Head Shape

There are a variety of causes of abnormal head shapes in babies. Early evaluation is important in an infant with an abnormal head shape in order to determine the cause and plan a course of treatment. Riley Hospital for Children at IU Health treats more head-shape differences than any hospital in Indiana.

Positional Plagiocephaly

The bones that make up a baby’s skull are thin and flexible. Constant pressure in one area of the skull can alter its shape, which is called plagiocephaly (skull molding), which is one of the most common forms of an abnormal head shape.

Many babies spend almost all of their time on their backs. Safe sleeping guidelines call for baby to sleep on his or her back. Car seats, strollers and other carries often also position babies on their backs. Babies with plagiocephaly often have noticeable flatness on the backs or sides of their head, and there is commonly little hair in those areas.

In other cases, your child may have a tight neck muscle causing a persistent twist of the neck to one side (torticollis). As your child lies down, one area of the head is consistently pressed against the bed surface and the area flattens.

How is Plagiocephaly treated?

Treating an infant with plagiocephaly starts with encouraging parents to reposition their baby onto its side or stomach to relieve pressure on the side or back of the head.

Infants with torticollis require dedicated physical therapy to stretch and straighten the neck. Through successful treatment of the torticollis, the head flattening usually improves.

In more severe cases, your doctor may prescribe a special helmet that helps distribute pressure around the baby’s entire head. That distribution of pressure helps prevent further flattening and promotes growth to a more rounded head shape.

Early intervention in the treatment of plagiocephaly is recommended to achieve the best results.

Craniosynostosis

Craniosynostosis means fused bones of the skull. The skull is made up of many bones that fit together like a puzzle. The place where the bones eventually grow together and fuse is called a suture. If one of the sutures fuses too early, growth can not continue in that area. This inability to grow normally results in an abnormally-shaped skull.

How is Craniosynostosis treated?

X-ray technology is often utilized to diagnose craniosynostosis. This may involve a traditional x-ray, or a CT scan, which at Riley Hospital for Children at IU Health gives doctors a three-dimensional view of the bones of the head.

If the CT scan shows craniosysostosis, surgery will be recommended. This procedure is performed with our pediatric neurosurgery team. Surgery to separate the bones helps relieve pressure in the skull, which allows the brain to expand and the bones to grow in a more normal shape.

Syndromic Craniosynostosis

In rare cases, multiple sutures in the skull fuse too early. This results in a variety of different syndromes, among them:

Apert syndrome: involves abnormal growth of the head and face. The shape and placement of the eyes and development of the upper jaw are commonly affected. Children with Apert’s have webbed fingers and toes, and may also have a cleft palate.

Crouzon syndrome: involves abnormal growth of the head and face. The shape and placement of the eyes and development of both the upper and lower jaws are commonly affected.

Pfeiffer syndrome: involves abnormal growth of the head and face. The shape of the forehead and nose, the position of the eyes and development of the upper jaw are commonly affected. Children with Pfieffer’s syndrome may also have crowded teeth and thumbs and toes that appear broadened.

Saethre-Chotzen syndrome: involves abnormal growth of the head and face. The shape and position of the eyes and nose, and development of the upper jaw may be affected. Children with Saethre-Chotzen may also have low hairlines and short or fused fingers.

Following a clinical exam by multiple experts on the craniofacial anomalies team, diagnostic x-rays, including 3-D CT scans, are almost always recommended. The family may also be referred to a genetics expert for counseling.

How is Multiple Suture Craniosynostosis treated?

Surgical intervention is necessary to treat multiple suture craniosynostosis. Several surgeries will be required to correct the problem as the child continues to grow and develop. Early intervention is recommended to achieve the best outcomes.

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