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Mupparapu M, Binder RE, Duarte F. Hereditary cranium bifidum persisting as enlarged parietal foramina (Catlin marks) on cephalometric radiographs. Am J Orthod Dentofacial Orthop 2006; 129:825-8. [PMID: 16769502 DOI: 10.1016/j.ajodo.2006.02.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2004] [Revised: 11/23/2004] [Accepted: 11/23/2004] [Indexed: 11/16/2022]
Abstract
Cranium bifidum occultum is a rare skull ossification disorder referred to as the Catlin mark characterized by ossification defects in the parietal bones. Evidence suggests that this condition has a strong genetic heterogenicity. It is believed that, as calvarial growth continues, ossification in parietal bones fills these defects, and they can remain as parietal foramina on either side of the sagittal suture. During the conversion phase of cranium bifidum to the persistent parietal foramen, there will be periods when the brain is unprotected because of the delay in the ossification of the parietal bones. This report describes cranium bifidum occultum diagnosed as an incidental finding in a 14-year-old boy who initially had large bilateral unossified parietal bones and many congenital abnormalities. The patient underwent various surgical procedures over 6 years for the correction of cleft lip and palate. With craniofacial corrections and orthodontic treatment, the patient now has stable dentition and a firm palate with most of the parietal bones ossified. Cranioplasty was not recommended by his family physician after consultation with a neurosurgeon. Orthodontists should be familiar with this genetic abnormality because it causes delay in parietal bone ossification, and they should be able to distinguish between anatomic parietal foramina and enlarged parietal foramina (persistent unossified areas of cranium bifidum occultum), especially when craniofacial abnormalities are noticed.
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Affiliation(s)
- Muralidhar Mupparapu
- Division of Oral and Maxillofacial Radiology, Department of Diagnostic Sciences, New Jersey Dental School, Newark, NJ 07101-1709, USA.
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Mendoza-Londono R, Lammer E, Watson R, Harper J, Hatamochi A, Hatamochi-Hayashi S, Napierala D, Hermanns P, Collins S, Roa BB, Hedge MR, Wakui K, Nguyen D, Stockton DW, Lee B. Characterization of a new syndrome that associates craniosynostosis, delayed fontanel closure, parietal foramina, imperforate anus, and skin eruption: CDAGS. Am J Hum Genet 2005; 77:161-8. [PMID: 15924278 PMCID: PMC1226190 DOI: 10.1086/431654] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2005] [Accepted: 05/04/2005] [Indexed: 11/03/2022] Open
Abstract
We describe the clinical characterization, molecular analyses, and genetic mapping of a distinct genetic condition characterized by craniosynostosis, delayed closure of the fontanel, cranial defects, clavicular hypoplasia, anal and genitourinary malformations, and skin eruption. We have identified seven patients with this phenotype in four families from different geographic regions and ethnic backgrounds. This is an autosomal recessive condition that brings together apparently opposing pathophysiologic and developmental processes, including accelerated suture closure and delayed ossification. Selected candidate genes--including RUNX2, CBFB, MSX2, ALX4, TWIST1, and RECQL4--were screened for mutations, by direct sequencing of their coding regions, and for microdeletions, by fluorescent in situ hybridization. No mutations or microdeletions were detected in any of the genes analyzed. A genomewide screen yielded the maximum estimated LOD score of +2.38 for markers D22S283 and D22S274 on chromosome 22q12-q13. We hypothesize that the gene defect in this condition causes novel context-dependent dysregulation of multiple signaling pathways, including RUNX2, during osteoblast differentiation and craniofacial morphogenesis.
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Affiliation(s)
- Roberto Mendoza-Londono
- Department of Human and Molecular Genetics, Baylor College of Medicine, Houston, TX 77030, USA.
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Perlyn CA, Schmelzer R, Govier D, Marsh JL. Congenital Scalp and Calvarial Deficiencies: Principles for Classification and Surgical Management. Plast Reconstr Surg 2005; 115:1129-41. [PMID: 15793456 DOI: 10.1097/01.prs.0000156217.33683.2b] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Congenital defects of the scalp and skull present a challenge for care providers because of a combination of their rarity and the magnitude of potential morbidity. Recent advancements in autogenous and alloplastic cranioplasty and scalp reconstruction techniques argue for a comprehensive consideration of this problem. This article (1) reviews the causes of congenital scalp and calvarial defects; (2) proposes a classification system based on defect type, similar to the tumor-node-metastasis classification, in that defect location, defect size, and extent of neuromeningeal involvement are the critical variables; and (3) presents algorithms for care based on the defect classification. A set of management principles on which treatment plans can be based for these unique problems is provided.
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Affiliation(s)
- Chad A Perlyn
- Division of Plastic Surgery and the Cleft Palate and Craniofacial Deformities Institute, St. Louis Children's Hospital & Washington University School of Medicine, and St. John's Medical Center, Kids Plastic Surgery, St. Louis, Mo 63141 , USA
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Spruijt L, Verdyck P, Van Hul W, Wuyts W, de Die-Smulders C. A novel mutation in theMSX2 gene in a family with foramina parietalia permagna (FPP). Am J Med Genet A 2005; 139:45-7. [PMID: 16222674 DOI: 10.1002/ajmg.a.30923] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Liesbeth Spruijt
- Department of Clinical Genetics, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
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Garcia-Miñaur S, Mavrogiannis LA, Rannan-Eliya SV, Hendry MA, Liston WA, Porteous MEM, Wilkie AOM. Parietal foramina with cleidocranial dysplasia is caused by mutation in MSX2. Eur J Hum Genet 2004; 11:892-5. [PMID: 14571277 DOI: 10.1038/sj.ejhg.5201062] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The combination of skull defects in the form of enlarged parietal foramina (PFM) and deficient ossification of the clavicles is known as parietal foramina with cleidocranial dysplasia (PFMCCD). It is considered to be distinct from classical cleidocranial dysplasia (CCD) and is listed as a separate OMIM entry (168550). So far, only two families have been reported and the molecular basis of the disorder is unknown. We present a third family with PFMCCD, comprising four affected individuals in three generations, and demonstrate that a heterozygous tetranucleotide duplication in the MSX2 homeobox gene (505_508dupATTG) segregates with the phenotype. PFMCCD is indeed aetiologically distinct from CCD, which is caused by mutations in the RUNX2 gene, but allelic with isolated PFM, in which MSX2 mutations were previously identified. Our observations highlight the role of MSX2 in clavicular development and the importance of radiological examination of the clavicles in subjects with PFM.
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Affiliation(s)
- Sixto Garcia-Miñaur
- South East Scotland Genetic Service, Western General Hospital, Edinburgh, UK
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Chen G, Zhang D, Feng G, Liu W, He L. A novel locus for parietal foramina maps to chromosome 4q21-q23. J Hum Genet 2003; 48:420-424. [PMID: 12905082 DOI: 10.1007/s10038-003-0050-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2003] [Accepted: 06/04/2003] [Indexed: 11/26/2022]
Abstract
Parietal foramina [PFM], inherited usually in an autosomal dominant mode, is an extremely rare developmental defect characterized by a symmetrical, oval hole in the parietal bone. It can be present as either an isolated or a syndromic feature. PFM types 1 and 2 (PFM1 and PFM2) have been found to be caused by mutations in the MSX2 and ALX4 genes, located to chromosomes 5 and 11, respectively. After exclusion of both the above loci in a large Chinese pedigree with autosomal dominant PFM, a genome-wide search revealed a linkage of the PFM to markers at the 4q21-q23 region. The maximum LOD score from two-point linkage analysis is 3.87 for marker D4S2961. Analysis of co-segregated haplotype localized the region to a 20-cM interval that flanks D4S392 and D4S2945. Therefore, we concluded that the PFM in the family is a new PFM locus. Although three genes, BMPR1B, PP1 and IBSP, are located to 4q21-q25 and their functions are related to bone morphogenesis, no mutations were identified by sequencing analysis of their exons.
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Affiliation(s)
- Gang Chen
- Shanghai Research Center of Life Sciences, Chinese Academy of Sciences, Shanghai, China
- Bio-X Life Science Research Center, Shanghai Jiao Tong University, Hao Ran Building, 1954 Hua Shan Road, PO Box 501, 200030, Shanghai, China
| | - Desan Zhang
- Epidemic Prevention Station of Gansu Province, Lanzhou, China
| | - Guoying Feng
- Shanghai Research Center of Life Sciences, Chinese Academy of Sciences, Shanghai, China
- Bio-X Life Science Research Center, Shanghai Jiao Tong University, Hao Ran Building, 1954 Hua Shan Road, PO Box 501, 200030, Shanghai, China
| | - Wanqing Liu
- Shanghai Research Center of Life Sciences, Chinese Academy of Sciences, Shanghai, China
- Bio-X Life Science Research Center, Shanghai Jiao Tong University, Hao Ran Building, 1954 Hua Shan Road, PO Box 501, 200030, Shanghai, China
| | - Lin He
- Shanghai Research Center of Life Sciences, Chinese Academy of Sciences, Shanghai, China.
- Bio-X Life Science Research Center, Shanghai Jiao Tong University, Hao Ran Building, 1954 Hua Shan Road, PO Box 501, 200030, Shanghai, China.
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Oliva Rodríguez-Pastor S, Camacho Alonso J, González Gómez J, Cano España J, Calvo Macías C. Agujeros parietales. An Pediatr (Barc) 2001. [DOI: 10.1016/s1695-4033(01)77709-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Ponzio GM, Cunningham ML. Clavicular hypoplasia, zygomatic arch hypoplasia, and micrognathia: a newly defined syndrome. AMERICAN JOURNAL OF MEDICAL GENETICS 2000; 92:200-5. [PMID: 10817655 DOI: 10.1002/(sici)1096-8628(20000529)92:3<200::aid-ajmg8>3.0.co;2-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We report on a 6-year-old boy with a previously undefined syndrome of clavicular hypoplasia, frontonasal malformation, zygomatic arch hypoplasia, micrognathia, and normal intelligence. His condition differs from similar syndromes on the basis of unique facial findings such as microcornea, stellate irises, and a midline maxillary cleft. We present his case, a review of the literature, and propose the acronym CHZAM, for clavicular hypoplasia, zygomatic arch, and micrognathia, to represent this syndrome.
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Affiliation(s)
- G M Ponzio
- University of Vermont College of Medicine, Burlington, USA
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Wilkie AO, Tang Z, Elanko N, Walsh S, Twigg SR, Hurst JA, Wall SA, Chrzanowska KH, Maxson RE. Functional haploinsufficiency of the human homeobox gene MSX2 causes defects in skull ossification. Nat Genet 2000; 24:387-90. [PMID: 10742103 DOI: 10.1038/74224] [Citation(s) in RCA: 197] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The genetic analysis of congenital skull malformations provides insight into normal mechanisms of calvarial osteogenesis. Enlarged parietal foramina (PFM) are oval defects of the parietal bones caused by deficient ossification around the parietal notch, which is normally obliterated during the fifth fetal month. PFM are usually asymptomatic, but may be associated with headache, scalp defects and structural or vascular malformations of the brain. Inheritance is frequently autosomal dominant, but no causative mutations have been identified in non-syndromic cases. We describe here heterozygous mutations of the homeobox gene MSX2 (located on 5q34-q35) in three unrelated families with PFM. One is a deletion of approximately 206 kb including the entire gene and the others are intragenic mutations of the DNA-binding homeodomain (RK159-160del and R172H) that predict disruption of critical intramolecular and DNA contacts. Mouse Msx2 protein with either of the homeodomain mutations exhibited more than 85% reduction in binding to an optimal Msx2 DNA-binding site. Our findings contrast with the only described MSX2 homeodomain mutation (P148H), associated with craniosynostosis, that binds with enhanced affinity to the same target. This demonstrates that MSX2 dosage is critical for human skull development and suggests that PFM and craniosynostosis result, respectively, from loss and gain of activity in an MSX2-mediated pathway of calvarial osteogenic differentiation.
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Affiliation(s)
- A O Wilkie
- Institute of Molecular Medicine, John Radcliffe Hospital, Headington, Oxford, UK.
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Rauch A, Opitz JM, Walker D. Syndromal foramina parietalia permagna: ?new? or FG syndrome? Comments on the paper by Chrzanowska et al. [1998]. ACTA ACUST UNITED AC 1998. [DOI: 10.1002/(sici)1096-8628(19980806)78:5<406::aid-ajmg2>3.0.co;2-j] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Abstract
We report on a boy with unique somatic and skeletal manifestations. The syndrome consists of branchial and auricular fistulae, abnormal face, and skeletal abnormalities including foramina parietalia permagna.
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Affiliation(s)
- K Chrzanowska
- Department of Genetics, Children's Memorial Health Institute, Warsaw, Poland
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Kutilek S, Baxova A, Bayer M, Leiska A, Kozlowski K. Foramina parietalia permagna: report of nine cases in one family. J Paediatr Child Health 1997; 33:168-70. [PMID: 9145364 DOI: 10.1111/j.1440-1754.1997.tb01023.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Nine members of a family with foramina parietalia permagna (FPP), inherited as an autosomal dominant trait are reported. Although usually benign, FPP may be associated with other malformations.
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Affiliation(s)
- S Kutilek
- Department of Paediatrics, First Medical Faculty, Charles University, Prague, Czech Republic
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