Crouzon Syndrome: Phenotypic Signs and Symptoms of the Postnatally Expressed Subtype
Abstract
In a retrospective study, the characteristics of a group of patients (n = 9) with a postnatally expressed Crouzon syndrome were described. Although they do not always display the physical signs of craniosynostosis, such patients are highly at risk of developing symptoms secondary to multiple suture synostosis. By reviewing the hospital files, radiographs, and three-dimensional computed tomography scans of these patients, it was possible to describe the pattern of suture obliteration chronologically. Furthermore, certain phenotypic signs and symptoms such as skull shape and development of digital impressions, a bulge at the bregma, and intracranial hypertension were inventoried as well as patients' genotypes. Interestingly, ossification started at the lambdoid sutures in at least four patients and most likely in three additional ones. The coronal sutures were the last to ossify in at least three of the patients. Various skull shapes were encountered. Furthermore, all nine patients developed digital impressions, starting occipitally in eight of them. Seven patients developed a bulge at the bregma, and four of them exhibited intracranial hypertension. The genotype varied in our patients. To recognize patients with postnatal Crouzon syndrome as soon as possible, special attention must be paid to 1) occipital development of digital impressions and/or ossification of sutures, 2) development of a prominent bregma, 3) development of intracranial hypertension, and/or 4) progressive characteristic "crouzonoid" features. Such patients can be considered as representing a subtype of Crouzon syndrome. To prevent or treat intracranial hypertension and/or loss of vision, surgical intervention should be performed at the onset of progressive craniosynostosis between 1 and 2 years of age.
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Crouzon syndrome can present with late-onset pansynostosis, although bicoronal synostosis is most common.
“Although bicoronal synostosis is most common, Crouzon syndrome can present with late-onset pansynostosis.18,19”
From Craniosynostosis (2011) · cites this paper as [18]
Cites
Birth Defects: Original Article Series.
(1971) · Annals of Internal Medicine · doi:10.7326/0003-4819-74-1-157_8 · Cited by 1,388 · see citing works
Mutations in the fibroblast growth factor receptor 2 gene cause Crouzon syndrome
Reardon, W., Winter, R., Rutland, P., Pulleyn, L., Jones, B., & Malcolm, S. (1994) · Nature Genetics · doi:10.1038/ng0994-98 · Cited by 746 · see citing works
Craniosynostosis: genes and mechanisms
Wilkie, A. O. M. (1997) · Human Molecular Genetics · doi:10.1093/hmg/6.10.1647 · Cited by 523 · see citing works
Sutural biology and the correlates of craniosynostosis
Cohen, M. M. (1993) · American Journal of Medical Genetics · doi:10.1002/ajmg.1320470507 · Cited by 394 · see citing works
Management of craniosynostoses
Renier, D., Lajeunie, E., Arnaud, E., & Marchac, D. (2000) · Child s Nervous System · doi:10.1007/s003810000320 · Cited by 384 · see citing works
Vajó, Z., Francomano, C. A., & Wilkin, D. J. (2000) · Endocrine Reviews · doi:10.1210/edrv.21.1.0387 · Cited by 323 · see citing works
Intracranial pressure and intracranial volume in children with craniosynostosis
Gault, D. T., Renier, D., Marchac, D., & Jones, B. M. (1992) · Plastic and Reconstructive Surgery · doi:10.1097/00006534-199209000-00003 · Cited by 309 · cited 1× · see citing works
“With regard to the intracranial pressure, hypertension frequently develops in patients with Crouzon syndrome if growth of the brain becomes restricted because of the multiple synostotic sutures.(16) Connolly et al(13) reported 15 patients exhibiting progressive postnatal craniosynostosis and evidence of increased intr…”
BackgroundHuang, M. H. S., Gruss, J. S., Clarren, S. K., Mouradian, W. E., Cunningham, M. L., Roberts, T. S., Loeser, J. D., & Cornell, C. J. (1996) · Plastic & Reconstructive Surgery · doi:10.1097/00006534-199610000-00001 · Cited by 225 · see citing works
Cinalli, G., Rénier, D., Sebag, G., Sainte-Rose, C., Arnaud, É., & Pierre-Kahn, A. (1995) · Journal of Neurosurgery · doi:10.3171/jns.1995.83.4.0575 · Cited by 210 · see citing works
Kreiborg, S., Marsh, J. L., Cohen, M. M., Liversage, M., Pedersen, H., Skovby, F., Børgesen, S. E., & Vannier, M. W. (1993) · Journal of Cranio-Maxillofacial Surgery · doi:10.1016/s1010-5182(05)80478-0 · Cited by 181 · see citing works
Park, W., Meyers, G., Li, X., Theda, C., Day, D. W., Oriow, S. J., Jones, M. C., & Jabs, E. (1995) · Human Molecular Genetics · doi:10.1093/hmg/4.7.1229 · Cited by 171 · see citing works
A Morphogenetic Classification of Craniofacial Malformations
van der Meulen, J. C., Mazzola, R. F., Vermey-Keers, C., Strieker, M., & Raphaël, B. (1983) · Plastic & Reconstructive Surgery · doi:10.1097/00006534-198304000-00022 · Cited by 160 · see citing works
Occipital plagiocephaly: a critical review of the literature
Rekate, H. L. (1998) · Journal of neurosurgery · doi:10.3171/jns.1998.89.1.0024 · Cited by 139 · see citing works
Molecular Diagnosis of Bilateral Coronal Synostosis
Mulliken, J. B., Steinberger, D., Kunze, S., & Müller, U. (1999) · Plastic & Reconstructive Surgery · doi:10.1097/00006534-199911000-00001 · Cited by 106 · see citing works
Cinalli, G., Chumas, P., Arnaud, É., Sainte‐Rose, C., & Rénier, D. (1998) · Neurosurgery · doi:10.1097/00006123-199801000-00013 · Cited by 93 · see citing works
Speltz, M. L., Morton, K., Goodell, E. W., & Clarren, S. K. (1993) · The Cleft Palate-Craniofacial Journal · doi:10.1597/1545-1569(1993)030 · Cited by 84 · see citing works
Pulleyn, L. J., Reardon, W., Wilkes, D. C., Rutland, P., Jones, B. M., Hayward, R. D., Hall, C. M., Brueton, L. A., Chun, N., Lammer, E. J., et al. (1996) · European Journal of Human Genetics · doi:10.1159/000472215 · Cited by 79 · see citing works
Mutation detection in FGFR2 craniosynostosis syndromes
Hollway, G. E., Suthers, G., Haan, E., Thompson, E. M., David, D. J., Gécz, J., & Mulley, J. C. (1997) · Human Genetics · doi:10.1007/s004390050348 · Cited by 57 · see citing works
Description of a Dry Skull with Crouzon Syndrome
Kreiborg, S., & Björk, A. (1982) · Scandinavian Journal of Plastic and Reconstructive Surgery · doi:10.3109/02844318209026215 · Cited by 50 · see citing works
Radical Correction of Senile Entropion and Ectropion
van der Meulen, J. C. (1983) · Plastic & Reconstructive Surgery · doi:10.1097/00006534-198303000-00004 · Cited by 27 · see citing works
Time: the fourth dimension in syndrome analysis applied to craniofacial malformations.
Pruzansky, S. (1977) · PubMed · Cited by 24 · see citing works
Lambdoid synostosis is an overdiagnosed condition
Cohen, M. M. (1996) · American Journal of Medical Genetics · doi:10.1002/ajmg.1320610109 · Cited by 23 · see citing works
No evidence of genetic heterogeneity in Crouzon craniofacial dysostosis
Wi, H., Lajeunie, E., Merrer, M. F. L., de Parseval, N., Serville, F., Weissenbach, J., Münnich, A., & Rénier, D. (1995) · Human Genetics · doi:10.1007/bf00210308 · Cited by 19 · see citing works
Steinberger, D., Collmann, H., Schmalenberger, B., & Müller, U. (1997) · Journal of Medical Genetics · doi:10.1136/jmg.34.5.420 · Cited by 19 · see citing works
Novel 7-DHCR mutation in a child with Smith-Lemli-Opitz syndrome
Patrono, C., Rizzo, C., Tessa, A., Giannotti, A., Borrelli, P., Carrozzo, R., Piemonte, F., Bertini, E., Dionisi‐Vici, C., & Santorelli, F. M. (2000) · American Journal of Medical Genetics · doi:10.1002/(sici)1096-8628(20000313)91:2 · Cited by 16 · see citing works
Consensus: Craniofacial synostoses
Bruce, D. A. (1996) · Child s Nervous System · doi:10.1007/bf00366159 · Cited by 9 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Johnson, D., & Wilkie, A. O. M. (2011) · European Journal of Human Genetics · doi:10.1038/ejhg.2010.235 · Cited by 499 · see citing works
A Genetic-Pathophysiological Framework for Craniosynostosis
Twigg, S. R. F., & Wilkie, A. O. M. (2015) · The American Journal of Human Genetics · doi:10.1016/j.ajhg.2015.07.006 · Cited by 276 · see citing works
Wilkie, A. O. M. (2005) · Cytokine & Growth Factor Reviews · doi:10.1016/j.cytogfr.2005.03.001 · Cited by 255 · see citing works
Mathijssen, I. M. J. (2015) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000002016 · Cited by 232 · see citing works
Fibroblast Growth Factor Receptor 2 (FGFR2) Mutation Related Syndromic Craniosynostosis
Azoury, S. C., Reddy, S., Shukla, V., & Deng, C. (2017) · International Journal of Biological Sciences · doi:10.7150/ijbs.22373 · Cited by 129 · see citing works
Brain malformation in syndromic craniosynostoses, a primary disorder of white matter: a review
Raybaud, C., & Rocco, C. D. (2007) · Child s Nervous System · doi:10.1007/s00381-007-0474-7 · Cited by 114 · see citing works
Anesthesia for Craniofacial Surgery in Infancy
Stricker, P. A., & Fiadjoe, J. E. (2013) · Anesthesiology Clinics · doi:10.1016/j.anclin.2013.10.007 · Cited by 106 · see citing works
Clinical dividends from the molecular genetic diagnosis of craniosynostosis
Wilkie, A. O. M., Bochukova, E. G., Hansen, R. M. S., Taylor, I. B., Rannan‐Eliya, S. V., Byren, J. C., Wall, S. A., Ramos, L. M., Venâncio, M., Hurst, J. A., et al. (2006) · American Journal of Medical Genetics Part A · doi:10.1002/ajmg.a.31366 · Cited by 105 · see citing works
Clinical dividends from the molecular genetic diagnosis of craniosynostosis†
Wilkie, A. O. M., Bochukova, E. G., Hansen, R. M. S., Taylor, I. B., Rannan‐Eliya, S. V., Byren, J. C., Wall, S. A., Ramos, L. M., Venâncio, M., Hurst, J. A., et al. (2007) · American Journal of Medical Genetics Part A · doi:10.1002/ajmg.a.31905 · Cited by 87 · see citing works
Craniosynostosis as a clinical and diagnostic problem: molecular pathology and genetic counseling
Kutkowska‐Kaźmierczak, A., Goś, M., & Obersztyn, E. (2018) · Journal of Applied Genetics · doi:10.1007/s13353-017-0423-4 · Cited by 66 · see citing works
Florisson, J. M. G., Barmpalios, G., Lequin, M. H., van Veelen, M. C., Bannink, N., Hayward, R. D., & Mathijssen, I. M. J. (2014) · Journal of Cranio-Maxillofacial Surgery · doi:10.1016/j.jcms.2014.11.023 · Cited by 55 · see citing works
Zhou, C., Zhu, M. B., Shi, Y., Lin, L., Chai, G., Zhang, Y., & Xie, L. (2017) · Aesthetic Plastic Surgery · doi:10.1007/s00266-017-0900-5 · Cited by 50 · see citing works
Minor Suture Fusion in Syndromic Craniosynostosis
Runyan, C. M., Xu, W., Alperovich, M. A., Massie, J. P., Paek, G., Cohen, B., Staffenberg, D. A., Flores, R. L., & Taylor, J. A. (2017) · Plastic & Reconstructive Surgery · doi:10.1097/prs.0000000000003586 · Cited by 43 · see citing works
Goriely, A., Lord, H., Lim, J., Johnson, D., Lester, T., Firth, H. V., & Wilkie, A. O. M. (2010) · American Journal of Medical Genetics Part A · doi:10.1002/ajmg.a.33513 · Cited by 41 · see citing works
Progressive postnatal pansynostosis: an insidious and pernicious form of craniosynostosis
Wood, B. C., Oh, A. K., Keating, R. F., Boyajian, M. J., Myseros, J. S., Magge, S. N., & Rogers, G. F. (2015) · Journal of Neurosurgery Pediatrics · doi:10.3171/2015.1.peds14464 · Cited by 32 · see citing works
Heuzé, Y., Martínez‐Abadías, N., Stella, J. M., Arnaud, E., Collet, C., García Fructuoso, G., Alamar, M., Lo, L., Boyadjiev, S. A., Di Rocco, F., et al. (2014) · Birth Defects Research Part A Clinical and Molecular Teratology · doi:10.1002/bdra.23228 · Cited by 27 · see citing works
Savoldi, F., Tsoi, J. K. H., Paganelli, C., & Matinlinna, J. P. (2017) · Tissue Engineering Part B Reviews · doi:10.1089/ten.teb.2017.0116 · Cited by 27 · see citing works
Progressive Postnatal Pansynostosis
Rogers, G. F., Greene, A. K., Proctor, M. R., Mulliken, J. B., Goobie, S. M., & Stoler, J. M. (2014) · The Cleft Palate-Craniofacial Journal · doi:10.1597/14-092 · Cited by 24 · see citing works
Morice, A., Cornette, R., Giudice, A., Collet, C., D, G. P. M., Arnaud, É., Galliani, E., Picard, A., Legeai‐Mallet, L., & Khonsari, R. H. (2020) · Bone · doi:10.1016/j.bone.2020.115600 · Cited by 23 · see citing works
Classification of Subtypes of Crouzon Syndrome Based on the Type of Vault Suture Synostosis
Lu, X., Sawh-Martinez, R. F., Forte, A. J., Wu, R. T., Cabrejo, R. G., Wilson, A. T., Steinbacher, D. M., Alperovich, M. A., Alonso, N., & Persing, J. A. (2020) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000006173 · Cited by 19 · see citing works
Clinical assessment and FGFR2 mutation analysis in a Chinese family with Crouzon syndrome
Shi, H., Yang, J., Guo, Q., & Zhang, M. (2021) · Medicine · doi:10.1097/md.0000000000024991 · Cited by 10 · see citing works
Crouzon's syndrome: literature review
Cunha, S. C., Monteiro, M., Palheta, A. C. P., Carneiro, S. G., Neto, F. X. P., da Silva, D. L., & Nunes, C. T. A. (2008) · DOAJ (DOAJ: Directory of Open Access Journals) · Cited by 9 · see citing works
Orbitofacial morphology changes with different suture synostoses in Crouzon syndrome
Lu, X., Forte, A. J., Junn, A., Dinis, J., Alperovich, M. A., Alonso, N., & Persing, J. A. (2021) · Journal of Cranio-Maxillofacial Surgery · doi:10.1016/j.jcms.2021.06.012 · Cited by 8 · see citing works
Bristol, R. E., Krieger, M. D., & McComb, J. G. (2011) · Journal of Craniofacial Surgery · doi:10.1097/scs.0b013e3181f752c2 · Cited by 8 · see citing works
Wilkie, A. O. M. (2005) · Cytokine · doi:10.1016/j.cyto.2005.01.003 · Cited by 6 · see citing works
Forme congénitale de la maladie de Crouzon
Mbika-Cardorelle, A., Makosso, E., & Moyen, G. M. (2006) · Archives de Pédiatrie · doi:10.1016/j.arcped.2006.01.004 · Cited by 5 · see citing works
Rao, V. P., Ali, R., Roussel, L. O., Crozier, J. W., Svokos, K. A., & Woo, A. S. (2021) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000007599 · Cited by 3 · see citing works
Alawneh, R. J., Johnson, A. L., Hoover-Fong, J. E., Jackson, E. M., Steinberg, J. P., & MacCarrick, G. L. (2022) · The Cleft Palate-Craniofacial Journal · doi:10.1177/10556656221090844 · Cited by 3 · see citing works
Ocular features in Egyptian genetically disabled children
El-Hawary, G. R., Shawky, R. M., El-Din, A. S., & El-Din, S. M. N. (2011) · Egyptian Journal of Medical Human Genetics · doi:10.1016/j.ejmhg.2011.06.004 · Cited by 3 · see citing works
Detecting an Undiagnosed Case of Nonsyndromic Facial Dysmorphism Using Geometric Morphometrics
Harris, S. M., & Ross, A. H. (2008) · Journal of Forensic Sciences · doi:10.1111/j.1556-4029.2008.00872.x · Cited by 3 · see citing works
Progressive Postnatal Pansynostosis in Crouzon Syndrome
Geisler, E. L., Hallac, R. R., Perez, J. K., & Kane, A. A. (2020) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000006931 · Cited by 3 · see citing works
Wei, X., Guori, H., Gui, B., Xie, B., Chen, S., Fan, X., & Chen, Y. (2022) · Molecular Genetics & Genomic Medicine · doi:10.1002/mgg3.1901 · Cited by 3 · see citing works
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Hashemi, H. M., Mohammadi, F., & Kahnamouii, S. S. (2016) · InTech eBooks · doi:10.5772/63739 · Cited by 2 · see citing works
Ng, J. J., Massenburg, B. B., Wu, M., Romeo, D. J., Swanson, J. W., Taylor, J. A., & Bartlett, S. P. P. (2024) · Plastic & Reconstructive Surgery Global Open · doi:10.1097/gox.0000000000005558 · Cited by 2 · see citing works
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Kanaparthy, R., & Kanaparthy, A. (2012) · Dentistry · doi:10.4172/scientificreports.196 · Cited by 2 · see citing works
Karaman, V., Toksoy, G., Karaman, B., Karabey, H. K., Başaran, S., Altunoğlu, U., Avcı, Ş., & Uyguner, Z. O. (2019) · Journal of Istanbul Faculty of Medicine / İstanbul Tıp Fakültesi Dergisi · doi:10.26650/iuitfd.422258 · Cited by 1 · see citing works
The Neural Crest and Craniofacial Malformations
Vermeij‐Keers, C., Mathijssen, I. M. J., Trainor, P. A., & ten Donkelaar, H. J. (2023) · Springer eBooks · doi:10.1007/978-3-031-26098-8_5 · Cited by 1 · see citing works
Self-citationSíndrome de Crouzon: Diagnóstico, tratamiento y correlaciones clínicas
D’Dalarponio, P. D. A. T., Carneiro, R. M., Abrão, B. M., Ayres, T. C. P., Veloso, R. C., Assis, A. R., Júnior, L. W. D. S., Dutra, M. B. F., Damião, D. N., Jeronimo, R. J., et al. (2023) · Research Society and Development · doi:10.33448/rsd-v12i10.43336 · Cited by 1 · see citing works
Saethre-Chotzen syndrome : cranofacial anomalies caused by genetic changes in the TWIST gene
de Heer, M. (2004) · Cited by 1 · see citing works
The dentist's role in diagnosing craniofacial dysostosis
Kanaparthy, A., & Gupta, Y. K. (2014) · International Journal of Case Reports and Images · doi:10.5348/ijcri-2013-05-307-cr-4 · Cited by 1 · see citing works
Achterrath, S., Kruse, T., Neuschulz, J., Graf, I., Zöller, J. E., & Braumann, B. (2021) · Children · doi:10.3390/children8121122 · Cited by 1 · see citing works
Aspectos fonoaudiológicos na síndrome de Crouzon: estudo de caso
Gomes, I. S., Limongi, S. C. O., Neves, I. F., Couto, M. I. V., & Matas, C. G. (2008) · Revista CEFAC · doi:10.1590/s1516-18462008000300005 · Cited by 1 · see citing works
Síndrome de Crouzon: Revisão de Literatura Crouzon's Syndrome: Literature Review
da Silva, D. L., Neto, F. X. P., Carneiro, S. G., Cristina, A., Palheta, P., Monteiro, M., Cunha, S. C., & Nunes, C. T. A. (2008)
Coronal Suture Morphology and Synostotic Progression in Rabbits with Delayed-Onset Craniosynostosis.
Deol, H. (2017) · D-Scholarship@Pitt (University of Pittsburgh)
Ngoc, N. T., & Duc, H. H. (2023) · VNU Journal of Science Natural Sciences and Technology · doi:10.25073/2588-1140/vnunst.5583
Ogawa, J. T., Guyler, M. R., Tomei, K. L., & Wang, H. D. (2025) · American Journal of Medical Genetics Part A · doi:10.1002/ajmg.a.64028
- Authors
- Hoefkens, M. F., Vermeij-Keers, C., & Vaandrager, J. M.
- Affiliations
- Erasmus MC (NL)
- Corresponding author
- Hoefkens, Mirjam F.
- Venue
- Journal of Craniofacial Surgery
- Published
- 2004-03
- Volume
- 15
- Issue
- 2
- Pages
- 233-240
- ISSN
- 1049-2275 (ISSN-L)
- OpenAlex
- W2086064195
- Cited by
- 47
- References
- 26
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 3 · 2022: 2 · 2021: 4 · 2020: 3 · 2019: 1 · 2018: 1 · 2017: 5 · 2016: 1 · 2015: 3 · 2014: 4 · 2013: 1 · 2012: 1
- FWCI
- 1.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Craniofacial Surgery (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Craniofacial Disorders and Treatments
- Health Sciences › Medicine › Surgery › Pectus Deformity Diagnosis and Treatment
- Health Sciences › Medicine › Rheumatology › Osteomyelitis and Bone Disorders Research
- Keywords
- Crouzon syndrome, lambdoid suture, coronal suture, digital impressions, intracranial hypertension, skull shape, genotypes, early surgical intervention
- MeSH terms
- Craniofacial Dysostosis, Craniosynostoses, Exophthalmos, Female, Humans, Infant, Male, Mutation, Phenotype, Retrospective Studies, Fibroblast Growth Factor 2, Disease Progression, Intracranial Hypertension
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