Head Shape Abnormalities

There are several types of head shape abnormalities. Each type has its own symptoms:

• Positional plagiocephaly. The bones that make up a baby’s skull are thin and flexible. Constant pressure in one area of the skull can change the skull's shape. This condition is called positional plagiocephaly (skull molding) and is one of the most common forms of abnormal head shapes. Babies with plagiocephaly often have noticeable flatness on the back or sides of their head, and there is typically little hair in those areas. This can be due to recommended safe sleeping guidelines, which promote babies lying on their backs for extended periods of time. Car seats, strollers and other carriers often position babies in this way, too. It is also possible for a tight neck muscle to cause torticollis (a persistent twist of the neck to one side). When this happens, one area of your child's
• Craniosynostosis. The skull is made up of many bones that fit together like a puzzle, and the place where the bones eventually grow together is called a suture. If one of these sutures fuses too early, growth cannot continue in that area. This condition is called craniosynostosis. This leads to an abnormally shaped skull. If this condition is not treated, it causes pressure inside the head along with head deformity, developmental delay and, in some cases, seizures. Craniosynostosis can be classified as non-syndromic and syndromic. Non-syndromic craniosynostosis is the most common form and is most often characterized by an isolated single suture synostosis.
• Syndromic craniosynostosis. Patients with this condition have craniosynostosis and associated anomalies involving the face and extremities, which can also affect the shape and placement of the eyes and development of the upper and lower jaw. Some of the associated syndromes are:
  • Apert syndrome. Children with Apert syndrome typically have craniosynostosis, midface hypoplasia (underdevelopment), increased intracranial pressure, exophthalmos/proptosis (bulging eyes) and syndactyly (webbed fingers or toes).
  • Crouzon syndrome. Children with Crouzon syndrome may have craniosynostosis, midface hypoplasia and mild exophthalmos.
  • Pfeiffer syndrome. Children with Pfeiffer syndrome may also have crowded teeth along with thumbs and toes that appear broadened and an abnormally shaped forehead or nose.
  • Saethre-Chotzen syndrome. In addition to affecting the position of the eyes, Saethre-Chotzen syndrome may also affect the position of the nose. Children with this condition may also have low hairlines and short or fused fingers.

Diagnosis of Head Shape Abnormalities

A craniofacial surgeon will obtain your child’s medical history and complete a detailed physical examination to diagnose a head shape abnormality. Doctors may also use medical imaging such as traditional X-rays or computed tomography (CT) to make a diagnosis.