Head Shape Abnormalities

Abnormal head shapes can develop in babies for a variety of reasons. The growth and development of the skull bones mainly influence the shape of a baby's head. Different conditions can affect this growth.

Early evaluation is important to determine the cause and plan a course of treatment. Doctors will perform a thorough exam to determine the issue. They may use medical imaging such as X-rays or CT scans as well as consult with other specialists.

The treatment plan will be based on the underlying cause. Timely treatment can address many cases of abnormal head shapes in babies, allowing for optimal growth and development.

Types of Head Shape Abnormalities

Positional plagiocephaly: Also known as flat head syndrome, this condition develops when babies spend too much time on their backs, whether in a crib, car seat or stroller. Noticeable flatness on the back or side of the head is a sign of this condition.
Craniosynostosis: This is a condition in which the sutures (joints) between the skull bones close prematurely. This can result in an abnormal head shape and restrict brain growth. If left untreated, it can cause increased pressure inside the head, skull shape deformities, and difficulty with vision.
Syndromic craniosynostosis: Children with this condition have skull fusion and face and limb deformities. This condition also affects the shape and placement of the eyes and development of the jaw. This can lead to the following:
- Apert syndrome: Children with Apert syndrome have underdeveloped facial features, pressure in the skull, bulging eyes, and webbed fingers or toes.
- Crouzon syndrome. Children with Crouzon syndrome may have skull fusion, underdeveloped facial features and mild bulging eyes.
- Pfeiffer syndrome. Children with Pfeiffer syndrome may have crowded teeth, broad thumbs and toes, and an unusual forehead or nose shape.
- Saethre-Chotzen syndrome. In addition to affecting the position of the eyes, Saethre-Chotzen syndrome can affect the position of the nose. Children with this condition can also have low hairlines and short or fused fingers.

Treatments

Treatment varies depending on the condition. Early recognition is important because it allows for more treatment options including minimally invasive surgeries. Riley Children’s offers many advanced surgeries, such as endoscopic and open repair, distraction techniques, total vault remodeling and spring assisted craniotomy.

Positional plagiocephaly: An immediate way to treat flat head syndrome is to place your baby on their side or stomach during the day. Infants with torticollis have a condition where the neck muscles cause the head to twist to one side. Typically, these babies need physical therapy to stretch and straighten the neck. In these cases, head flattening typically improves through treatment of torticollis. Your child's doctor may suggest a special helmet in severe cases. This helmet helps distribute pressure on your baby’s head and prevents it from becoming flatter. Early treatment for this condition leads to the best results.
Craniosynostosis. If a CT scan shows craniosynostosis, surgery to separate the skull bones is advised. This procedure relieves pressure in the skull so the brain can expand and grow to a normal shape. Doctors typically perform reconstructive surgery before the baby turns one. The Cleft and Craniofacial Anomalies Program is highly skilled in performing this delicate surgery.
Syndromic craniosynostosis: Multiple surgeries are necessary to correct the condition as your child grows and develops. Once again, early treatment leads to the best outcomes.

Comprehensive team approach

We offer a team-based approach for head shape abnormalities that includes:

Neurosurgeons: Our expert doctors who treat brain and spinal issues can address some conditions alone. These are usually the operations that occur before 3 months of age.
Plastic surgeons: Assist with operations after 3 months of age and all forms of syndromic craniosynostosis.
Genetics: Certain conditions are linked to genetic issues, so patients and families may be referred for more tests to better understand their child’s condition.
Ophthalmology: The eye doctor examines vision, eye alignment and signs of increased brain pressure. If left untreated, this can cause vision loss.
Pulmonary: Some types of craniosynostosis can cause changes in the face and breathing passages. The pulmonary doctor helps assess and treat these conditions.

Key Points to Remember

Positional plagiocephaly can develop when babies spend too much time on their backs. To relieve pressure, place your baby onto their side or stomach during the day.
Craniosynostosis occurs when the bones of the skull fuse too early, requiring surgical separation.
Syndromic craniosynostosis involves abnormal growth of the head and face. The shape and placement of the eyes and development of the upper and lower jaw may also be affected.
Early treatment of head shape abnormalities leads to the best outcomes.

Support Services & Resources

Visit these websites for more information on head shape abnormalities:

Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.

Learn More About Riley Support Services

Children's Craniofacial Association

This nonprofit organization addresses the medical, financial, psychosocial, emotional and educational concerns related to head shape abnormalities, including craniosynostosis, Apert syndrome, Crouzon syndrome, Pfeiffer syndrome and Saethre-Chotzen syndrome.

FACES: The National Craniofacial Association

This nonprofit organization provides education and support for families of children living with craniosynostosis.

MedlinePlus

This U.S. government site explains the causes, symptoms, diagnosis and treatment of craniosynostosis.

Locations

In addition to our primary hospital location at the Academic Health Center in Indianapolis, IN, we have convenient locations to better serve our communities throughout the state.