FLAT HEAD SYNDROME

PLAGIOCEPHALY

Plagiocephaly is the most common type of cranial deformity among all those described above. In recent years, plagiocephaly — also referred to as “oblique head” — has been diagnosed particularly frequently, which is probably related to the campaign promoting placing infants to sleep on their backs.

Although the campaign’s objective is well founded, its introduction reduced the incidence of SIDS (Sudden Infant Death Syndrome) by approximately 40%; however, an unintended consequence was an increase in cases of positional plagiocephaly. An infant’s skull is very soft and malleable, which means that any prolonged pressure on a small area may cause deformation.

Another cause of plagiocephaly is torticollis, a congenital muscular condition that occurs in approximately 85% of children with plagiocephaly. Children with torticollis have shortened neck muscles on one side, which makes it difficult for them to tilt their head in the opposite direction. As a result, they choose only one sleeping position, with the head turned to one side. The habit of lying for prolonged periods with the head turned to one side most often results in visible facial asymmetry.
In cases of plagiocephaly, when looking at the child’s head from above, its shape resembles a parallelogram.

Note! Plagiocephaly may lead to facial asymmetry in a child, and in some cases noticeable changes in shape may be observed:

• one eye may appear larger than the other (more prominent)
• the eyes may be positioned asymmetrically
• the ears may be positioned asymmetrically (one ear is more forward, the other is set back)
• the forehead may be more prominent on one side
• one cheek may appear fuller on one side

BRACHYCEPHALY

Brachycephaly, also known as “short head,” is a condition in which the back of the child’s head is uniformly broad and flat.

DOLICHOCEPHALY

This type of deformity is characterized by lateral flattening of the head, making it appear longer and narrower. Such cases occur most commonly in premature infants or when the baby’s head becomes lodged beneath the ribs during pregnancy.

CRANIOSYNOSTOSIS

Considered a very serious medical condition, craniosynostosis results from the premature fusion of one or more of the child’s cranial sutures. A ridge at the site of the fused suture may be palpable when touching the deformed part of the head. Suspected craniosynostosis can be diagnosed using a skull X-ray and computed tomography (CT).

This website and HeadCare products do not apply to cases in which head flattening is caused by craniosynostosis.

WHAT CAUSES POSITIONAL HEAD DEFORMITIES?

Plagiocephaly and other positional head deformities most commonly develop when an infant remains in the same sleeping position for prolonged periods, with the head pressing against the firm surface of the mattress.

Head flattening may also develop before birth. Possible causes include an abnormal position of the baby in the uterus, too little or too much amniotic fluid, uterine abnormalities or tumours, multiple pregnancy, or excessive fetal weight. Head deformation may also occur during delivery as the baby passes through the narrow birth canal. Premature infants are also at risk, as they may spend long periods in the same position in an incubator.

After birth, flat head syndrome is associated with:

• the newborn’s soft and malleable skull and its rapid growth during the first 3–4 months of life,
• long periods of sleep,
• underdeveloped and weak neck muscles — when lying down, the baby’s head tends to remain in the same position.

TORTICOLLIS

Torticollis is a condition caused by abnormalities affecting the neck muscles or the cervical spine, resulting in a forced tilting of the child’s head toward one shoulder, while the face turns in the opposite direction and is slightly elevated. Torticollis may have various causes and can therefore be divided into several types:

• muscular torticollis – results from shortening of the sternocleidomastoid muscle on one side, caused by abnormal development of blood vessels within the muscle, leading to fibrosis. This type of torticollis may also develop in connection with muscle inflammation, degeneration, abnormal development, or traumatic bleeding into the muscle. It can often be detected by palpation as a spindle-shaped thickening,
• osseous torticollis – develops as a result of asymmetrical formation of the cervical spine. The causes may vary and include asymmetrical development of the cervical vertebrae, abnormalities of individual vertebrae, or congenital syndromes such as Klippel-Feil syndrome. In this type of torticollis, asymmetrical tension of the sternocleidomastoid muscles is not present,
• positional torticollis – most commonly results from an abnormal position of the baby in the uterus or from an injury sustained during delivery,
• acquired torticollis – may be caused by various pathological conditions, including traumatic injury to the spine, inflammatory changes, or systemic diseases. Torticollis may also result from a habitual head position caused, for example, by a hearing or visual impairment, leading the child to tilt the head as a compensatory mechanism.