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delayed closure of the fontanelles

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Normally fontanelles close in the first two years of life; it is hard to feel an open fontanelle after one year. Causes of delayed closure include:

  • hydrocephalus
  • trisomies - particularly Down's syndrome
  • congenital hypothyroidism
  • skeletal dysplasias, such as achondroplasia or Russell-Silver dwarfism
  • metabolic causes such as mucopolysaccharidoses

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