J Korean Neurosurg Soc.  2012 Jan;51(1):31-36. 10.3340/jkns.2012.51.1.31.

Quantitative Analysis of Developmental Process of Cranial Suture in Korean Infants

• Sim SY
• Yoon SH
• Kim SY

• KMID: 2190465
• DOI: http://doi.org/10.3340/jkns.2012.51.1.31

Abstract

OBJECTIVE
The purpose of this study was to elucidate the anatomical development of physiologic suture closure processes in infants using three dimensional reconstructed computed tomography (CT).
METHODS
A consecutive series of 243 infants under 12 months of age who underwent three dimensional CT were included in this study. Four major cranial sutures (sagittal, coronal, lambdoidal and metopic suture) were classified into four suture closure grades (grade 0=no closure along the whole length, grade 1=partial or intermittent closure, grade 2=complete closure with visible suture line, grade 3=complete fusion (ossification) without visible suture line), and measured for its closure degree (suture closure rates; defined as percentage of the length of closed suture line divided by the total length of suture line).
RESULTS
Suture closure grade under 12 months of age comprised of grade 0 (n=195, 80.2%), grade 1 (n=24, 9.9%) and grade 2 (n=24, 9.9%) in sagittal sutures, whereas in metopic sutures they were grade 0 (n=61, 25.1%), grade 1 (n=167, 68.7%), grade 2 (n=6, 24%) and grade 3 (n=9, 3.7%). Mean suture closure rates under 12 months of age was 58.8% in metopic sutures, followed by coronal (right : 43.8%, left : 41.1%), lambdoidal (right : 27.2%, left : 25.6%) and sagittal sutures (15.6%), respectively.
CONCLUSION
These quantitative descriptions of cranial suture closure may help understand the process involved in the cranial development of Korean infants.

Keyword

Computed tomography; Cranial suture; Growth and development

MeSH Terms

Cranial Sutures
Growth and Development
Humans
Infant
Sutures

Figure

• 

  Fig. 1 Length measurement of the cranial suture. A : Total length of sagittal suture in this case is 'a' and length of closed suture line is 0. B : Total length of coronal suture in this case is 'a' and length of closed suture line is also 'a'. C : Total length of lambdoidal suture. D: Total length of metopic suture in this case is 'a' and length of closed suture line is 'a-b'.

• 

  Fig. 2 Suture closure grade in coronal suture. A : Grade 0=no closure along the whole length. B : Grade 1=partial or intermittent closure. C : Grade 2=complete closure (with a visible suture line). D : Grade 3=complete ossification (with no visible trace of the suture line).

• 

  Fig. 3 Graph showing age distribution of the infants. The infants are almot evenly distributed over the different age groups after one month of age.

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  Fig. 4 Differences in mean suture closure rates of major cranial sutures by age of months. Sagittal suture is all completely patent during first 4 month in all cases, then it start to partially obliterated since 5 months. At the age of 12 months, mean suture closure rates is 49.5%. In coronal and lambdoidal suture, suture closure rates within one month of age are 1.9% and 2.6%, respectively, then progressively increased during one year, mean suture closure rates at the age of 12 months is 86.8% and 88.9%, respectively. Suture closure rates of metopic suture are 1.9% within one month of age but at the age of 3 months, about 50% of entire metopic sutures are closed. At the 11 months of age, mean suture closure rates is 91.5%.

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