Fontanels
Under normal conditions the anterior fontanels should be completely closed at the age of one and a half years. If at the end of two years they have not completely closed it is abnormal and indicates cretinism, rickets or hydrocephalus. In case of hydrocephalus the sutures will be distinctly separated and the head will be enlarged. This condition may also obtain in rickets. When the fontanels are slow in closing the child should be very carefully analyzed and an effort made to find symptoms of other conditions which might be responsible for this abnormality. Most excellent results have been obtained from chiropractic adjustments in these cases. It is quite as objectionable for the fontanels to close too soon as it is for them to be too slow in closing and it may be much more serious. There are many cases on record in which the fontanels have been closed when the child was born. A case of this kind is ordinarily beyond the reach of Chiropractic. The closure of the fontanels during the first few weeks, or even at the middle of the first year, indicates microcephalus.
Normally the anterior fontanels should be completely closed about the eighteenth month, although it may be as late as the twenty-second month. In rachitic children it may be as late as the third year. In cretinism the fontanels may become very large and sometimes do not close until the eighth year. In hydrocephalus also the fontanels become very large, the head develops rapidly to an enormous size and this results in the spreading of the sutures. If these cases receive adjustments early enough in life, excellent results are obtained.
The posterior fontanel is very much smaller than the anterior and closes about the second month, normally.