Fontanelle Closure and Development

Abnormal Fontanelle Patterns

• The American Academy of Pediatrics notes that delayed fontanelle closure can be caused by conditions such as hypothyroidism, Down syndrome, and increased intracranial pressure in infants 1
• Delayed fontanelle closure, beyond 24 months, can also be associated with conditions like achondroplasia and rickets, with increased intracranial pressure being a potential cause 2

Imaging Considerations

• The anterior fontanelle serves as an acoustic window for brain ultrasonography in infants, allowing for non-invasive imaging, and its closure necessitates the use of CT and MRI for intracranial assessment 3
• The use of the anterior fontanelle as an acoustic window for brain ultrasonography is also supported by the American College of Radiology, with CT and MRI becoming primary imaging modalities after fontanelle closure 3, 4

Growth and Development Monitoring

• The American Academy of Pediatrics recommends monitoring head circumference in children receiving growth hormone therapy, as it can cause abnormal head growth, especially if fontanelles are open when therapy is initiated 1