PEDIATRIC NEUROSURGERY

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Deformational or positional plagiocephaly is a condition in which a baby’s head has an uneven or irregular shape. It may occur prior to birth as a result of pressure inside the uterus, but it can also happen after birth. The condition is frequently associated with another disorder, torticollis.

Deformational plagiocephaly can occur in the uterus or develop after birth. Babies that drop into the mother’s pelvis well before delivery, causing the head to rest against a flat surface, may develop deformational plagiocephaly. Unusually large babies, breech babies and multiple birth babies are also at increased risk. Intrauterine pressure from a small or misshapen uterus, or insufficient amounts of amniotic fluid, can be another factor. After birth, the condition is caused by the baby frequently lying in the same position. Premature babies with their especially soft skulls are most susceptible to severe forms of this disorder but it can also occur in normal full term newborns. Once the deformity occurs, the head naturally rests on the slightlyflattened area, potentially worsening the flattening.

More than 80 percent of the brain’s growth occurs during the first 13 months of life. If an infant has mild deformational plagiocephaly, it usually corrects itself with attention to positioning maneuvers. If not, infants can begin wearing a craniofacial orthosis (a custom-made brace for the skull) between the ages of four to eight months. After 12 to 13 months of age, the use of an orthosis is not as effective and is less likely to change the shape of the baby’s head. How can I tell if my baby’s head shape is normal and what does it mean if it is not? Your pediatrician or family doctor is well trained in watching for disorders of development and is the first line of resource if you are uncertain. If they see that the head shape is not normal, they will consult with or refer you to a pediatric neurosurgeon who is a craniofacial expert.

Please contact NSPC (631) 983-8400 for more information or to schedule an appointment.