Exact Period of Closure of Different Fontenellae of Neonatal Skull

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Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katihar...

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	Specialist Answers
Question
1. Could you please tell me the names, exact period of closure of different fontenellae of the neonatal skull? How much rise in neonatal head circumference(in case of meningitis)should be suspected for hydrocephallus? Closure of different skull sutures? 2.Could you please explain the findings of C.S.F. examination in neonatal meningitis, particularly in low birth wt babies, preterm babies?
Answer
Metopic suture - Nine months to two years (may persist into adulthood) Coronal, sagittal, lambdoid sutures - 40 years Anterior fontanelle - 9-18 months Posterior fontanelle - 3-6 months Anterolateral fontanelle - 3 months Posterolateral fontanelle - 2 years Head circumference more than normal for that child should make one suspect for macrocephaly. In infants one can correlate head circumference with total length. Interpretation of CSF findings is more difficult in neonates than in older children, especially in premature infants whose more permeable blood-brain barrier causes higher levels of glucose and protein. Normal CSF may contain up to 20 WBCs per mm3 in newborns. Several PMNs in a neonatal patient's CSF is not unusual. Newborn patients have up to 150 mg per dL (1.5 g per L) of protein. Back to All Questions

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