Separated Sutures

Written by Suzanne Allen
Medically Reviewed by George Krucik, MD

What Are Separated Sutures?

Separated sutures are large gaps in the skull of an infant that are not typical. A young child’s head is composed of six bony plates that fuse together as the child ages. The edges of the plates are connected and form what is known as a suture.

Sutures are very strong, flexible tissues that hold the cranial bones together. When two sutures join, they form a membrane known as a “soft spot” or fontanelle. Sutures help protect an infant’s brain, while allowing for growth. If sutures separate, there may be an obvious plate separation along with an indented or bulging space, which is most notable on the top of an infant’s head.

Seek immediate medical attention if you notice a separation of the sutures, because this may be a sign of a life-threatening medical condition.

Common Underlying Causes of Suture Separation

The separation of sutures can be caused by different variables. A common, non-threatening cause is childbirth. The plates of a newborn may overlap and form a ridge. However, the ridge goes away in a few days and takes on a common shape. Other causes are more serious and deserve immediate attention. Some main causes of suture separation are:

Nutritional Deficiencies

Some vitamin and mineral deficiencies can cause a separation of sutures. If your infant is malnourished, he or she is not receiving the proper nutrients to keep the connective tissues and bone plates healthy. In addition, dehydration (a lack of fluid) can cause sunken fontanelles that resemble suture separation.

Trauma

Trauma, such as non-accidental child abuse, can cause separation of the sutures, as well as a bulging “soft spot.” A blow to the head can cause internal bleeding in the brain or a collection of blood on the brain’s surface, known as a subdural hematoma. Head trauma in an infant is an emergency and needs immediate medical assistance.

Diseases and Conditions

Diseases and conditions that cause increased pressure in the skull may raise an infant’s risk of suture separation. Some conditions and diseases linked to increased intracranial pressure include:

  • meningitis
  • hydrocephalus
  • brain tumors
  • infections present at birth
  • Down syndrome
  • Dandy-Walker malformation

Emergency Issues

Contact your doctor immediately if you notice a separation of the brain plates or a bulging “soft spot” on your infant. If you notice any swelling, inflammation, or release of fluid from the suture areas, seek prompt medical assistance. Many causes of suture separation are life-threatening, and prompt treatment is important for a successful outcome.

Addressing and Easing Symptoms

Few home health options can help an infant with separated sutures because this is a serious condition that needs to be addressed by a doctor.

Home Health Options

“Soft spots” may bulge when your infant is throwing up, lying on his or her back, or crying. After your child becomes calm, sits upright, or stops vomiting, the “soft spot” should return to a normal position, a slight inward curve. If the “soft spot” continues to protrude, seek medical assistance.

Keep a detailed record of your child’s developmental milestones and medical history to help medical professionals understand your child’s condition and symptoms. This will be important if the underlying cause is determined to be chronic.

Doctor Visit and Diagnosis

Your healthcare provider will likely evaluate your child by giving him or her physical exam. The exam may prompt the physician to view the scalp and feel for gaps between the plates to determine the distance between the sutures. Additionally, the doctor may look at your child’s “soft spots” and veins in the head.

A medical history may be conducted to evaluate the symptoms. The doctor may ask you about your child’s appetite, activity level, the duration and progression of the presenting symptom, and other factors related to your child’s physical development.

Your physician may want to view the bone structure and inside of your infant’s head by running different diagnostic tests, such as a CT scan, an MRI, or an ultrasound. Additionally, blood tests and a potential spinal tap may be warranted. An eye exam may be conducted to determine whether your child has any sight problems.

Consequences of Untreated Suture Separation

Most underlying conditions causing suture separation are very serious and even life-threatening. Seeking immediate medical assistance is critical for a successful prognosis.

Preventing a Suture Separation

There is no one definitive method for preventing suture separation. However, you can take some steps to reduce the risk of this happening.

  • Stay up-to-date on your child’s vaccines, such as those that protect against certain strands of meningitis.
  • Avoid taking your child around individuals who have or have recently had meningitis.
  • Protect your child from an accidental trauma to the head by placing bumper pads in the crib, properly installing car seats, and eliminating unstable objects from the child’s environment.
  • Provide the daily-recommended allowance of nutrients and fluids for your child, as recommended by your physician.
  • Seek immediate medical care for unusual symptoms to prevent suture separation.
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