HomeConditions Abnormal Head Shape/Plagiocephaly

Abnormal Head Shape/Plagiocephaly in Dallas, TX

Parents can rely on the International Craniofacial Institute in Dallas, Texas for the most accurate assessment and treatment for Deformational Plagiocephaly – an abnormal head shape resulting from repeated positioning on a specific area of the skull.

The Head Shape/Plagiocephaly Clinic at the International Craniofacial Institute focuses on prevention and treatment utilizing the most up-to-date conservative measures with an emphasis on “tummy time” activities and neck stretches with your baby. Our team will first evaluate your baby’s abnormal head shape to rule out many of the more serious cranial malformations such as craniosynostosis (premature closure of sutures), which occurs in one in every 2,500 births worldwide.

Plagiocephaly Before and After

Pictured: 4 month old patient treated at the International Craniofacial institute for Deformational Plagiocephaly and Torticollis without a helmet.

What Is Abnormal Head Shape?

Deformational Plagiocephaly (abnormal head shape) is commonly seen for the following reasons:

  • In-Utero: Singletons or multiples that remain in the same position for a length of time.
  • Prematurity: Cranial bones are initially softer and easily morphed when remaining in the same position for a length of time.
  • Torticollis or Sternocleidomastoid Imbalance: Neck abnormalities that cause your baby’s neck to remain in a specific position due to a limited range of motion; this often presents by tilting the head to one side.
  • Prolonged positioning in the infant carriers, bouncy seats, swings, and many other devices that enable your baby to remain in the supine (back) position for a length of time.
  • Insufficient amount of tummy time: While the American Academy of Pediatrics recommends that your baby sleeps on his/her back, it is essential that your baby initiates a significant amount of supervised “tummy time” early in infancy.

Early Intervention

Deformational Plagiocephaly (in infancy) can be treated without helmets or helmet therapy. The most effective time to treat this condition is in the first year of life, as the cranial bones are malleable and will respond to supervised “tummy time” as well as neck stretches. Your baby’s head shape will continue to round out throughout infancy and toddlerhood.

How Is Abnormal Head Shape Diagnosed and Treated?

Diagnosis begins with a patient history. The mother’s pregnancy and the presence of an abnormal fetal position are taken into consideration. Questions are asked about prematurity, birth trauma, and multiple births. The patient history also includes inquiries about the infant’s sleeping position and the presence of neck tightness and/or torticollis, which is an abnormal, somewhat fixed twisting of the neck associated with muscle contractions.

A physical examination, which focuses on ridging of the sutures, shape of the head and neck, and other possible deformities associated with syndromes, follows the patient history. There is a distinctive head shape associated with early closure of specific sutures which differs from the head shape of infants with positional molding. Skull x-rays and computerized tomography are used to evaluate the presence of early fusion of the cranial sutures. Children with unusual syndromes may have underlying brain abnormalities that are best seen on MRI, magnetic resonance imaging, which is a non-invasive diagnostic technique that produces computerized images of soft tissue. Cervical spine x-rays are used in children with torticollis and/or neck tightness.

Is This Condition Painful?

Deformational Plagiocephaly does not cause any pain to the baby. Some babies do not find wearing a helmet comfortable, especially as they get older, but pain is not an issue. Over time, the baby’s head shape will return to normal, leaving no permanent problems or telltale signs that it was ever an issue.

Are There Different Types of Deformational Plagiocephaly?

There are two kinds of Deformational Plagiocephaly – anterior and posterior. Posterior refers to the back of the head. This is the most common type. Anterior refers to the front or forehead area. This is not as common but is still not serious.

Posterior Deformational Plagiocephaly is caused by an infant being laid in the same position all the time. Anterior Deformational Plagiocephaly is usually caused in the womb, by a baby lying against the mother’s pelvis. Both types can also be caused by a lack of room as with a multiple birth, a mother with a small pelvis, or even a baby that is breech. Preemies are also very susceptible to this syndrome as they have very soft heads and a lot of developing to do.

Lots of Babies Have Slightly Abnormal Head Shapes; How Do I Know When It Is Something to Worry About?

More than likely, a baby’s pediatrician will check the infant’s head at the baby’s regularly scheduled visit. If Deformational Plagiocephaly is suspected, the pediatrician will diagnose its severity and give one or two treatment options. The first option is the most common. In a case where the back of the head is flattened (posterior) the instructions are to simply keep the baby from sleeping on their back. Lay the baby on his side and change which side often. Try not to let the baby lay on his back during the day either. The head will regain its shape over time. For a case where the forehead (anterior) has flattened, if one side is flatter, lay the baby on the opposite side or back. Babies’ heads are very soft and will mold back easily. The second treatment option is a customized helmet. In a case where the head shape is not improving with changes in sleeping position, or if it is a very severe case, a helmet is used to reshape the baby’s head. A visit to a pediatric neurologist’s office will be made to have the helmet customized and fitted. The inside of the helmet has foam that can be removed over time to compensate for the baby’s head growth. Usually after 5 or 6 months, when the baby can sit up on its own, the helmet is no longer needed.

Who Gets Deformational Plagiocephaly?

Any infant can get Deformational Plagiocephaly. It is not a genetic condition but a result of a child’s environment either in or out of the womb.

What Are the Main Issues Related to Deformational Plagiocephaly?

Diagnosing, following the prescribed treatment option, and time are the main issues when dealing with Deformational Plagiocephaly. It is a very rare case that these issues do not cure the syndrome.

Why Choose International Craniofacial Institute?

Since its founding by Dr. Kenneth Salyer in 1971, the International Craniofacial Institute has gained worldwide recognition as being one of the most advanced facilities in the treatment of craniofacial disorders. The complexity of the field means we understand our patients have an array of dental, medical, psychosocial, and surgical needs. To address these issues, our team consists of many dedicated professionals who represent more than 15 disciplines of specialty. Our physicians have successfully treated more than 17,000 patients from more than 30 different countries. We additionally train surgeons from many world locations in the advanced techniques required for craniofacial diagnosis, surgical correction, and repair.

As soon as you notice your baby’s neck tilts to one side over the other, your baby’s head shape appears wide (brachycephalic) or long and narrow (scaphoid), or you have any questions or concerns regarding your baby’s head shape, contact us today for the best possible care.


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