{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T15:53:00Z","timestamp":1772553180090,"version":"3.50.1"},"reference-count":17,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Subjective evaluations typically guide craniosynostosis repair. This study provides normative values of anthropometric cranial indices that are clinically useful for the evaluation of multiple types of craniosynostosis and introduces 2 new indices that are useful in the evaluation and management of metopic and bicoronal synostosis. The authors hypothesize that normative values of the new indices as well as for established measures like the cephalic index can be drawn from the evaluation of CT scans of normal individuals.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>High-resolution 3D CT scans obtained in normal infants (age 0\u201324 months) were retrospectively reviewed. Calvarial measurements obtained from advanced imaging visualization software were used to compute cranial indices. Additionally, metopic sutures were evaluated for patency or closure.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>A total of 312 participants were included in the study. Each monthly age group (total 24) included 12\u201318 patients, yielding 324 head CT scans studied. The mean cephalic index decreased from 0.85 at age 0\u20133 months to 0.81 at 19\u201324 months, the mean frontoparietal index decreased from 0.68 to 0.65, the metopic index from 0.59 to 0.55, and the towering index remained comparatively uniform at 0.64 and 0.65. Trends were statistically significant for all measured indices. There were no significant differences found in mean cranial indices between sexes in any age group. Metopic suture closure frequency for ages 3, 6, and 9 months were 38.5%, 69.2%, and 100.0%, respectively.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Radiographically acquired normative values for anthropometric cranial indices during infancy can be used as standards for guiding preoperative decision making, surgical correction, and postoperative helmeting in various forms of craniosynostosis. Metopic and towering indices represent new cranial indices that are potentially useful for the clinical evaluation of metopic and bicoronal synostoses, respectively. The present study additionally shows that metopic suture closure appears ubiquitous after 9 months of age.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2016.5.peds14336","type":"journal-article","created":{"date-parts":[[2016,9,2]],"date-time":"2016-09-02T13:58:53Z","timestamp":1472824733000},"page":"667-673","source":"Crossref","is-referenced-by-count":35,"title":["Normative ranges of anthropometric cranial indices and metopic suture closure during infancy"],"prefix":"10.3171","volume":"18","author":[{"given":"Jonathan","family":"Pindrik","sequence":"first","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Molenda","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael","family":"Uribe-Cardenas","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amir H.","family":"Dorafshar","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward S.","family":"Ahn","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-peds14336","series-title":"Indian J Pediatr","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1007\/s12098-011-0377-1","article-title":"Craniofacial anthropometric analysis in Down syndrome","volume":"78","author":"Asha","year":"2011"},{"key":"b2-peds14336","series-title":"J Craniofac Surg","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1097\/SCS.0b013e3181cf6050","article-title":"A novel anthropometric chart for craniofacial surgery","volume":"21","author":"Christofides","year":"2010"},{"key":"b3-peds14336","series-title":"J Craniofac Surg","doi-asserted-by":"publisher","first-page":"1331","DOI":"10.1097\/SCS.0b013e3182997885","article-title":"Laypersons' ratings of appearance in children with and without single-suture craniosynostosis","volume":"24","author":"Collett","year":"2013"},{"key":"b4-peds14336","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"159","DOI":"10.3171\/jns.1989.70.2.0159","article-title":"Cranial vault growth in craniosynostosis","volume":"70","author":"Delashaw","year":"1989"},{"key":"b5-peds14336","series-title":"Ann Plast Surg","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1097\/01.sap.0000182656.59384.a2","article-title":"Anthropometric proportion indices in the craniofacial regions of 73 patients with forms of isolated coronal synostosis","volume":"55","author":"Farkas","year":"2005"},{"key":"b6-peds14336","series-title":"Cleft Palate Craniofac J","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1597\/1545-1569_1992_029_0303_agsoth_2.3.co_2","article-title":"Anthropometric growth study of the head","volume":"29","author":"Farkas","year":"1992"},{"key":"b7-peds14336","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"193","DOI":"10.3171\/2010.5.PEDS09313","article-title":"Surgical treatment of single-suture craniosynostosis: an argument for quantitative methods to evaluate cosmetic outcomes","volume":"6","author":"Hankinson","year":"2010"},{"key":"b8-peds14336","series-title":"J Craniofac Surg","doi-asserted-by":"publisher","first-page":"1167","DOI":"10.1097\/01.scs.0000230018.39272.67","article-title":"Aesthetic results of fronto-orbital correction in trigonocephaly","volume":"17","author":"Hilling","year":"2006"},{"key":"b9-peds14336","series-title":"Am J Phys Anthropol","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1002\/(SICI)1096-8644(199707)103:3<341::AID-AJPA4>3.0.CO;2-T","article-title":"Preoperative anthropometric dysmorphology in metopic synostosis","volume":"103","author":"Kolar","year":"1997"},{"key":"b10-peds14336","series-title":"J Craniofac Surg","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1097\/00001665-200107000-00003","article-title":"Active counterpositioning or orthotic device to treat positional plagiocephaly?","volume":"12","author":"Loveday","year":"2001"},{"issue":"6","key":"b11-peds14336","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E5","DOI":"10.3171\/2010.9.FOCUS10204","article-title":"The evolution of surgical management for craniosynostosis","volume":"29","author":"Mehta","year":"2010"},{"key":"b12-peds14336","series-title":"J Craniofac Surg","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1097\/00001665-200605000-00005","article-title":"Quantifying positional plagiocephaly: reliability and validity of anthropometric measurements","volume":"17","author":"Mortenson","year":"2006"},{"key":"b13-peds14336","series-title":"Cleft Palate Craniofac J","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1597\/09-026","article-title":"Accuracy of photographic assessment compared with standard anthropometric measurements in nonsynostotic cranial deformities","volume":"47","author":"Schaaf","year":"2010"},{"key":"b14-peds14336","series-title":"J Craniofac Surg","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1097\/00001665-200111000-00005","article-title":"The timing of physiologic closure of the metopic suture: a review of 159 patients using reconstructed 3D CT scans of the craniofacial region","volume":"12","author":"Vu","year":"2001"},{"key":"b15-peds14336","series-title":"Plast Reconstr Surg","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1097\/00006534-198708000-00006","article-title":"Craniosynostosis: an analysis of the timing, treatment, and complications in 164 consecutive patients","volume":"80","author":"Whitaker","year":"1987"},{"key":"b16-peds14336","series-title":"J Pediatr","doi-asserted-by":"publisher","first-page":"1120","DOI":"10.1016\/j.jpeds.2012.05.023","article-title":"Clinical classification of infant nonsynostotic cranial deformity","volume":"161","author":"Wilbrand","year":"2012"},{"key":"b17-peds14336","series-title":"J Craniomaxillofac Surg","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1016\/j.jcms.2010.03.010","article-title":"Value and reliability of anthropometric measurements of cranial deformity in early childhood","volume":"39","author":"Wilbrand","year":"2011"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/18\/6\/article-p667.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/18\/6\/article-p667.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/18\/6\/article-p667.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T13:11:30Z","timestamp":1681564290000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/18\/6\/article-p667.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,12]]},"references-count":17,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/2016.5.peds14336","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,12]]}}}