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      Apert syndrome: A case report and review of the literature

      case-report
      Northern Clinics of Istanbul
      Kare Publishing
      Acrocephalosyndactyly, Apert syndrome, craniosynostosis

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          Abstract

          Apert syndrome is the rare acrocephalosyndactyly syndrome type 1, characterized by craniosynostosis, severe syndactyly of hands and feet, and dysmorphic facial features. It demonstrates autosomal dominant inheritance assigned to mutations in the fibroblast growth factor receptor gene. Presently described is case of a 19-year-old female patient diagnosed on physical examination with Apert syndrome based on acrocephaly, prominent forehead, ocular hypertelorism, proptosis, short and broad nose, pseudoprognathism, dental crowding and ectopia, maxillar hypoplasia, low hairline, webbed neck, pectus excavatum, and severe, bilateral syndactyly of hands and feet. The multiple phenotypic signs of Apert syndrome make multidisciplinary team, including dentist, neurosurgeon, plastic surgeon, physiatrist, ophthalmologist, perinatalogist and geneticist, essential for successful management.

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          Most cited references19

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          Cervical spine in the Apert syndrome.

          Radiographs of the cervical spine--in many cases longitudinal--were available for study in 68 cases of Apert syndrome. Autopsy material was available in one of these cases, and a 3-dimensional reconstruction from a CT scan was also studied in one case. Variable degrees of fusion were observed, involving the articular facets, the neural arch or transverse processes, or block fusion of the vertebral bodies. Ossification may not always be evident in some early radiographs. However, early radiographic signs of impending fusion may be irregularity in vertical orientation of the vertebral bodies and narrowing of the involved intervertebral spaces. Cervical fusions occurred in 68%, single fusions being found in 37%, and multiple fusions in 31%. C5-C6 fusion was most common, alone or in combination with other fusions. In contrast, cervical fusions are known to occur in 25% of Crouzon patients, most commonly involving C2-C3 only. It appears that when fusions are present, C5-C6 involvement in the Apert syndrome and C2-C3 involvement in the Crouzon syndrome separate the 2 conditions in most cases. Because cervical anomalies may complicate an already compromised airway in any form of acrocephalosyndactyly, it is imperative to initiate radiographic study of the cervical spine before undertaking anesthesia for surgery.
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            What syndrome is this? Apert syndrome.

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              Agenesis of the corpus callosum. Its associated anomalies and syndromes with special reference to the Apert syndrome.

              Agenesis of the corpus callosum may be associated with a variety of central nervous system (CNS) and non-CNS abnormalities and is known to occur in a number of specific syndromes. It can be a marker for several inherited metabolic disorders. Study of the Apert syndrome shows a recurrent pattern of CNS abnormalities, including defects of the corpus callosum and limbic structures, megalencephaly, misshapen brain, distortion ventriculomegaly, and gyral anomalies.
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                Author and article information

                Journal
                North Clin Istanb
                North Clin Istanb
                Northern Clinics of Istanbul
                Kare Publishing (Turkey )
                2536-4553
                2016
                14 May 2016
                : 3
                : 2
                : 135-139
                Affiliations
                [1]Department of Physical Medicine and Rehabilitation, Malatya State Hospital, Malatya, Turkey
                Author notes
                Correspondence: Dr. Tuba Tulay KOCA. Malatya Devlet Hastanesi, Fiziksel Tip ve Rehabilitasyon Klinigi, Malatya, Turkey. Tel: +90 416 - 228 28 00 e-mail: tuba_baglan@ 123456yahoo.com
                Article
                NCI-3-135
                10.14744/nci.2015.30602
                5206464
                28058401
                95a9ac35-9e9f-454f-9ec7-152d497f5b29
                Copyright: © Istanbul Northern Anatolian Association of Public Hospitals

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

                History
                : 13 October 2014
                : 24 March 2015
                Categories
                Case Report

                acrocephalosyndactyly,apert syndrome,craniosynostosis

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