Deformational (or positional) plagiocephaly refers to a misshapen (asymmetrical) shape of the head (cranium) from repeated pressure to the same area of the head. Plagiocephaly literally means oblique head, from the Greek words plagio for oblique and cephale for head.
Craniosynostosis is premature fusion of one or more of the sutures in the skull. True synostosis may limit the size of the cranial vault (skull) and therefore impair brain growth. The diagnosis is made after a clinical evaluation by a craniofacial surgeon and/or a neurosurgeon. X-rays and CT scans of the head may be performed to confirm the diagnosis of craniosynostosis. Surgery is usually the recommended treatment.
In deformational plagiocephaly, there is no fusion of the skull sutures. It is a clinical diagnosis made after a thorough medical history and physical examination by a craniofacial surgeon or neurosurgeon. X-rays and/or CT scans are usually not necessary. Treatment of deformational plagiocephaly generally includes positioning and/or helmeting.
The major differences between craniosynostosis and deformational plagiocephaly are summarized in the chart below:
May include back sleeping, restrictive intrauterine environment, muscular torticollis, and prematurity
By keeping an infant's head in one position for long periods of time, the skull flattens (external pressure). Occasionally, a baby is born with this flattening because of a tight intrauterine environment (for example, in multiple births, small maternal pelvis, or with a breech position). Other factors which may increase the risk of deformational plagiocephaly include the following:
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The Craniofacial Program at Children’s National brings together experts from 10 pediatric disciplines to provide complete care for children with craniofacial disorders. Our multidisciplinary pediatric team helps more than 400 children every year.