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Do The Bones Of The Head Move?

By December 13, 2013June 21st, 2017Osteopathy, Physical Health

One of the components of the cranial concept for practitioners who practice cranial osteopathy or craniosacral therapy is that the bones of the head move along the sutures. The movement can be described as an expansion and compression that take place much how the rib cage moves during respiration. This idea has been highly controversial since it was first presented to the world over 60 years ago. To this day, there’s plenty of criticism that this concept is based on ‘pseudoscience.’ Many state that there is ‘no research’ supporting this idea. This statement is incorrect. There may not be sufficient evidence at this time supporting this idea. However, there is much more research showing that there the bones of the head can than there is research showing that the bones of the head do not move. Much of this research is on the Cranial Academy’s web site. I found a dissertation that discusses much of the research about the fusion of the sutures here. I am not arguing that this is sufficient research because I do feel more is needed. I want to discuss 5 reasons I have found that support the bones of the head do move.

Reason 1: Embryological

Side view of some of the bones of the skull

Side view of some of the bones of the skull

Why are there sutures in the head? If you look at a skull, there are sutures throughout the head making each bone identifiable. This may seem insignificant as evidence but during development, there are many bones that form in separate parts and do actually fuse to form one bone. For example, each pelvic bone develops as three separate parts (ischium, ilium, and pubis) that fuse into one bone with no sutures between them. There are many examples of this  during development. This even takes place in the head. The occiput forms by the fusion of 4 separate components. This fusion is complete and does not have any sutures between them. There are sutures between the occiput and the bones it articulates with. Clearly the human body would be capable of completely fusing the bones of the head if it intended it to do so. This fusion, however, does not take place or one would be unable to distinguish each separate bone of the skull once fusion had taken place. In addition, skulls can be disarticulated using the expansive properties of rice to separate the bones at the sutures. So if the body is capable of completely fusing the bones of the head, then why does it not do this?

Reason 2: Adaptation

Although there are not large amounts of movement in the head, there is some. Proper motion allows the head to be pliable to better absorb the shock of a trauma or changes in intracranial pressure. Part of the purpose of the skull is to encase and protect the brain. If one receives a blunt trauma to the head, the pliability allowed by movement of the bones of the head allows the bones to absorb much of the impact. This would allow the brain to be less affected by the trauma. If the skull fused, then the skull would be very hard like the outer casing of a helmet. A blunt trauma would break the skull easier like an egg shell and the force would be transferred to the brain more strongly. By not fusing, the head can then change and adapt better to changes in intracranial pressure. If a scenario occurs where the pressure in the head changes (such as flying or having a cold), then it would be helpful for the bones to be pliable and expand. That way, when the pressure in the head changes, the effect on the brain is minimized. Therefore, in terms of being able to handle traumas and changes in pressure, it would make sense of the head to be able to expand.

Reason 3: Braces

We have evidence that the bones of the head can move all around us. If the bones of the head fuse and could not move, there would be no reason for braces. Braces are based on the idea that the head is pliable and can be reshaped to align teeth.

Reason 4: Motion Testing

Part of the reason that there is so much controversy about whether or not the bones of the head move or not is because most practitioners put their hands on a person’s head and palpate the subtle movement taking place under their hands. Others who come along who cannot palpate this motion, then argue that this cannot be felt. Although I can feel this subtle motion, I feel restrictions in the sutures by getting a hold of the accessible bones of the head and move them through their range of motion. I compare how one side moves compared to the other. Usually one side moves better than the other. Under normal circumstances each bone has a small range of motion. There is significantly more motion than taking a plastic skull and trying to move it. By understanding where there are restrictions in the sutures, then I can work on freeing them up until both sides feel more symmetrical in their movement. I prove this idea to myself every day that I am at work.

Reason 5: Layout of Sutures

Finally the last piece of evidence I have found is in the sutures themselves. This goes back to anatomy. If one studies the specific motion described in the skull and the anatomy of the sutures, then one could see this idea as being plausible. There are different types of sutures and they articulate differently depending on the area. For example, the frontal bone overlaps the parietal bone medially, but as one moves out further along the coronal suture, there is a transition spot followed by the parietal bone overlapping the frontal bone. The sagittal suture for example, acts more like a hinge and the suture is put together in a way that allows for this type of a function. These are just a few examples although this takes place with the way all the bones articulate with each other. Simply put, the bones of the head act like a 3D puzzle that allows the head to go through its motion. In addition, dural membranes in the head come out externally through the sutures. Evidence for this is that epidural bleeds in the head do not cross suture lines because the dura travels externally at the sutures. The dural membranes inside the head act as a barrier preventing the bones of the head from fusing completely.

Can the bones of the head fuse? Absolutely. Anytime you take a joint and prevent it from moving for an extended period of time, then it will fuse. These are pathological cases. Why would the head be any different? Above are the reasons that I believe the bones of the head do move. Yes, more research is needed but it is time that people start to logically consider the idea. The human body develops the way it does for specific reasons. None of it is random. Perhaps we need to consider why there are sutures and the skull does not fuse into one solid bone.  Many healthcare providers and researchers stubbornly state the bones of the head fuse. They ask for research showing that the bones of the head move and will discredit anyone who states they do move because ’there is no research.’ I have never come across anyone who has ever cited a legitimate research study showing that the bones of the head without a shadow of a doubt actually do fuse. My experience as a provider of Osteopathic Manipulative Treatment (OMT) has shown me time and again that releasing dysfunctional structures in the head can release pain and tension throughout the rest of the body.

 

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Daniel Lopez, D.O.

Author Daniel Lopez, D.O.

Daniel Lopez, D.O. grew up with a lot of pain trying many things that did not help. Realizing that if he could not help himself, he would be unable to help others effectively, he dedicated himself to finding real answers. Since that time, Dr. Lopez has found a unique but powerful style where he has patients from around the country and the world that travel to see him for headaches, TMJ issues, eye issues, neck pain, back pain, and more. Daniel Lopez, D.O. is an osteopathic physician with Osteopathic Integrative Medicine. Prior to that he had a private practice in NYC for 6 years. He is the author of the Amazon best seller "Unwinding the Body and Decoding the Messages of Pain: An In-Depth Look into the World of Osteopathic Physicians and How They 'Magically' Use Their Hands for Healing." He lives in Aurora, CO with his wife and daughters.

More posts by Daniel Lopez, D.O.

Join the discussion 44 Comments

  • Laura says:

    I can feel a place in the top back of my skull that is painful at times when pushed. I can feel the seam between bones. Sometime it is not tender , other times more so, sometimes the shape of the skull there is different than before. I can also feel changes in the front of my skull.middle forehead at the hairline. And at the peak top of the head there is a tender spot.
    Any ideas as to whT is going on? Sorta like pressure points on the head.

    • Daniel Lopez, D.O. says:

      Hi Laura,

      It can mean there is an issue with how the seam is between the bones. It can become compressed or not work properly just like any other joint in the body. It can also be tender if the membranes coming out of the sutures are irritated. Unfortunately, there’s not a lot more I can tell you without being able to evaluate your whole skull. A good cranial osteopath should be able to help with those issues.

  • Laura says:

    Thank you Dr. Lopez,
    I appreciate your reply and may look into being seen here in MN.

  • Shawna says:

    Hi Dr. Lopez,
    Thank you for this article!
    Would quitting smoking cause my face to become less inflamed and cause the sutures to attempt to move around the head in response?
    I quit smoking, drinking, and eating inflammation causing foods and my head has been feeling like it’s changing shapes and sizes constantly. The only time it feels better is when I put extra pressure on facial muscles.
    I think the cause is the sutures, I no longer have excessive mucus in my face. without becoming obese is there a way to get them to reallign? Foods to assist?

    • Daniel Lopez, D.O. says:

      Hi Shawna,

      I’m not really sure, but potentially if the chemicals from the cigarettes were having an effect on your head and face bones, then they may move as you detox but should feel more comfortable once as the chemicals are cleared. That’s pure speculation on my part as I have not actually seen it.

      Thanks,

      Dr. Lopez

  • Kim says:

    Dr. Lopez,
    I’m so glad I stumbled across this research. I felt like I was going crazy with how the indentations move across the top of my head and on the crown of my head. I never noticed it until I started chemo and lost my hair. It’s not painful, they just move and create different crevices in different places. At least I also know it’s normal too! 🙂

  • Roth says:

    hello, I met an expert who does craniosacral therapy as well as endonasal balloon treatment, he said my facial asymmetries can be solved and I may achieve more symmetrical face by doing those treatments but I’ll have to shift to his clinic which is in different state from my city and to get my face symmetrical I’ll have to get 40 treatments ( per treatment a day). my main problem is a headache and uneven facial structure as in my right face is higher and wider than my left face, the expert told he’ll work on my left cheekbone to get in same level as my right face and also he’ll work on my jaw to reshape it, I wanna ask you is this treatment worth it or am I just wasting my time and money behind it? can I trust this expert and shift to his clinic? it’s gonna cost 3k usd and I’m 24 years old guy who’s still studying so please help me with your reply

    • Daniel Lopez, D.O. says:

      Hi Roth, I think it’s reasonable that a qualified person could get your face more symmetrical and help your headaches although the extent of it can by limited by certain things. The goal really should be to help with your headaches with symmetry being a side effect of achieving that. It shouldn’t really take 40 visits or at least not daily treatments. The amount of treatments and the number of times seems excessive to me. I honestly have never understood how someone comes up with the number of treatments needed? Sometimes it’s fast and sometimes it is not, but there’s no clear way to tell. At most, I see people once a week so their body can have a chance to adjust to the changes that have been made.

  • Nate says:

    I had an osteoma on the right side of my forehead but was excised a few years back. However by that time I noticed something similar was happening on the left side and now years later there is an exostotic growth on the left side as well. It is driving me insane and I have obsessive thoughts about it, like why it grew and how to get rid of it. Is it possible for bone growth like this to occur from me rubbish my forehead? Because I would rub it when I thought it was growing and now it’s bigger. Is it partially my fault? And is it possible to move to crack my forehead by hitting it with the front part of my hand if I do it with a lot of force? I know that some of these questions are weird but I need to hear it from a doctor to know whether my fears are valid.

    • Daniel Lopez, D.O. says:

      Hi Nate, I do not think rubbing your forehead would cause bone growth so I doubt it is partially your fault. I would not advise hitting your forehead with a lot of force. It could move it, but generally not in the way you would want.

  • antonia says:

    Hello Dr. Lopez
    I had the weirdest experience last night. I was rubbing my head and there was a ridge along a suture line on the top back side of my head on the suture line. I felt the other side and there was not symetrey in fact there was an indentation. At the bottom of the ridge it felt softer so I pressed going all along the suture and it moved back into place but is sore. I did go to the emergency and the doctor told me the skull bones do not move and made me feel like an idiot. He also told me that a cat scan was equal to the amount of radiation that the survivors of Hiroshima were exposed to. Scared the hell out of me so I went home. Oh last bit of information, I was in an auto accident 6 weeks ago and hit the head rest, I was not evaluated at the time because I thought I was OK. Want to know if you have ever heard of something like this.
    Thank you,
    Antonia

    • Daniel Lopez, D.O. says:

      Hi Antonia, doctors in general do not feel the bones of the head can move. You are certainly not an idiot for noticing that. What you’re describing is very possible. You may have a rotation in one of the bones that makes it pop out on one side and indent in the other. That can be common after a trauma like the car accident your describe. These are the kinds of things that doctors like me would work on treating and resolving for after traumas like that. A CT scan would not show anything regarding this so it is best to avoid it if possible, especially if you’re young. If you can’t find someone, you could try some of the maneuvers in the Ultimate Self-Help Guide to Headache Relief book I wrote.

  • Ron says:

    Dr. Lopez, have you heard of nasal release technique or cranial release technique, I see alot of positive things about this treatment, for concussions and vistubular issues ,I have had several concussions over the years,but most recent was 2013,since then I have had non-stop unstable and dizziness along with eye problems and sinutitus which I never had before ,my life has came to a stop due to this,neurologist,ents,eye doctors no one can figure it out,I spoke to Cynthia Stein from the website of nasalreleasetechnique.com, she says I’m a good candidate for this,but no one in my area does the procedure,she has many patients that swear this has changed their lives for the better,I tried to talk to my neurologist about it and she didn’t want to hear it,because she said the skull sutures don’t move. Your opinion or advice on this would be appreciated . Tks ron

  • Terra says:

    I am a healthy woman in my mid fifties, but I wanted to share with you something I never spoke about when I was younger, afraid others would think I was insane. When I was 18, the bones that make up my skull felt as though they were slightly shifting, or so it felt to me, and were quite tender and sore along the sutures. It lasted over a several month period, gradually lessening until it went away. It worried me quite a bit because I thought the worst, and I told no one until today, though I have wondered about it many times over all these years. Your clinical experience and theories are to me very plausible.

  • mike says:

    Hi Dr. Lopez. Thank you for this article. I had radiation done on the right side of my head for an acoustic neuroma August 2014. I am experiencing balance issues, not where I look drunk but where I can tell my body is working overtime. Now I am seeing a physical therapist and she tested my cranial movement and she said it is not. She works on it but the work does not hold.she has done it twice now. Is there anything I can do for my body to help relax or release them?
    Thank you.
    mike

    • Daniel Lopez, D.O. says:

      Hi Mike, sometimes it takes time to get the treatments to hold. It could also mean that there is something that is not being successfully addressed that needs to be addressed for the changes to hold. Unfortunately without being able to evaluate and treat, I could not tell you more than that.

  • Darlene says:

    I can feel all of the sutures in my skull sometimes I get sharp pains also. A stabbing pain I had a ct done one doctor said that part of the image was obstructed he asked another doctor to look at it he said it was normal. I also have a adrenal tumor, swollen lymph nodes and breast lumps I don’t know if it’s related, my mammogram was normal any advice?

    • Daniel Lopez, D.O. says:

      Hi Darlene, I could not tell you if they are related or not. Potentially it would be possible in my opinion, but I could not say for certain at all. Usually tenderness at the sutures may be indicative of dural membrane irritation for one reason or another. You could seek out a osteopathic physician that does cranial work to check you out and see if they could help you at http://www.cranialacademy.org. Best of luck,

      Dr. Lopez

  • Bean says:

    Regarding braces – do they not move just the teeth through the dental arch bone and not the bone itself?

    • Daniel Lopez, D.O. says:

      Thanks for the question. I don’t necessarily find that they do that because they also put pressure on the bones that have the teeth (maxillas and mandible). In general, they will also have an effect on that. I don’t think it would be so unreasonable that if teeth can be moved through a bone itself, that bones can move through sutures. I hope that helps.

  • Elina says:

    Hello. Great article, Dr.
    I was wondering how does it work on babies and if it could be actually dangerous. If it move the bones, could it cause craniosynostosis? Could it cause early closure of sutures and prevent the brain to grown? What if it was applyied by a bad osteopath? I am trying to figure out if it could have cause the overlaping of the plates that happened with my friend’s daugther.

    • Daniel Lopez, D.O. says:

      Hi Elina,

      This work can by done on babies by trained professionals, but this would not cause craniosynostosis. The treatments are not that aggressive that it would produce that kind of a result. Otherwise, kids could get it from bumps and hits to the head. However, when done by someone who does not know what they’re doing, they can introduce cause things to tighten and not move. That would have a negative impact on the child, but would not cause early closure of sutures as far as I have ever seen.

      Sincerely,

      Dr. Lopez

  • Ravi says:

    Hello Dr Lopez,

    My son is 15 months old and he has flat head from the back right side of the head. When he was 7 months old we purchased helmet as per the prescription, but we did not make him wear because he was very uncomfortable in it and kept hearing that it will roundup by itself as he grows old from my inlaws and other friends. but now he is 15 months and it has not fixed yet. Now I am worried that all the sutures must have fused by this age and looking for some kind of treatment that can fix the shape. Is it possible to fix it at this age.

    Thanks,
    Ravi

    • Hi Ravi, thanks for the comment and question. Yes, it would be possible to still get a result at 15 months. I still get changes in shape in adults although you would want to address this as soon as possible. I would recommend looking for someone through the Cranial Academy (www.cranialacademy.org). Best of look with your son.

      Sincerely,

      Dr. Lopez

  • Katherine says:

    Hello Dr Lopez,

    I’ve been searching for information about skull bone movement because during the last few weeks I’ve had a few random bleeding noses and the last 2 days I’ve had a constant somewhat debilitating headache (i rarely get headaches). A few days ago a spot on top of my head started burning, to the point where i got my husband to check that nothing had bitten me. He was rubbing my head and noticed that one side of my skull is a fair bit higher than the other. when you run your fingers across it from right to left you can actually feel the ‘drop’ from one side to the next. I have not had any trauma to it, but have been undergoing tests for autoimmune diseases as I am constantly getting sinus infections . Is this sort of thing normal at all or should I be getting to a doctor? (I’m a bit over seeing doctors lately so don’t want to go if I really don’t need to)
    Any advice would be much appreciated.
    Thanks
    Katherine

    • Hi Katherine, I’m sorry to hear about all this. I wouldn’t say this is normal, but it would be helpful to have someone evaluate your cranial bones and see if they are working correctly. The lack of motion could be creating the environment that causes sinus infections and headaches. The type of doctor you should be seeing if you want to address it is a cranial osteopathic physician (www.cranialacademy.org).

  • Vicky says:

    Hello, I am a 34yr old pregnant female and recently noticed an indentention along the coronal sturture along one of my temples going up into the hairline. Never noticed it before and definitely would. What could this be? What could be causing this? Bit worrying

    • Hi Vicky, without evaluating I can only speculate. It’s possible that your tailbone could be jammed and could be pulling your cranial bones on one side down through the dura. Otherwise, the change in fascial tension from pregnancy throughout your body could also produce structural changes in your skull. I don’t think this is anything necessarily to be concerned about. If you’re still concerned, you may want to see a cranial osteopathic physician.

  • Deb davis says:

    Dear Dr Lopez
    My name is Debra Davis i had sn extensive Crainiotomy for a tumor between my brain stem and left lower lobe. In 1994 the Drs tried a new closure procedure with a plastic material well i still have every opening they created on the top of my skull 7 holes onr is a first knuckle deep. I get excruciating headache from any kind of pressure change. Is there anything othet then closure surgery to deal with this? Im 55yrs old and the older i get the worse it gets.

    • Hi Debra, thanks for you comment. I’m really sorry for the delayed response. I’ve had some technical difficulties. I’m not sure if there would be anything else to do other than the closure surgery. Even then, I don’t know if that would work. It’s always tricky once you throw in a trauma like a surgery because even if it is needed, it alters the anatomy permanently.

  • Stacey says:

    Hi Dr Lopez,
    Thank god I stumbled across your sight, my 13 year old son has been diagnosed with neuro developmental delay disorder, he suffers from major meltdowns since birth. He was born with a v shaped bruise in the middle of his forehead many gp’s and peds said it would fade and disappear by 6mths of age. It’s still there to this day, becoming darker when he is tired or pre meltdown, I have also noticed the top of his head where the soft spot in new borns is will rise to a hard bone peak. Not only can you feel this change but as he is getting older you are able to see it at arms length. Many many specialists have told me I am lying and the skull is bone there for it can’t move! I know I’m not Insain! Any advise would be great

    • Hi Stacey, thanks for the question. I would recommend going to an osteopath that practices cranial osteopathy. If you’re in the US (www.cranialacademy.org). If you can’t find one near you or that is accessible, you could try a craniosacral therapist. Unfortunately like I wrote, it’s a controversial topic and many doctors and specialists are to stubborn to consider it could be possible. Best of luck with your son.

      -Dr. Lopez

  • John says:

    Just starting to introduce cranial osteopathy into my practice. Such an interesting Topic. Thanks for the video summarised very clearly!!

  • sue simpson says:

    Hi Dr. Lopez,
    I have had several NCR treatments (with endo-nasal ballon) to correct facial symmetry and scoliosis. I looked better (better facial balance) after the first few series, however, with the following series (as recommended by the NCR therapist) I experienced skull growth-protruding forehead, nose and cheekbones. Apparently. this is not an uncommon side effect. I have also experienced head shifting following exercise. My head often feels heavy and my vision is off as well. It has been a year since my last series and I l look and feel awful. I recently went to see a therapist who specializes in cranial osteopathy. He said he could feel my head shifting all over the place. He also said that he would like to see me once a week for 3 weeks to see if the treatment is working. I am hoping he can adjust the spend bone so I can look and feel the way I used to. Do you know if a shift in the sphenoid bone can alter facial structure? Thank you for your time.

    • Hi Sue, I’m sorry to hear about your experience. My guess is they went overboard with the endo-nasal balloon. Anyway, I hope the cranial osteopath can help you. If you cannot be helped by your person, you may have to seek out another who can. We’re not all the same. Also, yes, the sphenoid bone articulates with many bones in the skull and face so a shift in the sphenoid can alter facial structure quite a bit. Best of luck.

      -Dr. Lopez

  • Michael says:

    Hello doctor, i find it very intresting what you wrote here, in fact its the first im experiencing some kind of hope in few years.

    My problems is that after a car accident I had a reconstructive surgery of my forehead and everything went well but a few months later after the surgery I started experiencing weird symptoms like burning sensation on my temples, my face getting really hot/red and the worst weird is that shape of my forehead is changing as if its pushing backwards to my brain. Also when i experience those symptoms I can feel a strong coronal ridge on top of my head but when im calm/ relaxed its getting better and the shape of my forehead is back normal and the coronal ridge is gone. Its been 5 years I have this problem and dont really know what to do. What do suggest to me, is this a problem that will ever resolve? What do you advice doing on my self to improve this.. facial exercice?

    Kind regards from Belgium

    • Hi Michael, thanks for your questions. I’m sorry to hear about everything you’ve been through. Honestly, I do not know if this is a problem that will resolve. I would highly doubt that it would resolve at all if you nothing is changed. A cranial osteopath might be able to help, but it’s hard to say because of your traumas. When the anatomy is permanently altered through trauma or surgery, sometimes that can be very hard to get resolution. Having said that, I would not know what kind of a result I could get without trying. I do not know that there is anything easy that you could do to yourself to get this problem to resolve unless you had the training to do it. Facial exercises would not help necessarily. Best of luck and I truly hope you are able to find some answers and relief.

      Sincerely,

      Dr. Lopez

  • Hilary Mackey says:

    Hello Dr. Lopez

    10 years ago I had a sinus lift window surgery for 2 upper dental implants, with insufficient bone, at 16 and 17. Both implants ended up in my maxillary sinus with graft. Another window surgery removed a large fungus ball from the maxillary sinus and implants were removed in 2011. Life has been a nightmare; physically, emotionally, financially. I’ve worked hard with the fallout to my sinuses, eyes, ears and health is improving. My saggital suture has been jammed since 2011 when a 2nd set of double fused crowns were put on the implants, anchored in my shallow bone (and my maxillary sinus), creating a fulcrum. I felt my head shift quickly and the jam has been there since. There is a ridge in the upper central part of my skull and my forehead is tilted towards the former implant site. The Osteopath MD I saw for years, who wasn’t a cranial guy, was unable to unjam it, and I lived with it. 5 years ago I had a precision partial denture made, with milled crowns, and 2 lower bridges remade, and this worked for some time. I saw an Osteopath a dozen times, who helped my head become more neutral, though didn’t unjam it. I then had my dentist rework my partial which felt better for 4 days, then much worse and the discomfort in my skull is at it’s worst. I’ve stopped wearing it again while I get Chiropractic Adjusting Turner Style treatments. Can my suture(s) can be unjammed, since surgeries changed the right side of my jaw and face, and my recent dental work was done with my head in the position it is in? I live in Canada, on the West Coast.

    • Hi Hilary, I apologize for the delay in responding. I’m sorry to hear about all that. Anyway, in theory, yes the sutures can be unjammed, BUT there are factors that could prevent their release including the effects of the implant and the dental work. I cannot know for sure without evaluating and treating as to what could be unjammed or not, but often the permanent changes from surgery can be difficult or impossible to overcome. I hope this helps.

  • Ms. S. Angell says:

    Hello Doctor,
    I enjoy your site very much.
    Recently I saw my doctors with a concern about my scull. I noticed that the upper part of my forehead had dinted in a little. Now, about a year later, the tint reaches about four inches. I feel as if my scull is coming apart. My doctor said my scull felt normal but I know it did not have the dint before a year ago. I am 68 years old. Should I be worried?
    Ms. S Angell.

    • Hi Ms. S. Angell, thank you for the compliment. It is possible for there to be changes over time in response to different factors. Unfortunately, I couldn’t tell you what it means specifically without evaluating. If it keeps changing, be persistent with your doctor and may warrant a work up.

  • Zach Robertson says:

    Hi Doctor,

    My name is Zach Robertson and I’m a 20 year old male. I’m able to move the left and right sides of my skull independently, pushing one side further down or one side further out. I sustained some head trauma at the age of 6 right in the middle of my forehead, is it possible that my frontal bone never fused properly? And if so, is this concerning at all?

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