Development of The Skull

Development of The Skull

The skull bones develop from loosely organized embryonic C.T. that surrounds the brain (Mesenchyme) 2 bone formation mechanisms: 1. Intramembranous Ossification: mesenchyme bone (flat bones) 2. Endochondral Ossification mesenchyme cartilage bone (long bones, cranial base) The development of the skull starts during fetal period (Prenatal), however it continues after birth (Postnatal) until adulthood (16-18y)

Intramembranous Ossification
Mesenchyme condenses & become highly vascularized Mesenchymal cells osteoblasts Osteoblasts start to deposit bone matrix trabeculae Osteoblasts trapped in the matrix they secret osteocytes As growth continue, trabeculae become interconnected to form Woven bone

Endochondral Ossification
Mesenchyme turns into cartilaginous model Centers of ossification appear within the cartilage & start to spread out Within these ossification areas: chondrocytes enlarge matrix become calcified cells die Perichondrium becomes periosteum

Formation & Prenatal Development of The Skull

Prenatal skull consists of:

- Neurocranium (brain case) Membranous part: formed by ?, Cranial vault Cartilaginous part: formed by ?, Cranial base

- Viscerocranium (facial sk.) Memebranous: Jaw bones & Zygoma Cartilaginous: ear ossicles, mandibular condyle

Membranous Neurocranium
develops by intramembranous ossification to form C.V.

Includes cranial vault bones (Calvaria):

- Frontal

- Parietal
- Sq. of Temporal

- Sq. of Occipital

Cartilaginous Neurocranium
Formed by fusion of several cartilages that develops later into the cranial base by endochondral ossification Includes cranial base bones: - Basilar occipital bone - Petrous temporal bone - Sphenoid bone - Ethmoid bone

Prenatal Cranial Base Cartilages

Several cartilages formed around the age of ?

& fuse together to form the cartilaginous cranial base (Chondrocranium) at the age around ?
Later on: chondrocranium cartilages ossified to form bony cranial base

Chondrocranium Cartilages
Parachordal (basal) cartilage basilar occipital

Hypophysial cartilage forms around hypophysis (?) body of ?

Trabeculae Carnii body of ? Ala Orbitalis lesser wing of sphenoid Otic Capsule petrous & mastoid part of temporal bone

Membranous Viscerocranium
Formed by intramembranous ossification

Includes:
Maxillary bones

Zygomatic bones
Nasal bone

Mandible (Except?)

Cartilaginous Viscerocranium
Formed by endochondral ossification

Includes:
Middle ear ossicles

Styloid process of temporal

Postnatal Period

Newborn Skull
Characteristics Round & its bonse are thin Large in proportion to the rest of the body Large cranium relative to face Small size jaws Calvaria bones are separated by C.T. membranous areas (Fonatanelles) Absence of air sinuses

Postnatal Growth of The cranium

Contains 6 fontanelle areas: permit the cranium to enlarge in order to accommodate the growing brain The in calvaria size is greatest during first ?? of life

most head growth is accomplished by expansion along suture lines & fontanelles. Thereafter, the skull grows by internal resorption and external replacement.
Skull continues to in capacity until adulthood (16-18y) In facial height coincides with the growth of alveolar processes & eruption of deciduous teeth

Cranial Fontanelles
6 unossified membranous areas

Anterior fontanelle: 2 frontal & 2 parietal

Posterior fontanelle: 2 parietal & occipital 2 Anterolateral (Sphenoid): F, P, T, & S

2 Posterolateral (Mastoid): P, T, & Occip.

Clinical: Developmental Abnormalities of The Skull

Acrania
Failure of the cranial vault to develop (Absence of Calvaria) Associated with Anencephaly (absence of the brain) ~1/1000 birth Incompatible with life

Microcephaly
Small size calvaria with normal size face Infant has a small underdeveloped brain (Microencephaly) mental retardation Causes: Genetic Environmental: viral infection in utero (?) Ionizing radiation Alcohol abuse

Craniosynostosis
Several kinds of skull deformities result from premature closure of one of the skull sutures Males than females Types: (depend on which suture closes) Scaphcephaly: (~50%) premature closure of sagittal suture Oxycephaly (Turricephaly): premature closure of ? Suture Plagiocephaly: premature closure of coronal or lambdoid suture on one side

Scaphocephaly
Premature closure of sagittal suture long, narrow, wedge-shaped skull ~ 50% of cases

Oxycephaly (Turricephaly)
Premature closure of coronal suture High, tower-like skull ~ 30% of craniosynostosis

Plagiocephaly
Premature closure of coronal or lambdoid suture on one side Twisted, asymmetrical skull - Genetic Factors Enviromental Factor: sleeping position

Positional Plagiocephaly
A positional deformity that develops during infant sleeping in the same position most of the time It is primarily a cosmetic issue However, 10-15% intracranial Pr. The sooner the problem is addressed the better the outcome Rx.: alternate sleeping position 5-6 months orthotic management

Cloverleaf Skull
Premature closure of all three sutures together (S, P, & L) Cranial vault growth ceased However, the cranial base continue to grow in size Most common characteristic of Thanatophoric Dwarfism type II Due to mutation in FGFR3