View Full Version : 6 month old w/poss metopic??
03-02-2010, 05:13 PM
Hi... We went last week to a craniofacial specialist and had a ct done, my 6month old sons head circumference dropped from 25% at two months to below the growth chart at 6months, and he has a metopic ridge that is I would say pretty prominent.
The specialist said that it isnt effecting the brain or causing any head deformity other than the ridge, so he wanted to look at him again in acouple months to see if there is any changes....
We talked with our primary physician and he didnt want us to wait, so we are scheduled to see a neurosurgeon thursday morning....
Wondering if anyone has any thoughts on this?? And what u think on waiting to see if it starts affecting his brain development vs. getting surgery before it does?
Also if the suture is already closed, how does the front of his head or forehead grow?? Or will it start to become triangular?? I really dont want to wait on surgery if that is what he is going to end up needing in the long run! Help!!!!
03-02-2010, 06:30 PM
First of all....breathe. This is a very common concern here in cranio world. I want to try and get things correct.....does your child have a ridge or is there a triangular shape or narrowing of the forehead at all. When the Metopic is involved, very often physicians may be quick to dismiss this as "cosmetic". We have discussed recently that using the term cosmetic can give parents a feeling of anxiety and lead them to a path of uncertainty.
If your child has a "ridge" with NO Triginocephaly - then this is considered a Metopic ridge but NOT Craniosynostosis. Because the Metopic suture and when it fuses is debatable - doctors will (SHOULD) use the shape of the infant's skull, developmental milestones, baby's disposition and vision (eye placement) to determine whether or not a child is a candidate for surgery.
If your baby has a triangular shape to his skull - chances are that yes it will worsen with time. A ridge may get better with time but skull shape will continue to change with the rapid growing brain.
Email me or call.
03-02-2010, 07:39 PM
Hi & Welcome!
My son has a metopic ridge, as Amy described above. He is almost 2 and requires no surgery or intervention of any kind. He has met all his developmental milestones and we are no longer concerned but it did take meeting with the NS for me to feel comfortable with this diagnosis. I don't think it would hurt for you to see the NS to see if he agrees with the specialist you saw already. Do you have any pictures you can post of your little guy's ridge?
03-02-2010, 08:01 PM
I agree with Amy!!
My son had severe metopic(trigoncephaly) and it was pretty obvious from when he was born. Surgery for us was THE only option.
03-02-2010, 09:12 PM
Hi Welcome, I'm a coronal mom but just wanted to welcome you.
03-02-2010, 09:29 PM
Hi and welcome to CK.
Amy pretty much covered it.
If there is trig., or a triangular shape, this will not get better with time. If there is just a ridge, it may get better as the bones smooth out.
Getting the opinion of a NS is a good idea. If you are concerned about the opinion of the CFS, you can always get a second opinion. I warn you though, if one says no surgery and the other says yes to surgery you will only be more confused.
I don't like the wait and see approach, but sometimes it is all you can do. You do not want to do a needless surgery, but you don't want to wait until the brain is damaged... which is unlikely with one suture closing. If you could post some pics of your son we might be able to give you better opinions. Pics from above, especially when the head is wet are usually the best view.
My son was considered moderate metopic. He had trig, but he also had a few other concerning features. Does your son have any of these...... Arching eyebrows or dents above the brow line? Indents or pulling at the temple? These issues helped in our diagnosis, but are not always present.
Please keep us updates after your NS appointment.
03-02-2010, 10:21 PM
I also agree with the other ladies. They hit the nail right on the top of the "head" so to speak. I am a coronal mom so I dont have much experience with metopic but as a cranio mom in general I know I didnt want to "wait and see" if things with developement would get worse nor did I want to see if he would become more disfigured or not. I knew for me that if we could correct the problem at the pass then that would be what we should do. Brandon is now 1 month post op and I am proud of his outcome and know that I DID THE RIGHT THING for our particular situation. Dont let this scare you, let this empoyer you. You are your baby's only advocate. We are here for you!
03-02-2010, 10:24 PM
I just wanted to welcome you here and offer support. You will find the members on this forum VERY well educated as they are coming from personal experiences with their own kids. You will find accurate answers to your questions here!
03-03-2010, 08:45 AM
Hi and welcome. You've found a great place for support and information. Do post some pics when you get a chance. My 6 month old son is metopic w/severe trigon. You are welcome to go and view his albums so you can compare a little to what you might be seeing with your son. We won't have surgery until he's between 10 to 11 months old. Sounds like you at least have a good pediatrician that is on the ball and trying to get some answers for you. Good luck at your appt!
03-03-2010, 11:15 AM
I just wanted to welcome you to CK. Amy gave you great information, you'll find lots of support and advice here. If you can post some pictures we've got some of the best "head pickers" around.
03-03-2010, 04:21 PM
thanks for all the support!! this is the only pic i currently have.... i will try to take some tonight. His ridge seems to be more prominent than shown in the pic
03-03-2010, 04:23 PM
oh... and he does have some lines/ridges on the sides of his forhead by the temples
03-03-2010, 08:51 PM
Hi and welcome! Your son is a cutie pie and I do see the ridge in the pic you posted. The ladies have already given you some great info about the difference b/t a metopic ridge and trigonocephaly caused by metopic synostosis, but I wanted to add my welcome :) Hope to see some more pics.
03-03-2010, 08:55 PM
Hi and welcome to Craniokids! You'll find a ton of support here! I can see the ridge in your pic. The best way to view whether there is trigonocephaly is to take a pic from the top down including the cheekbones. Take a look at Julie's sons pic in her siggy above this post. My son also has a metopic ridge and those lines where his temples are. They are from the bones of the forehead going back to meet the rest of the skull. Some kids are more pronounced than others. If there is no trig, surgery is usually not indicated.
03-03-2010, 08:56 PM
here is the best pic i could get of the top of his head while he was splashing in the bath!
03-03-2010, 09:03 PM
That looks ok, but try to get one that shows his cheekbones so we can actually see his forehead in relation to his eyebrows.
03-03-2010, 10:46 PM
I noticed a vertical ridge on my 6 month old daugther's forehead about a month ago, so I menioned it to her ped. at her 6 month check up. She had a CT scan done on Monday, and they found that her metopic suture is indeed closed. We are being referred to a specialist in Iowa City. I have so many questions. Is there anyone out there who can answer them? What age is the metopic suture SUPPOSED to close? Is surgery the only option? What age does the "soft spot" go away? Any info would be very much appreciated!
03-04-2010, 02:37 AM
He's got a GREAT head shape!!! Sometimes the ridge is just a ridge. It's the first suture to close in very early childhood. And some kids fuse the ridge nice and smooth, some have the raised "speed bump" as we lovingly refer to it here. Sometimes it's so raised and so wide that the forehead takes on what looks like a trig appearance, but really it's just an illusion. What is most telling in trig is the brow pinching. Think of your hand pinching in the brow with thumb and pointer finger. It's the pinching that starts to turn the forehead into a more pointed shape (or in some cases a more heel shape. small and rounded). It makes the forehead appear WAY to small for the rest of the head. My son had a very small anterior fontanel at birth, and it closed shortly after he was 6 months old, EARLY, for that area to close. It's an indicator that something isn't right. Not an official diagnosis of cranio, but something that is an indicator. The metopic ridge has been shown to close VERY early is some babies and it NOT be cranio. Press for answers that sit right with you, but from what I can tell (a non Dr. opinion) he's looking pretty good. Keep us posted...
03-04-2010, 11:37 AM
I agree with Larkin. You baby's head looks good from that pic.
If the suture closes anytime after birth it is very likely just a ridge. The metopic suture can close early on after birth and this, for whatever reason, can be considered completely normal. Sometimes you will get a ridge until the bones smooth out with time.
The triangular shape and temple pinching are what usually indicate it is more than just a ridge. I feel it is always good to see a specialist if you have been told the suture is closed, but just because it is closed does not mean it is cranio.
If there is trig. the only way to correct it is with surgery. A helmet will not help because it can not open a closed suture. Do not assume that surgery is needed if you have been told the suture is closed at 6 months. A lot of things can happen in those 6 months and all could be fine.
03-14-2010, 09:07 AM
what a great noggin!! i think that the head shape looks great..although seeing the cheaks int he picture will help alot!
03-14-2010, 10:32 PM
Hi and welcome to CK. I'm also a metopic mommy. Florence was born with hers already fused, and while she wasn't diagnosed until 3 months, looking back at pictures, you can tell it was fused even in utero.
Your sons head looks nice and rounded to me. I definitely think you should see a doctor to get your peace of mind and get on their "watchlist", but imo you probably won't need surgery. If you look around at pictures of the metopic babies on this site, you will see how definitive that triangulation can be.
Good luck and keep us posted.
03-29-2010, 07:24 PM
hi! my name is mary anne and mya daughter, mya, is 6 mo old. we took her to the dr today because we noticed her forehead was "raised". the doctor called it a metopic ridge suture? we had to go get an xray and are awaiting the results which we should have by the morning. i am just needing more information on this. i think if she does have it it is a mild case. also, they told me that if they sutures ARE fused (which we find out tomorrow) that she could possible need a helmet to adjust the skull. anyhow...i will post when we find out more..here are some pictures of her http://i44.tinypic.com/2506kbr.jpg
03-29-2010, 07:24 PM
ps sorry the pic is HUGE
04-02-2010, 01:49 PM
I am new here too. Welcome. My son was born with moderate/severe metopic cranio & trigon which got worse as he aged. I toiled over the decision to have surgery when my doctor said "it's mainly cosmetic." As it turns out, it was not mainly cosmetic. Joseph had the surgery at 11 months and in the ensuing years suffered from speech delays and impairments, bedwetting, and severe impusivity/attention issues. I often wonder if I had made the decision to move forward with surgery earlier if it would have made a difference.
I don't mean to scare you. This was only my experience. But I do feel that seeing a NS is a good step. The more opinions, the better. It will enable you to be feel more confident and educated in your decision.
Best of luck to you! We all love our cranio kids to pieces, so either way, everything will work out :)
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