Craniofacial Anomalies

A 4-month-old, otherwise healthy, full-term baby boy is brought to the pediatrician by his parents due to concern about the shape of his head. They note it has seemed long and narrow since birth, and this has become more pronounced. He is meeting all developmental milestones. On physical exam, the infant is alert. His head circumference is at the 75th percentile. The anterior fontanelle is open and soft. Palpation of the sagittal suture reveals a prominent, bony ridge. The head is markedly elongated anteroposteriorly with bitemporal narrowing. The remainder of the physical exam is normal.