Single-Suture Craniosynostoses

Classic appearances associated with premature closure of various sutures:

• Sagittal suture: Most common form. Scaphocephaly (skaphe=a light boat or skiff) or dolichocephaly (dolicho=long). Long and narrow head.
• Metopic suture: Trigonocephaly (trigonon=triangle). The head looks triangle-shaped when viewed from above with a ridge along the middle of the forehead. Hypotelorism and parietooccipital bossing.
• Coronal suture: Unilateral: Harlequin or winking eye, due to ipsilateral frontal bone flattening that leads to elevation of the superior orbital rim and contralateral frontal bossing that leads to depression of the superior orbital rim. Bilateral: Brachycephaly (brachys=short). Decreased anteroposterior dimension and increased bitemporal distance and height.
  
  The harlequin eye can also be seen with neurofibromatosis (due to dysplasia of the greater wing of the sphenoid) or focal calvarial expansion from an intracranial mass.
• Lambdoid suture: Very rare. Posterior plagiocephaly (plagio=oblique). Most commonly the appearance represents deformational (positional) plagiocephaly. The ears will be pulled back, in contrast to the much more common positional plagiocephaly, where the ears are pushed forward.