Sutures - separated

Alternative names

Separation of the sutures

Definition

Separated sutures are defined as an abnormally wide separation of the bony sutures of the skull in an infant.

Considerations

The skull of an infant or young child is made up of bony plates that allow for growth. The borders at which these plates intersect are called sutures or suture lines.

In an infant only a few minutes old, the pressure from delivery may compress the head, making the bony plates overlap at the sutures and creating a small ridge. This is a normal finding of newborns. In the next few days the head expands, the overlapping disappears, and the edges of the bony plates meet edge to edge. This is the normal position.

Diseases or conditions that cause an abnormal increase in the pressure within the head can cause the sutures to spread apart. These separated sutures can be a sign of increased intracranial pressure (pressure within the skull).

Separated sutures may be associated with bulging fontanelles and, if intracranial pressure is significantly increased, prominent veins over the scalp.

Common Causes

• Dandy-Walker malformation
  
• Arnold-Chiari malformation
  
• Battered child syndrome
  
• Hydrocephalus
  
• Congenital infections
  
• Meningitis
  
• brain tumor
  
• Intraventricular hemorrhage (bleeding inside the brain)
  
• Subdural hematoma or subdural effusion
  
• Lead poisoning
  
• Down syndrome
  
• Hypothyroidism
  
• Some types of vitamin deficiency
  

Home Care
Home care is based on the specific diagnosis associated with separated sutures.

Call your health care provider if

• Your child has noticeably separated sutures, bulging fontanelles, or prominent scalp veins
  
• There is redness, swelling, or discharge from the area of the sutures
  

What to expect at your health care provider's office