Accessory sutures
Mendosal
suture • Persistant mendosal suture - Ganzer Fall bei Radiopaedia
Mendosal
suture • Accessory occipital bone sutures - Ganzer Fall bei Radiopaedia
Wormscher
Knochen in der Lambdanaht. Ansicht von hinten auf den Schädel. Computertomographie mit Volume rendering Rekonstruktion.
Infant with a
bump in the left occiput. 3D reconstruction of a CT without contrast of the brain shows a lucency arising from the left lambdoid suture inferiorly and curving to the left that has a zig zag pattern and seems to interdigitate within the skull. Soft tissue windows showed no associated soft tissue swelling.The diagnosis was accessory skull suture.
Infant with
left parietal soft tissue swelling. 3D reconstruction of a CT without contrast of the brain shows a lucency arising from the left lambdoid suture anteriorly and curving anteriorly that has a zig zag course through the parietal bone.The diagnosis was an intraparietal accessory skull suture.
Persistierende
Sutura frontalis bei einer 20-jährigen. Normalerweise schließt sich die Sutur im ersten Lebensjahr.
Accessory
sutures • Accessory occipital suture - Ganzer Fall bei Radiopaedia
Accessory
sutures • Accessory intraparietal suture - Ganzer Fall bei Radiopaedia
Accessory
sutures • Occipital bone ossification centers - Ganzer Fall bei Radiopaedia
The parietal and occipital bones in particular are common regions for accessory sutures because of their multiple ossification centers.
It is important to know these anatomic variations, mainly on the head trauma image studies in children, where it could be difficult to differentiate non-depressed skull fractures from an accessory suture.
Radiographic differentiation of skull fracture and accessory suture
Accessory sutures usually:
- make a "zig-zag" pattern with interdigitations
- have sclerotic borders similar to major calvarial sutures
- are often present on both sides and are fairly symmetric especially in the parietal bones
- occipital accessory sutures can be complex and multiple but are also frequently bilateral
Simple non-depressed skull fractures usually:
- have sharp lucencies with non-sclerotic edges
- widen as they approach the suture or there is associated diastasis of the adjacent synchondrosis or suture
- can cross suture lines or extend from one major suture to another (in high impact fractures)
- have associated soft tissue swelling or hematoma
- absence does not exclude a fracture
Related articles
Siehe auch:
- Wormsche Knochen
- Schädelfraktur
- akzessorische Sutura intraparietalis
- akzessorische okzipitale Sutur
- persistierende Sutura frontalis mediana
und weiter:
Assoziationen und Differentialdiagnosen zu akzessorische Suturen des Schädels: