A Critique of Current Views on Acrocephaly and Related Conditions

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Abstract
Certain conditions associated with mental deficiency derive their name from some characteristic skeletal deformity. One of these is abnormal highheadedness or acrocephaly, a term often used interchangeably with oxycephaly, tower skull or turricephaly. To be sure, certain criteria have been recommended by some workers for confining each of the above terms to different sub-varieties of highheadedness and many alternative names have also been proposed (Günther 1941), but none of these have taken root. A distinction is made by many writers between acrocephaly and hypsocephaly or ordinary highheadedness: it is stated that the essential feature of acrocephaly is not highheadedness in itself but exaggerated upward pointing or angling of the head at some distance along its superior curvature so that, in theory, an acrocephalic head need not necessarily be hypsocephalic. However, it is doubtful if this distinction can always be sustained since many otherwise quite normal individuals have abnormal angling of the skull, while some recorded cases of acrocephaly presented a smooth and rounded profile of their upper cranial curvature in photographs and lateral skull X-rays.
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