Plagiocephaly

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Plagiocephaly
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ICD-10 Q67.3
ICD-9 754.0
DiseasesDB 29858

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List of terms related to Plagiocephaly

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and Keywords: cranial asymmetry; asymmetric head; plageocephaly

Overview

Plagiocephaly is a condition characterized by an asymmetrical distortion (flattening of one side) of the skull.[1]

Plagiocephaly is the word that is used to describe a diagonal asymmetry across the head shape. This word particularly describes a flattening which is to one side at the back of the head and there is often some facial asymmetry. Brachycephaly describes a very wide head shape with a flattening across the whole back of the head. [2]

Causes

It is a common finding at birth and may be the result of a restrictive intrauterine environment.

Causes in Alphabetic Order

  • Craniofacial dysmorphism-polysyndactyly syndrome
  • Craniosynostosis: If there is premature union of skull bones, this is more properly called craniosynostosis. The unusual head shape in plagiocephaly is caused by pressure in the womb giving a "diamond" shaped head when seen from above. In pronounced cases there may be flattening of one side of the head as well.
  • Muenke syndrome
  • Neck pain: It can be caused by an inability of the infant to turn their head in one direction due to neck pain. This causes the baby to always be on the same side of the skull and it will become flat. Once normal movement is restored head begins to develop normally.
  • Sudden Infant Death Syndrome: The incidence of plagiocephaly has increased dramatically since the advent of Sudden Infant Death Syndrome recommendations for parents to keep their babies on their backs.[3] Treatments range from a simple repositioning of babies below the age of 5 months to more involved treatment with a helmet for children under the age of 18 months.[4]
  • Wolf-Hirschhorn syndrome

Natural History, Complications, and Prognosis

There are some beginning studies that indicate that babies with plagiocephaly tend to have learning difficulties later on in school, however these studies are still early, and do not yet represent a scientific consensus.[5] Other more complete studies suggest that there is no evidence to suggest that plagiocephaly is harmful to brain development, vision, or hearing.[3]

Treatment

The condition will sometimes improve as the baby grows, but in many cases, treatment can significantly improve the shape of a baby’s head. Initially, treatment usually takes the form of reducing the pressure on the affected area through repositioning of the baby onto his or her tummy for extended periods of time throughout the day. Other treatments include repositioning the child's head throughout the day so that the rounded side of the head is placed dependent against the mattress, repositioning cribs and other areas that infants spend time in so that they will have to look in a different direction to see their parents, or others in the room, repositioning mobiles and other toys for similar reasons, and avoiding extended time sleeping in car-seats (when not in a vehicle), bouncy seats, or other supine seating which is thought to exacerbate the problem. If the child appears to have discomfort or cries when they are repositioned, they may have a problem with the neck.[6][7] If this is unsuccessful, treatment using a cranial remolding orthosis (baby helmet)[8] can help to correct abnormal head shapes.

File:Cranial Remolding Band.jpg
Example of Cranial Remolding Band

These helmets are used to treat deformational plagiocephaly, brachycephaly, scaphocephaly and other head shape deformities in infants 3–18 months of age. For years, infants have been successfully treated with cranial remolding orthoses.

A cranial remolding orthosis (helmet) provides painless total contact over the prominent areas of the skull and leaves voids over the flattened areas to provide a pathway for more symmetrical skull growth. Treatment generally takes 3–4 months, but varies depending on the infant's age and severity of the cranial asymmetry.

See also

References

  1. plagiocephaly at Dorland's Medical Dictionary
  2. "Plagiocephaly and Brachycephaly" Technology in Motion Plagiocephaly Clinic
  3. 3.0 3.1 "Plagiocephaly and related cranial deformities" Pediatric Views, April 2010 available online from Children's Hosptial Boston accessed May 14, 2010
  4. One Parent's Blog on Battling Brachycephaly and Plagiocephaly
  5. "Flat-headed babies may face learning problems". CBC News. December 3, 2010.
  6. Persing J, James H, Swanson J, Kattwinkel J (2003). "Prevention and management of positional skull deformities in infants. American Academy of Pediatrics Committee on Practice and Ambulatory Medicine, Section on Plastic Surgery and Section on Neurological Surgery". Pediatrics. 112 (1 Pt 1): 199–202. PMID 12837890. Unknown parameter |month= ignored (help)
  7. http://www.repositioning.info/
  8. http://www.craniokidz.com/

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