Separated sutures are large, atypical gaps in the skull of an infant. 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 strong, flexible tissues that hold the cranial bones together. Two sutures form a membrane known as a soft spot, or fontanel, where they meet. Sutures help protect an infant’s brain while also allowing for growth. If sutures separate, you may notice an obvious plate separation, along with an indented or bulging space that is most notable on the top of the infant’s head.
Seek immediate medical attention if you notice a separation of the sutures in your infant. It may be a sign of a life-threatening medical condition.
Suture separation can be caused by variety of factors. A common, nonthreatening cause is childbirth. The plates of a newborn’s skull may overlap and form a ridge. In such cases, the ridge typically goes away in a few days, allowing the skull to take on a normal shape. Other causes of suture separation are more serious and deserve immediate attention. Some main causes of suture separation are described below.
Some vitamin and mineral deficiencies can cause a separation of sutures. Your infant can become malnourished if they do not receive the proper nutrients for keeping the connective tissues and bone plates healthy. Dehydration (a lack of fluid) can also cause sunken fontanels that resemble suture separation.
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 requires 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:
- brain tumors
- infections present at birth
- Down syndrome
- Dandy-Walker malformation
Contact your child’s doctor immediately if you notice a separation of the brain plates or a bulging soft spot on your infant. Seek prompt medical attention if you notice any swelling, inflammation, or release of fluid from the suture areas. Many causes of suture separation are life threatening, and prompt treatment is important for a successful outcome.
Few home health options can help an infant with separated sutures. It 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 their back, or crying. The soft spot should return to a normal position — a slight inward curve — once your child becomes calm, sits upright, or stops vomiting. Seek medical assistance if the soft spot continues to protrude.
Keep a detailed record of your child’s developmental milestones and medical history. This can help medical professionals understand your child’s condition and symptoms. This will be important if the underlying cause is determined to be chronic.
Your child’s doctor will likely evaluate them by performing a physical exam. The exam will typically involve viewing the scalp and feeling for gaps between the plates to determine the distance between the sutures. The doctor may also look at your child’s soft spots and the veins in their 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 doctor may want to view the bone structure and inside of your infant’s head by running different diagnostic tests, such as a computed tomography (CT) scan, magnetic resonance imaging (MRI), or ultrasound. Other tests that may be required are blood tests and a spinal tap. An eye exam may be conducted to determine whether your child has any sight problems and to look at the optic nerve.
Most underlying conditions causing suture separation are very serious and possibly life threatening. Seeking immediate medical assistance is critical for a successful prognosis.
There is no one definitive method for preventing suture separation. However, there are steps you can take to reduce the risk of this happening:
- Stay up to date on your child’s vaccines, including those that protect against certain strands of meningitis.
- Avoid exposing your child to people 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 your child with the proper daily intake of nutrients and fluids as recommended by your doctor.
- Seek immediate medical care for unusual symptoms your child is experiencing.