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<meta name="keywords" content="C1832451, cranial hyperostosis, enlargement of skull bones, excessive growth of skull bones, finding, hyperostosis of cranial bones, hyperostosis of cranial vault, hypertrophy of cranial bones, increased ossification of cranial bones, overgrowth of skull bones, thick skull bones, autosomal dominant, autosomal recessive, birth defects, chromosomal disease, chromosome, clinical features, clinical findings, clinical genetics, clinical recommendations, clinvar, congenital chromosomal disease, consumer genetic resources, cytogenetic location, disease characteristics, disease definitions, disease descriptions, disease ontology, disease synonyms, disease vocabulary, dysmorphology, entrez, familial disease, gene, gene-disease relationship, genereviews, genetic disease, genetic disorder, genetic terminology, genetic testing registry, genetics home reference, genomic disease, gtr, hereditary disease, heritable disease, hpo, human phenotype ontology, inherited disease, management guidelines, maternal inheritance, medgen, medical genetics, medical subject headings, mesh, mitochondrial inheritance, mode of inheritance, national center for biotechnology information, national institutes of health, national library of medicine, ncbi, nih, nlm, omim, ordo, orphanet, paternal inheritance, phenome, position statements, professional practice guidelines, rare disease, reference sequence, refseq, snomed ct, syndrome, undiagnosed diseases, x-linked recessive" /><meta name="description" content="Excessive growth of the bones of cranium, i.e., of the skull." /><meta name="robots" content="index,nofollow,noarchive" />
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<!--
UID=318629
ConceptID=C1832451
-->
<!--imgCountBooks = 0--><h1 class="medgenTitle"><div class="MedGenTitleText">Cranial hyperostosis</div></h1><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>318629</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C1832451</a></dd><dt><span class="dotprefix"></span></dt><dd>Finding</dd></dl></div></div><table class="medgenTable"><tbody><tr><td>Synonym:</td>
<td>Hyperostosis of cranial vault</td></tr>
<tr><td colspan="2" class="small"> </td></tr><tr><td>HPO:</td>
<td><a target="_blank" title="Human Phenotype Ontology" href="https://hpo.jax.org/app/browse/term/HP:0004437">HP:0004437</a></td></tr>
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<div class="portlet_head mgSectionHead ui-widget-header"><h1 class="nl" id="Definition">Definition</h1><a sid="100" href="#" class="portlet_shutter" title="Show/hide content"></a></div>
<div class="portlet_content ln">Excessive growth of the bones of cranium, i.e., of the skull. [from <a title="Human Phenotype Ontology" href="http://www.human-phenotype-ontology.org" class="defSource" target="_blank">HPO</a>]</div>
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<div class="portlet_head mgSectionHead ui-widget-header"><h1 class="nl" id="Term_Hierarchy">Term Hierarchy</h1><a sid="118" href="#" class="portlet_shutter" title="Show/hide content"></a></div>
<div class="portlet_content ln HierarchyGTR"><div class="jig-ncbitabs"><ul><li><a href="#tabGTR">GTR</a></li><li><a href="#tabMGEN">MeSH</a></li></ul><div id="tabGTR"><div class="search_result"><div class="rprts"><div class="chiclet_legend"><span class="chiclet_list" style="position:static;"><span title="Clinical test" class="chiclet Ccolor round">C</span><span>Clinical test,  </span><span title="Research test" class="chiclet Rcolor round">R</span><span>Research test,  </span><span title="OMIM" class="chiclet Ocolor ">O</span><span>OMIM,  </span><span title="GeneReview" class="chiclet Gcolor">G</span><span><em>GeneReviews</em>,  </span><span title="ClinVar" class="chiclet Vcolor">V</span><span>ClinVar  </span></span></div><div id="hierarchy" class="margin_t1"><div class="ds_tree"><ul><li class="matched_ds"><span class="chiclet_list"><span class="chiclet unavailable round" title="Clinical test">C</span><span class="chiclet unavailable round" title="Research Tests">R</span><span class="chiclet unavailable" title="OMIM">O</span><span class="chiclet unavailable" title="GeneReviews">G</span><span class="chiclet unavailable" title="ClinVar">V</span></span><span class="TLline">Cranial hyperostosis</span></li></ul></div></div></div></div></div><div id="tabMGEN"><div class="ds_tree"><ul><li><span class="TLline"><a href="/medgen/867443" ref="tree=MeSH" title="MedGen record for Phenotypic abnormality">Phenotypic abnormality</a></span><ul><li><span class="TLline"><a href="/medgen/1763488" ref="tree=MeSH" title="MedGen record for Abnormality of the musculoskeletal system">Abnormality of the musculoskeletal system</a></span><ul><li><span class="TLline"><a href="/medgen/867418" ref="tree=MeSH" title="MedGen record for Abnormality of the skeletal system">Abnormality of the skeletal system</a></span><ul><li><span class="TLline"><a href="/medgen/868760" ref="tree=MeSH" title="MedGen record for Abnormal skeletal morphology">Abnormal skeletal morphology</a></span><ul><li><span class="TLline"><a href="/medgen/9366" ref="tree=MeSH" title="MedGen record for Hyperostosis">Hyperostosis</a></span><ul><li><span class="matched_ds">Cranial hyperostosis</span><ul><li><span class="TLline"><a href="/medgen/350147" ref="tree=MeSH" title="MedGen record for Calvarial hyperostosis">Calvarial hyperostosis</a></span></li><li><span class="TLline"><a href="/medgen/327093" ref="tree=MeSH" title="MedGen record for Hyperostosis cranialis interna">Hyperostosis cranialis interna</a></span></li><li><span class="TLline"><a href="/medgen/9367" ref="tree=MeSH" title="MedGen record for Hyperostosis interna frontalis">Hyperostosis interna frontalis</a></span></li></ul></li></ul></li></ul></li></ul></li></ul></li></ul></li></ul></div></div></div></div>
</div>
<div class="portlet mgSection" id="ID_112">
<div class="portlet_head mgSectionHead ui-widget-header"><h1 class="nl" id="Conditions_with_this_feature">Conditions with this feature</h1><a sid="112" href="#" class="portlet_shutter" title="Show/hide content"></a></div>
<div class="portlet_content ln clinfeat">
<div class="divPopper rprt" id="rdis_39698"><div><strong>Hurler syndrome</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>39698</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C0086795</a></dd><dt><span class="dotprefix"></span></dt><dd>Disease or Syndrome</dd></dl></div></div></div>
<div class="spaceAbove">Mucopolysaccharidosis type I (MPS I) is a progressive multisystem disorder with features ranging over a continuum of severity. While affected individuals have traditionally been classified as having one of three MPS I syndromes (Hurler syndrome, Hurler-Scheie syndrome, or Scheie syndrome), no easily measurable biochemical differences have been identified and the clinical findings overlap. Affected individuals are best described as having either a phenotype consistent with either severe (Hurler syndrome) or attenuated MPS I, a distinction that influences therapeutic options. Severe MPS I: Infants appear normal at birth. Typical early manifestations are nonspecific (e.g., umbilical or inguinal hernia, frequent upper respiratory tract infections before age 1 year). Coarsening of the facial features may not become apparent until after age one year. Gibbus deformity of the lower spine is common and often noted within the first year. Progressive skeletal dysplasia (dysostosis multiplex) involving all bones is universal, as is progressive arthropathy involving most joints. By age three years, linear growth decreases. Intellectual disability is progressive and profound but may not be readily apparent in the first year of life. Progressive cardiorespiratory involvement, hearing loss, and corneal clouding are common. Without treatment, death (typically from cardiorespiratory failure) usually occurs within the first ten years of life. Attenuated MPS I: Clinical onset is usually between ages three and ten years. The severity and rate of disease progression range from serious life-threatening complications leading to death in the second to third decade, to a normal life span complicated by significant disability from progressive joint manifestations and cardiorespiratory disease. While some individuals have no neurologic involvement and psychomotor development may be normal in early childhood, learning disabilities and psychiatric manifestations can be present later in life. Hearing loss, cardiac valvular disease, respiratory involvement, and corneal clouding are common.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/39698">Condition Record</a></div></div>
<div class="divPopper rprt" id="rdis_91042"><div><strong>Osteopetrosis with renal tubular acidosis</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>91042</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C0345407</a></dd><dt><span class="dotprefix"></span></dt><dd>Disease or Syndrome</dd></dl></div></div></div>
<div class="spaceAbove">Osteopetrosis is a bone disease that makes bone tissue abnormally compact and dense and also prone to breakage (fracture). Researchers have described several major types of osteopetrosis, which are usually distinguished by their pattern of inheritance: autosomal dominant or autosomal recessive. The different types of the disorder can also be distinguished by the severity of their signs and symptoms.\n\nAutosomal dominant osteopetrosis (ADO), which is also called Albers-Schönberg disease, is typically the mildest type of the disorder. Some affected individuals have no symptoms. In affected people with no symptoms, the unusually dense bones may be discovered by accident when an x-ray is done for another reason. \n\nIn individuals with ADO who develop signs and symptoms, the major features of the condition include multiple bone fractures after minor injury, abnormal side-to-side curvature of the spine (scoliosis) or other spinal abnormalities, arthritis in the hips, and a bone infection called osteomyelitis. These problems usually become apparent in late childhood or adolescence.\n\nAutosomal recessive osteopetrosis (ARO) is a more severe form of the disorder that becomes apparent in early infancy. Affected individuals have a high risk of bone fracture resulting from seemingly minor bumps and falls. Their abnormally dense skull bones pinch nerves in the head and face (cranial nerves), often resulting in vision loss, hearing loss, and paralysis of facial muscles. Dense bones can also impair the function of bone marrow, preventing it from producing new blood cells and immune system cells. As a result, people with severe osteopetrosis are at risk of abnormal bleeding, a shortage of red blood cells (anemia), and recurrent infections. In the most severe cases, these bone marrow abnormalities can be life-threatening in infancy or early childhood.\n\nOther features of autosomal recessive osteopetrosis can include slow growth and short stature, dental abnormalities, and an enlarged liver and spleen (hepatosplenomegaly). Depending on the genetic changes involved, people with severe osteopetrosis can also have brain abnormalities, intellectual disability, or recurrent seizures (epilepsy).\n\nA few individuals have been diagnosed with intermediate autosomal osteopetrosis (IAO), a form of the disorder that can have either an autosomal dominant or an autosomal recessive pattern of inheritance. The signs and symptoms of this condition become noticeable in childhood and include an increased risk of bone fracture and anemia. People with this form of the disorder typically do not have life-threatening bone marrow abnormalities. However, some affected individuals have had abnormal calcium deposits (calcifications) in the brain, intellectual disability, and a form of kidney disease called renal tubular acidosis.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/91042">Condition Record</a></div></div>
<div class="divPopper rprt" id="rdis_98484"><div><strong>Hyperphosphatasemia tarda</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>98484</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C0432272</a></dd><dt><span class="dotprefix"></span></dt><dd>Disease or Syndrome</dd></dl></div></div></div>
<div class="spaceAbove">SOST-related sclerosing bone dysplasias include SOST-related sclerosteosis and SOST-related endosteal hyperostosis, van Buchem type (van Buchem disease), both disorders of progressive bone overgrowth due to increased bone formation. The major clinical features of SOST-related sclerosteosis are progressive skeletal overgrowth, most pronounced in the skull and mandible, and variable syndactyly, usually of the second (index) and third (middle) fingers. Affected individuals appear normal at birth except for syndactyly. Facial distortion due to frontal bossing and mandibular overgrowth is seen in nearly all individuals and becomes apparent in early childhood with progression into adulthood. Hyperostosis of the skull results in narrowing of the foramina, causing entrapment of the seventh cranial nerve (leading to facial palsy) with other, less common nerve entrapment syndromes including visual loss (2nd cranial nerve), neuralgia or anosmia (5th cranial nerve), and sensorineural hearing loss (8th cranial nerve). In SOST-related sclerosteosis, hyperostosis of the calvarium reduces intracranial volume, increasing the risk for potentially lethal elevation of intracranial pressure. Survival of individuals with SOST-related sclerosteosis into old age is unusual but not unprecedented. The manifestations of van Buchem disease are generally milder than SOST-related sclerosteosis. Stature is typically normal, cranial nerve entrapment of the seventh and eighth cranial nerves are common, and increased intracranial pressure is rare, seen only in severely affected individuals. Individuals with van Buchem disease do not have syndactyly or other digit deformities. Life span appears not to be altered.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/98484">Condition Record</a></div></div>
<div class="divPopper rprt" id="rdis_371331"><div><strong>Ectodermal dysplasia with natal teeth, Turnpenny type</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>371331</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C1832444</a></dd><dt><span class="dotprefix"></span></dt><dd>Disease or Syndrome</dd></dl></div></div></div>
<div class="spaceAbove">A rare disorder with manifestation of hypo or oligodontia and acanthosis nigricans. It has been described in four generations of one family. Onset generally occurs during adolescence. Some patients are born with multiple teeth. Hair anomalies (sparse body and scalp hair) also reported. Inheritance is autosomal dominant.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/371331">Condition Record</a></div></div>
<div class="divPopper rprt" id="rdis_342420"><div><strong>Autosomal recessive osteopetrosis 2</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>342420</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C1850126</a></dd><dt><span class="dotprefix"></span></dt><dd>Disease or Syndrome</dd></dl></div></div></div>
<div class="spaceAbove">Osteopetrosis is a bone disease that makes bone tissue abnormally compact and dense and also prone to breakage (fracture). Researchers have described several major types of osteopetrosis, which are usually distinguished by their pattern of inheritance: autosomal dominant or autosomal recessive. The different types of the disorder can also be distinguished by the severity of their signs and symptoms.\n\nAutosomal dominant osteopetrosis (ADO), which is also called Albers-Schönberg disease, is typically the mildest type of the disorder. Some affected individuals have no symptoms. In affected people with no symptoms, the unusually dense bones may be discovered by accident when an x-ray is done for another reason. \n\nIn individuals with ADO who develop signs and symptoms, the major features of the condition include multiple bone fractures after minor injury, abnormal side-to-side curvature of the spine (scoliosis) or other spinal abnormalities, arthritis in the hips, and a bone infection called osteomyelitis. These problems usually become apparent in late childhood or adolescence.\n\nAutosomal recessive osteopetrosis (ARO) is a more severe form of the disorder that becomes apparent in early infancy. Affected individuals have a high risk of bone fracture resulting from seemingly minor bumps and falls. Their abnormally dense skull bones pinch nerves in the head and face (cranial nerves), often resulting in vision loss, hearing loss, and paralysis of facial muscles. Dense bones can also impair the function of bone marrow, preventing it from producing new blood cells and immune system cells. As a result, people with severe osteopetrosis are at risk of abnormal bleeding, a shortage of red blood cells (anemia), and recurrent infections. In the most severe cases, these bone marrow abnormalities can be life-threatening in infancy or early childhood.\n\nOther features of autosomal recessive osteopetrosis can include slow growth and short stature, dental abnormalities, and an enlarged liver and spleen (hepatosplenomegaly). Depending on the genetic changes involved, people with severe osteopetrosis can also have brain abnormalities, intellectual disability, or recurrent seizures (epilepsy).\n\nA few individuals have been diagnosed with intermediate autosomal osteopetrosis (IAO), a form of the disorder that can have either an autosomal dominant or an autosomal recessive pattern of inheritance. The signs and symptoms of this condition become noticeable in childhood and include an increased risk of bone fracture and anemia. People with this form of the disorder typically do not have life-threatening bone marrow abnormalities. However, some affected individuals have had abnormal calcium deposits (calcifications) in the brain, intellectual disability, and a form of kidney disease called renal tubular acidosis.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/342420">Condition Record</a></div></div>
<div class="divPopper rprt" id="rdis_338945"><div><strong>Craniometaphyseal dysplasia, autosomal dominant</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>338945</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information."><span class="highlight" style="background-color:">C1852502</span></a></dd><dt><span class="dotprefix"></span></dt><dd>Disease or Syndrome</dd></dl></div></div></div>
<div class="spaceAbove">Autosomal dominant craniometaphyseal dysplasia (designated AD-CMD in this review) is characterized by progressive diffuse hyperostosis of cranial bones evident clinically as wide nasal bridge, paranasal bossing, widely spaced eyes with an increase in bizygomatic width, and prominent mandible. Development of dentition may be delayed and teeth may fail to erupt as a result of hyperostosis and sclerosis of alveolar bone. Progressive thickening of craniofacial bones continues throughout life, often resulting in narrowing of the cranial foramina, including the foramen magnum. If untreated, compression of cranial nerves can lead to disabling conditions such as facial palsy, blindness, or deafness (conductive and/or sensorineural hearing loss). In individuals with typical uncomplicated AD-CMD life expectancy is normal; in those with severe AD-CMD life expectancy can be reduced as a result of compression of the foramen magnum.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/338945">Condition Record</a></div></div>
<div class="divPopper rprt" id="rdis_409627"><div><strong>Autosomal recessive osteopetrosis 5</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>409627</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C1968603</a></dd><dt><span class="dotprefix"></span></dt><dd>Disease or Syndrome</dd></dl></div></div></div>
<div class="spaceAbove">Autosomal recessive osteopetrosis-5 (OPTB5) is a form of infantile malignant osteopetrosis, characterized by defective osteoclast function resulting in decreased bone resorption and generalized osteosclerosis. Defective resorption causes development of densely sclerotic fragile bones and progressive obliteration of the marrow spaces and cranial foramina. Marrow obliteration is associated with extramedullary hematopoiesis and hepatosplenomegaly, and results in anemia and thrombocytopenia, whereas nerve entrapment accounts for progressive blindness and hearing loss. Other major manifestations include failure to thrive, pathologic fractures, and increased infection rate. Most affected children succumb to severe bone marrow failure and overwhelming infection in the first few years of life (summary by Quarello et al., 2004).</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/409627">Condition Record</a></div></div>
<div class="divPopper rprt" id="rdis_442876"><div><strong>CLOVES syndrome</strong><div class="aux"><div class="resc"><dl class="rprtid"><dt>MedGen UID: </dt><dd>442876</dd><dt><span class="dotprefix"></span>Concept ID: </dt><dd><a href="/medgen/docs/help/#sources" target="_blank" title="Concept Unique Identifier from NLM's Unified Medical Language system (UMLS)&#10;Click for more information.">C2752042</a></dd><dt><span class="dotprefix"></span></dt><dd>Disease or Syndrome</dd></dl></div></div></div>
<div class="spaceAbove">PIK3CA-related overgrowth spectrum (PROS) encompasses a range of clinical findings in which the core features are congenital or early-childhood onset of segmental/focal overgrowth with or without cellular dysplasia. Prior to the identification of PIK3CA as the causative gene, PROS was separated into distinct clinical syndromes based on the tissues and/or organs involved (e.g., MCAP [megalencephaly-capillary malformation] syndrome and CLOVES [congenital lipomatous asymmetric overgrowth of the trunk, lymphatic, capillary, venous, and combined-type vascular malformations, epidermal nevi, skeletal and spinal anomalies] syndrome). The predominant areas of overgrowth include the brain, limbs (including fingers and toes), trunk (including abdomen and chest), and face, all usually in an asymmetric distribution. Generalized brain overgrowth may be accompanied by secondary overgrowth of specific brain structures resulting in ventriculomegaly, a markedly thick corpus callosum, and cerebellar tonsillar ectopia with crowding of the posterior fossa. Vascular malformations may include capillary, venous, and less frequently, arterial or mixed (capillary-lymphatic-venous or arteriovenous) malformations. Lymphatic malformations may be in various locations (internal and/or external) and can cause various clinical issues, including swelling, pain, and occasionally localized bleeding secondary to trauma. Lipomatous overgrowth may occur ipsilateral or contralateral to a vascular malformation, if present. The degree of intellectual disability appears to be mostly related to the presence and severity of seizures, cortical dysplasia (e.g., polymicrogyria), and hydrocephalus. Many children have feeding difficulties that are often multifactorial in nature. Endocrine issues affect a small number of individuals and most commonly include hypoglycemia (largely hypoinsulinemic hypoketotic hypoglycemia), hypothyroidism, and growth hormone deficiency.</div>
<div class="spaceAbove nowrap">See: <a href="/medgen/442876">Condition Record</a></div></div>
<div class="hangingIndent"><a title="click for more information" class="jig-ncbipopper" href="#rdis_342420" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Autosomal recessive osteopetrosis 2</a></div>
<div class="hangingIndent"><a title="click for more information" class="jig-ncbipopper" href="#rdis_409627" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Autosomal recessive osteopetrosis 5</a></div>
<div class="hangingIndent"><a title="click for more information" class="jig-ncbipopper" href="#rdis_442876" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">CLOVES syndrome</a></div>
<div class="hangingIndent"><a title="click for more information" class="jig-ncbipopper" href="#rdis_338945" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Craniometaphyseal dysplasia, autosomal dominant</a></div>
<div class="hangingIndent"><a title="click for more information" class="jig-ncbipopper" href="#rdis_371331" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Ectodermal dysplasia with natal teeth, Turnpenny type</a></div>
<div class="hangingIndent"><a title="click for more information" class="jig-ncbipopper" href="#rdis_39698" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Hurler syndrome</a></div>
<div class="hangingIndent"><a title="click for more information" class="jig-ncbipopper" href="#rdis_98484" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Hyperphosphatasemia tarda</a></div>
<div class="hangingIndent"><a title="click for more information" class="jig-ncbipopper" href="#rdis_91042" data-jigconfig="hasArrow: true, openEvent: 'click', closeEvent: 'mouseout', openAnimation: 'fadeIn', closeAnimation: 'fadeOut', triggerPosition: 'center right', destPosition: 'center left', arrowDirection: 'left'">Osteopetrosis with renal tubular acidosis</a></div></div>
</div>
<div class="portlet mgSection" id="ID_105">
<div class="portlet_head mgSectionHead ui-widget-header"><h1 class="nl" id="Professional_guidelines">Professional guidelines</h1><a sid="105" href="#" class="portlet_shutter" title="Show/hide content"></a></div>
<div class="portlet_content ln"><h3 class="subhead">PubMed<a class="help jig-ncbi-popper" data-jig="ncbipopper" href="#guidelinesHelpPM"><img class="pulldown" src="//static.pubmed.gov/portal/portal3rc.fcgi/4223267/img/4204968" /></a></h3>
<div class="nl"><a target="_blank" href="/pubmed/36907844">Worth Syndrome-Patient Report, Diagnostic Work-Up, and Surgical Management of a Rare Craniofacial Entity.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Shafarenko MS,
Klieb HB,
Antonyshyn OM</span><br />
<span class="medgenPMjournal">J Craniofac Surg</span>
2023 May 1;34(3):e330-e331.
Epub 2023 Mar 13
doi: 10.1097/SCS.0000000000009259.
<span class="bold">PMID: </span><a href="/pubmed/36907844" target="_blank">36907844</a></div>
<div class="nl"><a target="_blank" href="/pubmed/35205306">Clinical and Molecular Diagnosis of Osteocraniostenosis in Fetuses and Newborns: Prenatal Ultrasound, Clinical, Radiological and Pathological Features.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Rosato S,
Unger S,
Campos-Xavier B,
Caraffi SG,
Beltrami L,
Pollazzon M,
Ivanovski I,
Castori M,
Bonasoni MP,
Comitini G,
Nikkels PGJ,
Lindstrom K,
Umandap C,
Superti-Furga A,
Garavelli L</span><br />
<span class="medgenPMjournal">Genes (Basel)</span>
2022 Jan 28;13(2)
doi: 10.3390/genes13020261.
<span class="bold">PMID: </span><a href="/pubmed/35205306" target="_blank">35205306</a><a href="/pmc/articles/PMC8871755" target="_blank" class="PubMedFree">Free PMC Article</a></div>
<div class="nl"><a target="_blank" href="/pubmed/21560744">Combination syndrome symptomatology and treatment.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Tolstunov L</span><br />
<span class="medgenPMjournal">Compend Contin Educ Dent</span>
2011 Apr;32(3):62-6.
<span class="bold">PMID: </span><a href="/pubmed/21560744" target="_blank">21560744</a></div>
<div><a target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/?term=(cranial%20hyperostosis)%20AND%20(%22english%20and%20humans%22%5BFilter%5D)%20AND%20(%20(%22practice%20guideline%22%5BFilter%5D)%20OR%20(practice*%5Btitl%5D%20AND%20(guideline%5Btitl%5D%20OR%20parameter%5Btitl%5D%20OR%20resource%5Btitl%5D%20OR%20bulletin%5Btitl%5D%20OR%20best%5Btitl%5D))%20OR%20(genetic*%5Btitl%5D%20AND%20(evaluation%5Btitl%5D%20OR%20counseling%5Btitl%5D%20OR%20screening%5Btitl%5D%20OR%20test*%5Btitl%5D))%20OR%20(clinical%5Btitl%5D%20AND%20((expert%5Btitl%5D%20AND%20consensus%5Btitl%5D)%20OR%20utility%5Btitl%5D%20OR%20guideline*%5Btitl%5D))%20OR%20(management%5Btitl%5D%20AND%20(clinical%5Btitl%5D%20OR%20diagnos*%5Btitl%5D%20OR%20recommendation%5Btitl%5D%20OR%20pain%5Btitl%5D%20OR%20surveillance%5Btitl%5D%20OR%20emergency%5Btitl%5D%20OR%20guideline*%5Btitl%5D%20OR%20therap*))%20OR%20(treatment%5Btitl%5D%20AND%20((evaluation%5Btitl%5D%20AND%20diagnosis%5Btitl%5D)%20OR%20(assessment%5Btitl%5D%20AND%20prevention%5Btitl%5D)%20OR%20therap*))%20OR%20(Diagnos*%5Btitl%5D%20AND%20(prenatal%5Btitl%5D%20OR%20treatment%5Btitl%5D%20OR%20follow-up%5Btitl%5D%20OR%20statement%5Btitl%5D%20OR%20criteria%5Btitl%5D%20OR%20newborn%5Btitl%5D%20OR%20differential%5Btitl%5D%20OR%20neonatal%5Btitl%5D%20OR%20neonate%5Btitl%5D))%20OR%20(guideline*%5Btitl%5D%20AND%20(pharmacogenetic*%5Btitl%5D%20OR%20recommendation%5Btitl%5D%20OR%20therap*%5Btitl%5D%20OR%20evidence-based%5Btitl%5D%20OR%20consensus%5Btitl%5D%20OR%20(technical%5Btitl%5D%20AND%20standard*%5Btitl%5D)%20OR%20(molecular%5Btitl%5D%20AND%20testing%5Btitl%5D)))%20OR%20(risk%5Btitl%5D%20AND%20assessment%5Btitl%5D)%20OR%20(recommendation*%5Btitl%5D%20AND%20(statement%5Btitl%5D%20OR%20Evidence-based%5Btitl%5D%20OR%20Consensus%5Btitl%5D))%20OR%20(care%20AND%20((Patient%5Btitl%5D%20AND%20standard*%5Btitl%5D)%20OR%20primary%5Btitl%5D%20OR%20psychosocial%5Btitl%5D))%20OR%20(Health%5Btitl%5D%20AND%20supervision%5Btitl%5D)%20OR%20(statement%5Btitl%5D%20AND%20(policy%5Btitl%5D%20OR%20position%5Btitl%5D%20OR%20Consensus%5Btitl%5D))%20OR%20(pharmacogenetics%5Btitl%5D%20AND%20(Dosing%5Btitl%5D%20OR%20therap*%5Btitl%5D%20OR%20genotype*%5Btitl%5D%20OR%20drug*%5Btitl%5D))%20OR%20(Chemotherapy%5Btitl%5D%20AND%20decision*%5Btitl%5D)%20OR%20(screening%5Btitl%5D%20AND%20(newborn%5Btitl%5D%20OR%20neonat*%5Btitl%5D%20OR%20detection%5Btitl%5D%20OR%20diagnos*%5Btitl%5D))%20OR%20(criteria%5Btitl%5D%20OR%20genotype*%5Btitl%5D)%20)%20NOT%20(%22Case%20reports%22%5BPublication%20type%5D%20OR%20%22clinical%20study%22%5BPublication%20Type%5D%20OR%20%22randomized%20controlled%20trial%22%5BPublication%20Type%5D)" title="PubMed search">See all (13)</a></div></div>
</div>
<div class="display-none help-popup" id="guidelinesHelpPM">These guidelines are articles in PubMed that match specific search criteria developed by MedGen to capture the most relevant practice guidelines. This list may not be comprehensive and may include broader topics as well. See the <a href="/medgen/docs/faq/" title="Frequently asked questions" target="_blank">FAQ</a> for details.</div><div class="display-none help-popup" id="guidelinesHelpCurated">These guidelines are manually curated by the MedGen team
to supplement articles available in PubMed. See the <a href="/medgen/docs/faq/" title="Frequently asked questions" target="_blank">FAQ</a> for details.</div>
<div class="portlet mgSection" id="ID_103">
<div class="portlet_head mgSectionHead ui-widget-header"><h1 class="nl" id="Recent_clinical_studies">Recent clinical studies</h1><a sid="103" href="#" class="portlet_shutter" title="Show/hide content"></a></div>
<div class="portlet_content ln"><h3 class="subhead">Etiology</h3>
<div class="nl"><a target="_blank" href="/pubmed/33666531">Triad of hypovitaminosis A, hyperostosis, and optic neuropathy in males with autism spectrum disorders.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Godfrey D,
Stone RT,
Lee M,
Chitnis T,
Santoro JD</span><br />
<span class="medgenPMjournal">Nutr Neurosci</span>
2022 Aug;25(8):1697-1703.
Epub 2021 Mar 5
doi: 10.1080/1028415X.2021.1892252.
<span class="bold">PMID: </span><a href="/pubmed/33666531" target="_blank">33666531</a></div>
<div class="nl"><a target="_blank" href="/pubmed/28137547">Repeat Intracranial Expansion After Skull Regrowth in Hyperostotic Disease: Technical Note.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Wong T,
Herschman Y,
Patel NV,
Patel T,
Hanft S</span><br />
<span class="medgenPMjournal">World Neurosurg</span>
2017 Jun;102:555-560.
Epub 2017 Jan 27
doi: 10.1016/j.wneu.2017.01.061.
<span class="bold">PMID: </span><a href="/pubmed/28137547" target="_blank">28137547</a></div>
<div class="nl"><a target="_blank" href="/pubmed/25180662">Exome sequencing reveals a mutation in DMP1 in a family with familial sclerosing bone dysplasia.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Gannagé-Yared MH,
Makrythanasis P,
Chouery E,
Sobacchi C,
Mehawej C,
Santoni FA,
Guipponi M,
Antonarakis SE,
Hamamy H,
Mégarbané A</span><br />
<span class="medgenPMjournal">Bone</span>
2014 Nov;68:142-5.
Epub 2014 Aug 30
doi: 10.1016/j.bone.2014.08.014.
<span class="bold">PMID: </span><a href="/pubmed/25180662" target="_blank">25180662</a></div>
<div class="nl"><a target="_blank" href="/pubmed/20216456">Management of craniofacial hyperostosis in Proteus syndrome.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Sakamoto Y,
Nakajima H,
Kishi K,
Shimizu R,
Nakajima T</span><br />
<span class="medgenPMjournal">J Craniofac Surg</span>
2010 Mar;21(2):414-8.
doi: 10.1097/SCS.0b013e3181cfa7f0.
<span class="bold">PMID: </span><a href="/pubmed/20216456" target="_blank">20216456</a></div>
<div class="nl"><a target="_blank" href="/pubmed/17699709">Apnoea-hypopnoea and mandibular retrusion as uncommon findings associated with Proteus syndrome.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Nogueira RL,
Teixeira RC,
Lima MC,
Sant'ana E,
Santos CF</span><br />
<span class="medgenPMjournal">Dentomaxillofac Radiol</span>
2007 Sep;36(6):367-71.
doi: 10.1259/dmfr/42508276.
<span class="bold">PMID: </span><a href="/pubmed/17699709" target="_blank">17699709</a></div>
<div><a target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/?term=%22Cranial%20hyperostosis%22%20AND%20Etiology%2Fbroad%5Bfilter%5D%20%20AND%20%22english%20and%20humans%22%5Bfilter%5D%20NOT%20comment%5BPTYP%5D%20NOT%20letter%5BPTYP%5D" title="PubMed search">See all (6)</a></div><h3 class="subhead">Diagnosis</h3>
<div class="nl"><a target="_blank" href="/pubmed/27550858">Somatic AKT1 mutations cause meningiomas colocalizing with a characteristic pattern of cranial hyperostosis.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Keppler-Noreuil KM,
Baker EH,
Sapp JC,
Lindhurst MJ,
Biesecker LG</span><br />
<span class="medgenPMjournal">Am J Med Genet A</span>
2016 Oct;170(10):2605-10.
Epub 2016 Aug 23
doi: 10.1002/ajmg.a.37737.
<span class="bold">PMID: </span><a href="/pubmed/27550858" target="_blank">27550858</a><a href="/pmc/articles/PMC5580816" target="_blank" class="PubMedFree">Free PMC Article</a></div>
<div class="nl"><a target="_blank" href="/pubmed/3377009">Polyostotic fibrous dysplasia with cranial hyperostosis: new entity or most severe form of polyostotic fibrous dysplasia?</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Viljoen DL,
Versfeld GA,
Losken W,
Beighton P</span><br />
<span class="medgenPMjournal">Am J Med Genet</span>
1988 Mar;29(3):661-7.
doi: 10.1002/ajmg.1320290325.
<span class="bold">PMID: </span><a href="/pubmed/3377009" target="_blank">3377009</a></div>
<div class="nl"><a target="_blank" href="/pubmed/3772245">Cranial hyperostosis and hearing loss (a new syndrome?).</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Moesker WH,
Tange RA</span><br />
<span class="medgenPMjournal">J Laryngol Otol</span>
1986 Oct;100(10):1187-93.
doi: 10.1017/s0022215100100805.
<span class="bold">PMID: </span><a href="/pubmed/3772245" target="_blank">3772245</a></div>
<div class="nl"><a target="_blank" href="/pubmed/1135718">Radiology of the autosomal dominant form of craniometaphyseal dysplasia.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Spiro PC,
Hamersma H,
Beighton P</span><br />
<span class="medgenPMjournal">S Afr Med J</span>
1975 May 17;49(21):839-42.
<span class="bold">PMID: </span><a href="/pubmed/1135718" target="_blank">1135718</a></div>
<div class="nl"><a target="_blank" href="/pubmed/1129482">Decompression hyperostosis: cranial hyperostosis mimicking bilateral subdural hematoma on brain scintigraphy.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Hattner RS,
Putman C,
Shames DM</span><br />
<span class="medgenPMjournal">Radiology</span>
1975 Jun;115(3):673-4.
doi: 10.1148/15.3.673.
<span class="bold">PMID: </span><a href="/pubmed/1129482" target="_blank">1129482</a></div>
<div><a target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/?term=%22Cranial%20hyperostosis%22%20AND%20Diagnosis%2Fbroad%5Bfilter%5D%20%20AND%20%22english%20and%20humans%22%5Bfilter%5D%20NOT%20comment%5BPTYP%5D%20NOT%20letter%5BPTYP%5D" title="PubMed search">See all (10)</a></div><h3 class="subhead">Therapy</h3>
<div class="nl"><a target="_blank" href="/pubmed/33666531">Triad of hypovitaminosis A, hyperostosis, and optic neuropathy in males with autism spectrum disorders.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Godfrey D,
Stone RT,
Lee M,
Chitnis T,
Santoro JD</span><br />
<span class="medgenPMjournal">Nutr Neurosci</span>
2022 Aug;25(8):1697-1703.
Epub 2021 Mar 5
doi: 10.1080/1028415X.2021.1892252.
<span class="bold">PMID: </span><a href="/pubmed/33666531" target="_blank">33666531</a></div>
<div class="nl"><a target="_blank" href="/pubmed/23459379">Focal cranial hyperostosis from meningioma: a complication from previous radiation treatment for childhood T-cell acute lymphoblastic leukemia.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Songdej N</span><br />
<span class="medgenPMjournal">J Pediatr Hematol Oncol</span>
2014 Mar;36(2):148-9.
doi: 10.1097/MPH.0b013e3182830d56.
<span class="bold">PMID: </span><a href="/pubmed/23459379" target="_blank">23459379</a></div>
<div><a target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/?term=%22Cranial%20hyperostosis%22%20AND%20Therapy%2Fbroad%5Bfilter%5D%20%20AND%20%22english%20and%20humans%22%5Bfilter%5D%20NOT%20comment%5BPTYP%5D%20NOT%20letter%5BPTYP%5D" title="PubMed search">See all (2)</a></div><h3 class="subhead">Prognosis</h3>
<div class="nl"><a target="_blank" href="/pubmed/21465231">Brain and spine MRI features of Hunter disease: frequency, natural evolution and response to therapy.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Manara R,
Priante E,
Grimaldi M,
Santoro L,
Astarita L,
Barone R,
Concolino D,
Di Rocco M,
Donati MA,
Fecarotta S,
Ficcadenti A,
Fiumara A,
Furlan F,
Giovannini I,
Lilliu F,
Mardari R,
Polonara G,
Procopio E,
Rampazzo A,
Rossi A,
Sanna G,
Parini R,
Scarpa M</span><br />
<span class="medgenPMjournal">J Inherit Metab Dis</span>
2011 Jun;34(3):763-80.
Epub 2011 Apr 5
doi: 10.1007/s10545-011-9317-5.
<span class="bold">PMID: </span><a href="/pubmed/21465231" target="_blank">21465231</a></div>
<div class="nl"><a target="_blank" href="/pubmed/20216456">Management of craniofacial hyperostosis in Proteus syndrome.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Sakamoto Y,
Nakajima H,
Kishi K,
Shimizu R,
Nakajima T</span><br />
<span class="medgenPMjournal">J Craniofac Surg</span>
2010 Mar;21(2):414-8.
doi: 10.1097/SCS.0b013e3181cfa7f0.
<span class="bold">PMID: </span><a href="/pubmed/20216456" target="_blank">20216456</a></div>
<div class="nl"><a target="_blank" href="/pubmed/17699709">Apnoea-hypopnoea and mandibular retrusion as uncommon findings associated with Proteus syndrome.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Nogueira RL,
Teixeira RC,
Lima MC,
Sant'ana E,
Santos CF</span><br />
<span class="medgenPMjournal">Dentomaxillofac Radiol</span>
2007 Sep;36(6):367-71.
doi: 10.1259/dmfr/42508276.
<span class="bold">PMID: </span><a href="/pubmed/17699709" target="_blank">17699709</a></div>
<div class="nl"><a target="_blank" href="/pubmed/1135718">Radiology of the autosomal dominant form of craniometaphyseal dysplasia.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Spiro PC,
Hamersma H,
Beighton P</span><br />
<span class="medgenPMjournal">S Afr Med J</span>
1975 May 17;49(21):839-42.
<span class="bold">PMID: </span><a href="/pubmed/1135718" target="_blank">1135718</a></div>
<div><a target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/?term=%22Cranial%20hyperostosis%22%20AND%20Prognosis%2Fbroad%5Bfilter%5D%20%20AND%20%22english%20and%20humans%22%5Bfilter%5D%20NOT%20comment%5BPTYP%5D%20NOT%20letter%5BPTYP%5D" title="PubMed search">See all (4)</a></div><h3 class="subhead">Clinical prediction guides</h3>
<div class="nl"><a target="_blank" href="/pubmed/20216456">Management of craniofacial hyperostosis in Proteus syndrome.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Sakamoto Y,
Nakajima H,
Kishi K,
Shimizu R,
Nakajima T</span><br />
<span class="medgenPMjournal">J Craniofac Surg</span>
2010 Mar;21(2):414-8.
doi: 10.1097/SCS.0b013e3181cfa7f0.
<span class="bold">PMID: </span><a href="/pubmed/20216456" target="_blank">20216456</a></div>
<div class="nl"><a target="_blank" href="/pubmed/19926765">Scenes from the past: the Medici Project: radiographic survey.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Villari N,
Fornaciari G,
Lippi D,
Cerinic MM,
Ginestroni A,
Pellicanò G,
Mascalchi M</span><br />
<span class="medgenPMjournal">Radiographics</span>
2009 Nov;29(7):2101-14.
doi: 10.1148/rg.297085212.
<span class="bold">PMID: </span><a href="/pubmed/19926765" target="_blank">19926765</a></div>
<div class="nl"><a target="_blank" href="/pubmed/10745041">Localisation of the gene causing diaphyseal dysplasia Camurati-Engelmann to chromosome 19q13.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Janssens K,
Gershoni-Baruch R,
Van Hul E,
Brik R,
Guañabens N,
Migone N,
Verbruggen LA,
Ralston SH,
Bonduelle M,
Van Maldergem L,
Vanhoenacker F,
Van Hul W</span><br />
<span class="medgenPMjournal">J Med Genet</span>
2000 Apr;37(4):245-9.
doi: 10.1136/jmg.37.4.245.
<span class="bold">PMID: </span><a href="/pubmed/10745041" target="_blank">10745041</a><a href="/pmc/articles/PMC1734563" target="_blank" class="PubMedFree">Free PMC Article</a></div>
<div class="nl"><a target="_blank" href="/pubmed/10631145">Genetic mapping of the Camurati-Engelmann disease locus to chromosome 19q13.1-q13.3.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Ghadami M,
Makita Y,
Yoshida K,
Nishimura G,
Fukushima Y,
Wakui K,
Ikegawa S,
Yamada K,
Kondo S,
Niikawa N,
Tomita Ha</span><br />
<span class="medgenPMjournal">Am J Hum Genet</span>
2000 Jan;66(1):143-7.
doi: 10.1086/302728.
<span class="bold">PMID: </span><a href="/pubmed/10631145" target="_blank">10631145</a><a href="/pmc/articles/PMC1288319" target="_blank" class="PubMedFree">Free PMC Article</a></div>
<div class="nl"><a target="_blank" href="/pubmed/3585355">Computed tomographic findings of brain and skull in myotonic dystrophy.</a></div>
<div class="portlet_content ln"><span class="medgenPMauthor">Avrahami E,
Katz A,
Bornstein N,
Korczyn AD</span><br />
<span class="medgenPMjournal">J Neurol Neurosurg Psychiatry</span>
1987 Apr;50(4):435-8.
doi: 10.1136/jnnp.50.4.435.
<span class="bold">PMID: </span><a href="/pubmed/3585355" target="_blank">3585355</a><a href="/pmc/articles/PMC1031878" target="_blank" class="PubMedFree">Free PMC Article</a></div>
<div><a target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/?term=%22Cranial%20hyperostosis%22%20AND%20Clinical%20prediction%20guides%2Fbroad%5Bfilter%5D%20%20AND%20%22english%20and%20humans%22%5Bfilter%5D%20NOT%20comment%5BPTYP%5D%20NOT%20letter%5BPTYP%5D" title="PubMed search">See all (6)</a></div></div>
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