plagiocephaly; skull deformity

Introduction

Deformity or mishaping of the skull.

Etiology

• sleeping in supine position as infant*

* sleeping in supine position is STILL recommended by the American Academy of Pediatrics for prevention of SIDS

Radiology

• x-rays or ultrasound imaging of the suspect suture*
• computed tomography if x-rays or ultrasound nondiagnostic

* imaging if diagnosis is equivocal (rarely necessary) [NGC]

Complications

• facial or frontal deformities (uncommon)
• developmental delay

Management

• active repositioning [NGC]
• helmets 23 hours/day may be superior to repositioning
  • recommended for infants with persistent moderate-severe plagiocephaly conservative treatment (repositioning &/or physical therapy [NGC]
  • recommended for infants with moderate to severe plagiocephaly presenting at an advanced age [NGC]
  • helmets of no long-term benefit for infants with positional skull deformity
• physical therapy may be superior to repositioning [NGC]
• prognosis
  • 87% of children normalize by agee 4 without use of a helmet

More general terms

• skeletal deformity

Additional terms

• brachycephaly