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Abnormal head shapes11/12/2023 ![]() ![]() The exact shape depends on which parts of the skull are affected. Instead, the skull compensates by growing in other directions, which results in an abnormal head shape. As a result, the skull can no longer grow larger normally. It occurs when the bone plates in the skull fuse earlier than usual. Unlike plagiocephaly, craniosynostosis is a birth defect. However, the earlier you seek evaluation of your child’s condition, the easier it is to reshape the soft bones of his or her skull. Surgery is not necessary to correct deformational plagiocephaly, and this condition does not affect how your child’s brain develops. ![]() Helmet therapy may be prescribed for severe cases. Plagiocephaly is primarily treated with repositioning exercises and possibly therapy. It can occur in twin pregnancies or if a child is born with a congenital stiff neck. Plagiocephaly usually develops gradually over the first few months of life but can also develop in the womb. ![]() The flat spots are called deformational plagiocephaly and are the most common cause of abnormal head shape in infants. Telemedicine appointments are also available upon request.Babies are born with soft skulls that can develop flat spots when they spend too much time in one position. This typically depends upon the severity of the asymmetry at the age at which the child is seen in our clinic. We typically recommend an orthotic from Orthomerica ( A “helmet” is recommended for less than 1/3rd of our patients, which means that approximately 70% of the time we can manage the problem with physical therapy and a home program alone. The plan will be customized for your child and may include a home program, a recommendation for physical therapy or occupational therapy and may also include a recommendation for an orthotic cranial molding helmet. When you visit our multidisciplinary clinic, you will be seen by a craniofacial surgeon, an experienced physician assistant, and a physical therapist or occupational therapist trained in the diagnosis and management of torticollis. You will also be evaluated by state-of-the-art equipment which will provide quick and accurate imaging of your child’s head shape. At the end of your appointment you will have a diagnosis and treatment plan. The importance of having these large muscle strong and working in coordination is why our first line of defence for positional cranial molding is to strengthen these muscles and why we feel Physical Therapy and a consistent home program, demonstrating how to encourage tummy time, is so important to correcting and avoiding these problems. If they are week there tends to be a flat spot directly in the back of the head. The muscles that extend the neck begin in the back and attach approximately halfway up the back of the head. This can worsen the facial asymmetry noted with plagiocephaly. If you look at the child from the back, you may notice one ear is closer to the shoulder than the other. You can also see a tilt of the head to one side. If these muscles are not acting equally and together (Torticollis), the infant will have difficulty turning his head to one side and will end up having a sleeping preference to the opposite side. The muscles that turn the head from left to right are called the Sternocleidomastoid muscles (SCM) and attach from behind the ear and to the clavicle and sternum in front. These forces are the push of the brain from the inside (brain growth) and the pull of the various muscle groups acting on the outside. The shape of our head is determined by the forces acting on it. These problems are commonly associated with set of muscle weaknesses referred to as Torticollis. These asymmetries can present together and are then referred to as an asymmetric brachycephaly. Brachycephaly means “short head” which presents as a flattening in the back of the head. Plagiocephaly means “flat head” and is a right or left sided problem. The most common cause of abnormal head shape is “positional molding” and the two common presentations of positional molding are Plagiocephaly and Brachycephaly. This is a rare event and is typically thought to occur in approximately one in 3000 live births. These conditions often require a surgical intervention to correct but are fortunately seldom in occurrence. Synostosis implies that there has been an abnormal fusion of some of the cranial bones leading to abnormal growth and shape. These abnormal shapes are divided into synostotic(rare) and nonsynostotic causes. The Head Shape Evaluation Clinic is a unique collection of multidisciplinary clinical experts dedicated to the evaluation and treatment of problems leading to abnormal head shape in the infant and related causes. ![]()
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