Could Autism Spectrum Disorder Be Associated With Craniosynostosis?

INTRODUCTION: Craniosynostosis is a common pediatric condition that results in variable symptoms that range from asymptomatic cosmetic deformities to severe signs of intracranial hypertension. Little is understood about the relationship between craniosynostosis and neurocognitive and neurodevelopmental symptoms, including autism spectrum disorder (ASD). OBJECTIVE: The purpose of this study is to compare skull vault measurements between patients with ASD and craniosynostosis to determine if those with ASD have abnormal findings related to synostotic changes. METHODS: The authors performed a retrospective chart review of pediatric patients with CT scans of the head to compare several cranial vault measurements between children with craniosynostosis, those with ASD, and those with neither diagnosis. RESULTS: One hundred ninety-eight patients' CT scans were reviewed. Of those with sagittal craniosynostosis, significant differences were found in cephalic index, interparietal distance, intercoronal distance, and metopic severity index between controls and those with craniosynostosis, but not between controls and those with ASD, nor between those with craniosynostosis with or without ASD. Of those with metopic craniosynostosis, significant differences were found in metopic angle, interparietal distance, intercoronal distance, and metopic severity index between controls and those with craniosynostosis, but not between controls and those with ASD, nor between those with craniosynostosis with or without ASD. There were no significant measurement differences between those with craniosynostosis alone and those with craniosynostosis and ASD diagnosis in either type of craniosynostosis. CONCLUSIONS: No significant differences were found in cranial vault measurements of patients with ASD versus controls. Among patients with craniosynostosis, those who also had ASD did not have significantly different measurements, although the population was small. It is likely that the 2 diagnoses are incidental rather than causal.