Abstract
Background Traditional views of the human cranial vault are facing challenges as researchers find that the complex details of its development do not always match previous opinions that it is a relatively passive structure. In particular, that stability of the vault is dependant on an underlying brain; and sutural patency merely facilitates cranial expansion. The influence of mechanical forces on the development and maintenance of cranial sutures is well-established, but the details of how they regulate the balance between sutural patency and fusion remain unclear. Previous research shows that mechanical tensional forces can influence intracellular chemical signalling cascades and switch cell function; and that tensional forces within the dura mater affect cell populations within the suture and cause fusion. Understanding the developmental mechanisms is considered important to the prevention and treatment of premature sutural fusion – synostosis – which causes skull deformity in approximately 0.05% of live births. In addition, the physiological processes underlying deformational plagiocephaly and the maintenance of sutural patency beyond early childhood require further elucidation. Method Using a disarticulated plastic replica of an adult human skull, a model of the cranial vault as a tensegrity structure which could address some of these issues is presented. Conclusions The tensegrity model is a novel approach for understanding how the cranial vault could retain its stability without relying on an expansive force from an underlying brain, a position currently unresolved. Tensional forces in the dura mater have the effect of pushing the bones apart, whilst at the same time integrating them into a single functional unit. Sutural patency depends on the separation of cranial bones throughout normal development, and the model describes how tension in the dura mater achieves this, and influences sutural phenotype. Cells of the dura mater respond to brain expansion and influence bone growth, allowing the cranium to match the spatial requirements of the developing brain, whilst remaining one step ahead and retaining a certain amount of autonomy. The model is compatible with current understandings of normal and abnormal cranial physiology, and has a contribution to make to a hierarchical systems approach to whole body biomechanics.
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