0 Fontanelle or fontanel

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Normal full term baby has 6 fontanelle :
  • Anterior
  • Posterior
  • 2 Mastoid
  • 2 Sphenoidal



Posterior :
  • Close at birth
  • In only 3% it is open (here it just admits tip of finger)

Anterior : 
  • Diamond shape
  • Open at birth
  • 2.5 x 2.5 cm
  • Pulsatile
  • Closes at 18 - 24 months life.



Causes of Delayed closure of Anterior fontanelle :
  1. Down's Syndrome
  2. Hypothyroidism
  3. Hypophosphatasia
  4. Rickets
  5. Cleidocranial dysostosis

First four (1-4) and idiopathic are causes of delayed dentition. (Delayed dentition is non eruption of teeth by 13 months life )



Early closure of Anterior fontanelle : Craniosynostosis
Complications :
  • Microcephaly
  • Increased ICT - Optic atrophy
  • Cosmetic - head shape (if only one suture fuses early)
Associated syndromes :
  • APERT (AD)
  • CROUZON (AD)
  • CARPENTER - Autosomal recessive
  • PFIFFER (AD)



Increased ICT : Anterior fontanelle - bulging & non pulsatile
Dehydration : Depressed Anterior fontanelle



Img source : http://en.wikipedia.org/wiki/File:Gray197.png

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