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 often times there is some facial asymmetry. Brachycephaly describes a very wide head shape with a flattening across the whole back of the head. Craniosynostosis is another condition in which there is a premature union of skull bones, .
Abnormal head shape is a common finding at birth and may be the result of positioning in the womb or difficult passage through the birth canal. Usually this resolves in the first 6-8 weeks of life. If is persists longer than 6-8 weeks it is considered Plagiocephaly.
Often, Plagiocephaly is caused by the inability of the infant to turn their head in one direction due Torticollis, a condition where the neck muscles on one side are tightened or shortened. This causes the baby to always apply pressure to the same side of the skull causing it to become flat.
Treatments for Plagiocephaly range from repositioning of babies below the age of 5 months to cranium molding helmets. In mild cases, repositioning usually resolves the Plagiocephaly and the skull rounds out on its own. Treatment usually takes the form of reducing the pressure on the affected area through supervised tummy time throughout the day. Also, repositioning the child's head so that the rounded side of the head is placed 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 bouncy seats, swings, or other reclined seating which is thought to exacerbate the problem.
Moderate to severe cases require treatment with a cranium molding helmet. These helmets are used to treat Plagiocephaly and other head shape deformities in infants 3 to18 months of age. A cranial remolding 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 to 4 months, but varies depending on the infant's age and severity of the cranial asymmetry.
A pediatrician will evaluate the baby's head from the top, sides, and back to front. Misalignment of the ears, jaws, or eyes or asymmetry in the face may be signs of Plagiocephaly. If the pediatrician sees significant asymmetry, the baby will be referred to a trained specialist to measure the extent of the asymmetry. The specialist will take a quick and painless scan of the baby's head to determine the extent of the asymmetry. Specific measurements are recorded using a scanner which produces 3D images of the baby's skull. This information is used to create a custom molded helmet specific to the baby. Repeat scans will monitor the progression of the baby's treatment.