M. Michael Cohen

Editorial: Perspectives on craniosynostosis

Dr. Oostra, Dr. van der Wolk, and Dr. Hennekam are to be congratulated on their analysis of skulls with craniosynostosis and suture-related conditions from the extraordinary collection at the Museum Vrolik in Amsterdam. The authors are equally skilled in using knowledge from modern sutural biology to bear on their description of skulls. Their interpretations bring a new perspective to a nineteenth century osteological collection. Their work is also courageous because some techniques in sutural biology cannot be applied to the study of skulls. For example, Albright and Byrd [1981] removed sutures en bloc during craniectomies and studied them by serial histologic sectioning. They found that even a microfocus of sutural fusion, which could not be visualized radiographically, caused complete growth arrest of the suture. Some years ago, my friend and colleague, Raoul Hennekam, shepherded me through theMuseum Vrolik. We spent the day examining skulls, includingmany of those described byOostra and his colleagues. I took several rolls of film that day. One of my prized photographs shows three holoprosencephalic skulls lined up in a row. Three early drawings of cloverleaf skulls [Loschge, 1800; Vrolik, 1849; Fridolin, 1885] are illustrated in Figures 1, 2 and 3, and two skulls from an American Indian archaeological site [Bennett, 1967] are shown in Figures 4 and 5. Vrolik, in 1849, published a case of type II thanatophoric dysplasia with cloverleaf skull (Fig. 1). Loschge, in 1800, showed a child with cloverleaf skull and a protruding left eye (Fig. 2). Fridolin, in 1885, published a drawing of a cloverleaf skull in Apert syndrome (Fig. 3). A scaphocephalic skull resulting from sagittal synostosis is illustrated in Figure 4. A mildly plagiocephalic skull resulting from relatively late developing unilateral coronal synostosis is shown in Figure 5. In this editorial, my role will be to reinforce the work of Oostra and his coworkers by elaborating and expanding on modern concepts of craniosynostosis. I shall conclude with a critique of some problems of historical precedence and a few alternative interpretations.

The Number of “Magic” Squares, Cubes, and Hypercubes

(2003). The Number of “Magic” Squares, Cubes, and Hypercubes. The American Mathematical Monthly: Vol. 110, No. 8, pp. 707-717.