Differential diagnosis of craniosynostosis

• Coronal craniosynostosis
• Lambdoid craniosynostosis
• Metopic craniosynostosis
• Sagittal craniosynostosis
• Cloverleaf skull
• Positional plagiocephaly

Approach to the differential diagnosis of craniosynostosis:

• Clinical presentation is an unusual shape of the head
  — Bilateral coronal craniosynostosis – skull is shortened (brachycephaly)
  — Unilateral coronal craniosynostosis – skull is trapedzoidal in shape and is flattened anteriorly (plagiocephaly), orbit has a harlequin eye deformity
  — Bilateral lambdoid craniosynostosis – skull is shortened (brachycephaly)
  — Unilateral lambdoid craniosynostosis – skull is trapedzoidal in shape and is flattened posteriorly (plagiocephaly)
  — Metopic craniosynostosis – skull has a pointed forehead (trigonocephaly), orbits show hypotelorism (quizzical eyes)
  — Sagittal craniosynostosis – skull is elongated in length (scaphocephaly / dolicocephaly)
  — Cloverleaf skull – sagittal / coronal / lambdoid sutures are fused with compensatory widening of squamosal sutures
• Positional plagiocephaly is a diagnosis of exclusion after craniosynostosis has been ruled out