Abnormal Skull Shape in Children – Types and FAQs Answered

Abnormal skull shape in babies can develop for different reasons. The cause and symptoms of the condition will depend on the type of head shape abnormality. Once the type of abnormality is confirmed, the pediatric neurologist will be able to determine the cause and recommend a treatment plan at Rainbow Children’s Hospital. Here are the different types of head shape abnormalities:

1. Positional Plagiocephaly
The skull of a baby is thin and flexible. If constant pressure is applied to an area of the skull, it will change its shape. This is known as skull molding or positional plagiocephaly. Such babies have noticeable flatness on the sides and back of the head. The area also has less hair than usual. One of the causes of this condition can be the safe child care sleeping guidelines that recommend that you make your baby lie on their back for a long period of time. Strollers, car seats, and other carriers also involve positioning babies in this way. In some cases, the neck muscle can get tight resulting in torticollis.

2. Craniosynostosis
The bones in the skill fit together like a puzzle. A suture is a place where the bones will grow together eventually. If due to any circumstances, one of these sutures starts fusing too early, the area cannot take any more growth. This condition is known as craniosynostosis that ultimately leads to abnormal skull shape. It is very important to treat this condition immediately, even if it requires Cranio maxillofacial surgery. Failure to do so can lead to increased pressure inside the head causing a developmental delay, head deformity, and even seizures. There are two types of craniosynostosis - syndrome and non-syndromic. The latter is more common and can be organized by single, isolated suture synostosis.

3. Syndromic Craniosynostosis
Children with this condition have craniosynostosis along with associated anomalies of face and extremities. This can affect and the development of the lower and upper jaw, and the placement and shape of the eyes and may require neurosurgery. Some of the associated syndromes are:

Apert syndrome - This includes craniosynostosis, increased intracranial pressure, midface hypoplasia, proptosis/exophthalmos (bulging eyes), syndactyly

(webbed toes and fingers), and increased intracranial pressure.
Crouzon syndrome - This includes craniosynostosis, mild exophthalmos, and midface hypoplasia.
Pfeiffer syndrome - This includes crowded teeth, broadened toes and thumbs, and abnormally shaped nose or forehead.
Saethre-Chotzen syndrome - This includes affect in the positioning of the eyes, and nose, fused and short fingers, and low hairlines.

FAQs
What is helmet therapy?
Helmet therapy at Children's Hospital involves the use of a cranial orthosis for the treatment of abnormal skull shapes in the babies. The helmets are used to direct the growth from the flat spot. For this to work, the helmet should be worn at a time when the skull and the brain are growing actively.

What are the other ways of treating a kid with positional plagiocephaly?
In some cases, the pediatric orthopedic surgeon can recommend some conservative treatments like physical therapy to check if there is a need for a helmet to correct the shape of the head. This is a preferred method if the baby has torticollis. This is the condition where the muscles of the neck get short on one side. Due to this, the neck of the baby turns in a twisted position where he/she is tilting their head to one side with their chin pointing to the other side. In such cases, physical therapy can help in dealing with head-turning preferences and muscle weakness. However, if your child is not responding to physical therapy, a helmet will be prescribed.

How will the doctor fit my child for a helmet?
To get the shape of the child’s head, either a laser light scan or a plaster mold will be used. These measurements will be used for designing a custom-fitted helmet. The helmets will have a foam lining inside that would be adjusted after the baby has worn it for a little while. The aim of the helmet is holding the round areas of the head steady. It also allows the flat spot to grow and round out gradually, on its own.