Some parents may notice that their baby's head is not round, and they may think that they are sleeping on their head. However, the situation is not so simple, and early closure of the cranial sutures may occur, which should not be taken lightly. Early closure of cranial sutures can be harmful to many babies. Under normal circumstances, cranial sutures are always present. Before the age of 3, the skull will grow vertically along the cranial sutures, providing space for the development of the baby's brain tissue while protecting it from damage. There are four main gaps in the skull of a newborn baby - the frontal gap, the coronal and sagittal gaps at the top, and the "human" shaped gap in the occipital region. Shortly after birth, the frontal sutures physiologically close, while the other three cranial sutures form a "gong" shape. The cranial sutures are equivalent to the origin of the skull, with fibrous connections between them, and a large number of osteoblasts growing adaptively inside, forming a new cranial structure. The skull expands and grows at the junction of the sutures, thereby increasing the volume of the cranial cavity and providing space for the development of brain tissue. This process mainly occurs before the baby is 3 years old. After the age of 3, the volume growth of the cranial cavity becomes very slow. During the development of the skull, some babies experience premature fusion of the skull, leading to the disappearance and closure of the cranial sutures, which limits the growth of the skull and causes a decrease in local cranial cavity volume, resulting in abnormal head shape. This pathological phenomenon is called craniosynostosis. Early closure of the cranial sutures is like putting a hoop on the brain tissue, constantly reciting the "Tightening Hoop Curse". Premature disappearance or closure of one or several cranial sutures in a baby can cause various hazards, such as limited brain tissue development due to low cranial cavity volume, which may affect the baby's intellectual development; The cranial cavity volume is too small, causing compression between brain tissue and skull, resulting in increased intracranial pressure, leading to eye protrusion, optic disc edema, cerebellar tonsillar hernia, etc; At the same time as the closure of the cranial sutures, compensatory growth of other skull bones can cause serious deformities in the craniofacial region, affecting aesthetics. If not treated early, it can affect the normal psychological and mental state of the baby. There are four inspection methods for situations similar to "sleeping on the head", which require careful examination of the baby's head through "one look", "two touches", "three evaluations", and "four inspections". At first glance, the most typical manifestation of a baby is abnormal head, asymmetrical appearance, and even deformities. Premature closure of the sagittal suture causes limited lateral growth of the skull, resulting in compensatory expansion and growth of the skull towards the front and back. This is manifested as long head deformity, also known as boat shaped head deformity, which is the most common head deformity, accounting for about 40% to 70%. Premature closure of one coronal suture leads to asymmetric growth of the entire frontal and orbital regions, known as anterior oblique head deformity. Premature closure of bilateral coronal sutures causes restricted growth of the skull in the anterior posterior direction, resulting in a short frontal area and compensatory growth of the skull in the left and right directions, known as short head deformity. The premature closure of one side of the herringbone seam causes the two ears to be asymmetrically positioned, resulting in a deviation of the occipital region, known as posterior oblique head deformity. In addition, there are some rare cases where multiple cranial sutures merge, resulting in severe reduction of cranial cavity volume, causing the child's eyeball to protrude and the fontanelle to not close, known as pointed deformity. Second touch, in most cases, you can touch the closed ridge of the cranial sutures with your fingers. If the baby's anterior fontanelle is full and the fontanelle is swollen, it indicates high intracranial pressure and helps to identify early closure of the cranial sutures. Three assessments, the pediatric health clinic has infrared head shape analysis, which can preliminarily determine whether the head shape is abnormal. Insufficient brain capacity leads to delayed development of the brain and nervous system. Compared to children of the same age, affected children exhibit behavioral abnormalities, intellectual disabilities, and developmental delays. If there is a sustained increase in intracranial pressure, it is manifested as a rapid increase in the baby's head circumference in a short period of time, a big head doll like appearance, or the appearance of a sunset sign under both eyes. The gold standard for determining early closure of cranial sutures through four examinations is cranial CT+three-dimensional reconstruction of the skull, which can provide detailed analysis of skull deformities, the nature of early closure of cranial sutures, complete or partial closure, and brain tissue development. However, the above-mentioned radiographic examinations need to be completed in the CT room, and young babies require sedative treatment, making the examination process more complicated. Head MRI can effectively evaluate the development of brain tissue, but the examination is time-consuming and also requires sedation treatment for the baby. One of the purposes of early closure of cranial sutures based on age is to relieve the pressure of the skull on brain tissue, expand the cranial cavity, and provide space for brain tissue development. In addition, early closure of cranial sutures can also have a serious impact on the appearance of the child's head, eyes, ears, nose, and other facial features. Therefore, one of the purposes of the surgery is also to improve the abnormal craniofacial appearance of the baby, laying the foundation for the baby to enter society as an adult. The individual differences in babies with craniosynostosis are significant, and follow-up of babies after craniosynostosis surgery is not yet complete, so the standard surgical age is uncertain. Studies both domestically and internationally have shown that early surgery is beneficial for the recovery of neurological function in babies. The earlier the surgery, the better the recovery of cognitive function in the brain. In addition, the skull of babies under 1 year old has a strong ability to repair surgical defects, but this repair ability gradually weakens with age. Therefore, the surgical procedure should be determined based on the patient's type of early closure of the cranial sutures, the nature of the stenosis, the degree of teratogenicity, and the presence of intracranial pressure. According to the age of the baby, the types of early closure of cranial sutures are different, and the surgical methods can be roughly divided into four situations. Firstly, when the age is between 3-5 months, the best surgical outcome is achieved. Endoscopic assisted closed cranial suture strip resection can be chosen, and corrective helmets can be worn for shaping after surgery. Secondly, for children aged 5-11 months, simple osteotomy can be used. For common cases of early closure of sagittal sutures, the "π" - shaped osteotomy method can be applied, and corrective helmets can be worn after surgery. Thirdly, for children over 1 year old, different surgical methods for skull reconstruction should be selected based on the type of early closure of cranial sutures. For children with premature closure of coronal and frontal sutures that affect the orbit, methods of frontal and orbital reconstruction and remodeling are also needed. Finally, other methods may be considered for older children, such as floating skull flap technique, free bone flap transfer and remodeling, absorbable fixation material with bone flap surgery, and distraction osteogenesis technique. In addition, some babies with premature closure of cranial sutures also have complications such as hydrocephalus, cerebellar tonsillar hernia, and strabismus, which require symptomatic treatment. In short, regarding the appearance of a baby's head, it's not as simple as sleeping off track. The above is for reference only. It is recommended to seek medical treatment at a regular hospital for specific situations. (New Society)