Perinatology.  2023 Sep;34(3):145-149. 10.14734/PN.2023.34.3.145.

Unilateral Lambdoid Craniosynostosis in a Twin-to-Twin Transfusion Syndrome Donor: A Case Report

• Kim HY
• Yoon HS
• Kim SY

• KMID: 2546720
• DOI: http://doi.org/10.14734/PN.2023.34.3.145

Abstract

Unilateral lambdoid craniosynostosis is a rare form of craniosynostosis that involves premature fusion of the lambdoid suture on one side of the skull, resulting in flattening or asymmetry in the head. Distinguishing between posterior deformational plagiocephaly and lambdoid craniosynostosis remains challenging. Herein, we present a case of unilateral lambdoid craniosynostosis in a preterm infant. The patient was a male newborn: the second of monochorionic monoamniotic twins, born via emergency cesarean section due to fetal distress at 33 weeks and 4 days of gestation with low birth weight (1,540 g). The infant was diagnosed with twin-to-twin transfusion syndrome. Asymmetric changes in his head shape were observed during hospitalization, which we initially misdiagnosed as posterior deformational plagiocephaly. He was discharged 47 days after birth. However, his asym metric head shape worsened despite positional correction at home. We confirmed a diagnosis of right lambdoid craniosynostosis on 3-dimensional computed tomography at the outpatient clinic. The patient was referred to a tertiary hospital for surgical treatment and underwent endoscopic strip craniectomy. Paying close attention to identifying the signs and symptoms of unilateral lambdoid synostosis is crucial, which can be mistaken for posterior deformational plagiocephaly, because early diagnosis usually leads to better outcomes.

Keyword

Unilateral lambdoid craniosynostosis; Deformational plagiocephaly; Endoscopic strip craniectomy