includes more than 150 syndromes. These include Crouzon and Pfeiffer syndrome and the main treatment if the condition is surgery.

As I read all this information I wondered if any examples had been found in the archaeological record. After a very quick search I found two good examples of craniosynostosis; one of a clinical study by Giuffra et al (2011) and an article by Duncan & Stojanowski (2008). In both cases the individuals there was evidence of partial closure of the coronoid and squamous sutures.

Image depicting the bone of the skull and it's sutures. Image taken from : http://uprightdoctor.wordpress.com/craniopathic-strain-correction/

Image depicting the bone of the skull and it’s sutures. Image taken from: http://uprightdoctor.wordpress.com/craniopathic-strain-correction/

The remains in the Giuffra et al study belonged to a female aged 22-25 years old. These remains were excavated at ‘Fortino delle Donne Seriesi’ (women’s fortress in Sieria). As a result of craniosynostosis the coronal suture had been completely obliterated, with partial fusion of the left squamous suture and bilateral fusion of the occipitmastoid suture. These caused a reduction in the length of the cranium giving an overall much rounder appearance. Interesting this individual also retained the metopic suture which usually fuses by the are of 2 years old. Other than the craniosynostosis no other pathologies were found in the skeleton.

IMage depicting female skull with Craniosynostosis by Giuffra et al. (2011) p.1744

IMage depicting female skull with Craniosynostosis by Giuffra et al. (2011) p.1744

The second skeleton showing craniosynostosis dates to the 16th Centuary and was of a male aged 23 – 45 years old. This individual consisted of a calvaira (skull cap) and portion of the cranial base and nasal bones and was found in a trashpit. There was partial fusion of the left coronal and squamosal sutures with the right sutures still being present. This created an asymmetry of the frontal bones  and elongation of the right frontal bone. This asymmetry is also visiable in the parietal bones.

Male skull with craniosynostosis. Image taken from Duncan & Stojanowaski (2008) p.409

Male skull with craniosynostosis. Image taken from Duncan & Stojanowaski (2008) p.409

Both of these cases show fusion of the coronoid and squamosal sutures producing a disfigurment of the overall skull shape. As also mentioned the modern day treatment for this condition involves surgery however this would not have been avaliable to the individuals above. On the other hand it indicates that it is possible to live with craniosynostosis without too many problems. There are more examples of craniosynostosis in the archaeological record which are listed in the Duncan & Stojanowski (Table 1 p.844).

Referenes:

Duncan, W. N. and C. M. Stojanowski (2008). “A case of squamosal craniosynostosis from the 16th century southeastern United States.” International Journal of Osteoarchaeology 18(4): 407-420.

Giufra, V., Sbrana, F., Caramella, D., Giustini, D., Tixier, B. and Fornaciari, G. (2011). ‘Syndromic Craniosynostosis in a Modern-Age Skeleton From Siena, Italy’. The Journal of Craniofacial Surgery 22: 1743 – 1754

 

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