{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:58:38Z","timestamp":1785286718160,"version":"3.55.0"},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,7,27]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>While frequently sporadic or genetic in etiology, craniosynostosis may occur secondarily due to underlying defects in bone mineralization. X-linked hypophosphatemia represents a common genetic cause of rickets, with sequelae including craniosynostosis and Chiari malformation type I (CM-I). In contrast, severe nutritional vitamin D deficiency\u2013induced rickets represents a rare cause of acquired or postnatal craniosynostosis and CM-I, with few cases reported in the published literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>The authors present the case of a 2-year-old boy with a history of severe vitamin D deficiency rickets who presented with multisuture craniosynostosis, acquired CM-I, and clinical symptoms and signs of increased intracranial pressure (ICP). His headaches and papilledema resolved with cranial vault expansion and bone-only posterior fossa decompression. By the time of his presentation with craniosynostosis, his vitamin D deficiency had been treated and resolved for about 1 year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Secondary or postnatal craniosynostosis often does not present with characteristic head shape changes but may be associated with elevated ICP and acquired CM-I, which may require surgical intervention. Late presentation or diagnosis of craniosynostosis in young children without typical features should prompt investigation for underlying disorders of bone metabolism.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE26200\">https:\/\/thejns.org\/doi\/10.3171\/CASE26200<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case26200","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:01:29Z","timestamp":1784678489000},"source":"Crossref","is-referenced-by-count":0,"title":["Multisuture craniosynostosis and acquired Chiari malformation secondary to vitamin D deficiency rickets: illustrative case"],"prefix":"10.3171","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7601-2740","authenticated-orcid":true,"given":"Andrew","family":"Linkugel","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, The Ohio State University College of Medicine, Columbus"},{"name":"Department of Plastic and Reconstructive Surgery, Nationwide Children\u2019s Hospital, Columbus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sacha C.","family":"Hauc","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, The Ohio State University College of Medicine, Columbus"},{"name":"Department of Plastic and Reconstructive Surgery, Nationwide Children\u2019s Hospital, Columbus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Pearson","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, The Ohio State University College of Medicine, Columbus"},{"name":"Department of Plastic and Reconstructive Surgery, Nationwide Children\u2019s Hospital, Columbus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Isaacs","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurosurgery, Nationwide Children\u2019s Hospital, Columbus"},{"name":"Department of Neurological Surgery, The Ohio State University College of Medicine, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Pindrik","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurosurgery, Nationwide Children\u2019s Hospital, Columbus"},{"name":"Department of Neurological Surgery, The Ohio State University College of Medicine, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"bib1","series-title":"J Pediatr","first-page":"396","article-title":"Craniosynostosis in the rachitic spectrum","volume":"64","author":"Reilly","year":"1964","unstructured":"Reilly BJLeeming JMFraser D.Craniosynostosis in the rachitic spectrum. 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Accessed June 5, 2025. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK431076\/"}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/4\/article-CASE26200.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/4\/article-CASE26200.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/4\/article-CASE26200.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:01:29Z","timestamp":1785283289000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/4\/article-CASE26200.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,27]]},"references-count":26,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/case26200","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,27]]}}}