The human skull is connected by a small amount of connective tissue and forms a gap called the cranial suture. As a newborn baby’s brain is not yet fully developed, the unclosed cranial suture provides a plastic cranial cavity to accommodate the growing brain as it grows heavier and more functional with age. Premature closure of the cranial suture can turn the cranial cavity into a small closed space, compressing and restricting the growing brain tissue, causing increased intracranial pressure and brain dysfunction. What is cranial suture premature closure? Premature closure of the cranial suture is a congenital anomaly caused by premature closure of the cranial suture, the cause of which is currently unknown, and is the most common type of craniofacial anomaly with an incidence of 4-6 cases per 10,000 live births. The presence of one or more prematurely closed cranial sutures is usually referred to as craniosynostosis, and is generally divided into syndromic craniosynostosis and nonsyndromic craniosynostosis, of which the syndromic type is associated with severe complications such as increased intracranial pressure, headache, neurodevelopmental delay, and congenital malformations of other parts of the body, such as facial, limb, or brain malformations. The effect of cranial suture premature closure on intelligence Cranial suture premature closure, also known as craniosynostosis or craniosynostosis, often leads to narrowing of the cranial cavity and constrains or changes the brain tissue structure, affecting the normal development of the nervous system. We often think that children with big heads are smart, and regardless of the scientific validity of this statement, premature craniosynostosis often leads to poor brain development, causing increased intracranial pressure and various brain neurological dysfunctions, and even emotional and behavioral abnormalities. Not only does craniosynostosis lead to delayed neurological development during infancy and early childhood, but this effect continues into school age with learning disabilities and other abnormalities. A large cohort study showed significant delays in mental development in children with premature craniosynostosis. The study included 182 children with a single prematurely closed cranial suture and compared their learning and IQ levels at school age with normal children, finding that the children had significantly poorer IQ and math levels, while reading and spelling-related functions were not affected; in particular, premature closure of the coronal and herringbone sutures was most likely to cause neurodevelopmental abnormalities. Diagnosis of premature closure of cranial suture Typical cranial deformities, such as acromegaly, long head deformity or oblique head deformity; and concomitant symptoms such as intracranial hypertension, brain dysfunction; X-ray cranial examination reveals premature disappearance of sutures, replaced by high density bone, and signs of increased intracranial pressure with increased cerebral gyrus pressure traces and saddleback thinning, premature closure of cranial suture is not difficult to diagnose. However, radiography as a first-line test for the diagnosis of craniosynostosis often exposes infants and children to unnecessary radiation. A recent study published in the Journal of Pediatrics concluded that cranial ultrasound can be an effective first-line imaging test to diagnose or rule out craniosynostosis in young children requiring craniosynostosis, and may reduce radiation exposure in this sensitive group. Also, cranial ultrasound has a sensitivity of 100% and a specificity of 98% for the diagnosis of craniosynostosis. Intervention for Premature Suture Closure Premature suture closure is usually treated surgically, either by removing the prematurely closed suture and reconstructing the suture, or by removing a large piece of the skull and performing cranial reconstruction to reduce intracranial pressure and improve brain development. The earlier the surgery, the better. Those operated within one year after birth have better intellectual development, while those operated later may have optic nerve atrophy and irreversible mental retardation.