Sutural diastasis is an abnormal widening of the skull sutures. It may be physiological in a neonate during a growth spurt.
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Pathology
In non-traumatic scenarios accelerated growth of the sutural connective tissue without concurrent ossification is the underlying pathology.
Etiology
- traumatic
- raised intracranial pressure, e.g. intracerebral tumor, hydrocephalus or subdural collection
- infiltration of the sutures, e.g. leukemia, lymphoma or neuroblastoma
- metabolic, e.g. hypoparathyroidism, rickets or hypophosphatasia
Radiographic features
- widening of the sutures may be appreciated on plain radiograph and is better still appreciated on CT
- the following widths are considered to be diagnostic of sutural diastasis
- >10 mm at birth
- >3 mm at two years
- >2 mm at three years
- in cases of trauma, it may be associated with fractures
- in cases of mass lesions or elevated intracranial pressure, secondary evidence of the same would be demonstrated
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