PMC3985371_01
(a and b) Photographs show characteristic features of syndromic craniosynostoses in our patient: Hypertelorism, proptosis, midfacial hypoplasia, and abnormal head shape. (Published with permission and informed consent of the patient)
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F1
Hypertelorism, proptosis, midfacial hypoplasia, and abnormal head shape [Figures 1a and b]. However, the patient and his family did not admit to a hospital for this reason before, despite prominent Cruzonoid features.
(a) Anteroposterior (AP) and lateral plain radiographs of head shows increase of AP diameter of the head and midfacial-orbital hypoplasia. Fusion of multiple calvarial sutures is also remerkable, (b) Axial cranial computed tomography scan demonstrated the abnormal head shape and the fusion of bilateral coronal and lambdoid sutures alongside with sagittal suture
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F2
Anteroposterior (AP) and lateral plain radiographs of head and a cranial computed tomography (CT) demonstrated midfacial and orbital hypoplasia, the fusion of bilateral coronal and lambdoid sutures and sagittal suture, alongside with the increase of AP diameter of the head [Figures 2a and b].
Sagittal T2-weighted magnetic resonance imaging shows a 18 mm cerebellar tonsil herniation into the foramen magnum with accompanying syringomyelia between Th 4 and Th 7 with the largest thickness of 11 mm
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F3
Cranial and spinal magnetic resonance imaging (MRI) studies were obtained and it showed a 18 mm cerebellar tonsil herniation into the foramen magnum with accompanying syringomyelia between Th 4 and Th 7 [Figure 3].
(a) Sagittal T2-weighted MRI of the craniocervical junction showed complete resolution of 18 mm cerebellar tonsil herniation, (b) Sagittal T2-weighted thoracal MRI showed relative resolution of the accompanying syringomyelia between Th 4 and Th 7 with the largest thickness of 7 mm
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F4
Control MRI showed complete resolution of the tonsillar herniation and significant reducement of the syringomyelia both in length and thickness [Figures 4a and b].