Brachycephaly and Plagiocephaly

Brachycephaly and plagiocephaly are two types of flat head syndrome, which are conditions characterized by an abnormal shape of the skull.

Definition

Brachycephaly refers to a short, wide skull shape, where the back of the head is flattened. This can cause the head to appear broader than usual.

Plagiocephaly refers to a condition where one side of the head is flattened, resulting in an asymmetrical skull shape.

Causes

The main causes of brachycephaly and plagiocephaly include:

• Prolonged pressure on one area of the skull, often due to:
• Supine sleeping position (sleeping on the back)
• Prolonged use of infant car seats or swings
• Torticollis (a condition where the neck muscles are tight, causing the head to be tilted to one side)
• Genetic factors
• Premature birth
• Muscular issues, such as torticollis or facial asymmetry

Symptoms

The symptoms of brachycephaly and plagiocephaly may include:

• A flat spot on the back or side of the head
• An asymmetrical skull shape
• A noticeable difference in the shape of the two sides of the face
• Eyelid or ear misalignment
• Jaw or facial asymmetry

Diagnosis

Diagnosis is typically made through a physical examination by a pediatrician or a specialist, such as an orthotist or a neurosurgeon. The doctor will:

• Examine the shape of the skull and face
• Check for any signs of torticollis or other muscular issues
• Take measurements of the head to assess the severity of the condition
• May use imaging tests, such as X-rays or CT scans, to rule out other conditions

Treatment

Treatment for brachycephaly and plagiocephaly depends on the severity of the condition and the age of the child. Options may include:

• Repositioning techniques: Changing the way the baby sleeps or is positioned to reduce pressure on the affected area
• Physical therapy: To address any underlying muscular issues, such as torticollis
• Helmets or head molds: Custom-made devices that apply gentle pressure to the skull to help reshape it
• Surgery: In severe cases, surgery may be necessary to correct any underlying conditions or to reshape the skull

Prevention

To reduce the risk of brachycephaly and plagiocephaly:

• Provide tummy time when the baby is awake and supervised
• Avoid prolonged use of infant car seats or swings
• Alternate the direction of the baby's head while sleeping
• Use a firm, flat mattress and avoid soft bedding or pillows

Prognosis

The prognosis for brachycephaly and plagiocephaly is generally good, especially if treatment is started early. With proper care and intervention, most children can achieve a normal or near-normal head shape.