Deformational Plagiocephaly

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Deformational Plagiocephaly
2014-03-07 18:07:30
Deformational Plagiocephaly
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  1. Deformational Plagiocephaly
    Results from the inability of an otherwise normal malleable cranial complex to grow symmetrically either as result of intrauterine constraint and/or postnatal positioning
  2. Common Types
    • Brachycephaly: short, flattening, wide
    • Dolichocephaly: long (a.k.a. scaphocephaly)
    • Deformational Plagiocephaly: flat, asymmetric
  3. Five Stages of Occipital Plagiocephaly
    • Type 1: restricted to back of skull, posterior asymmetry
    • Type 2: adds malposition to affected ear
    • Type 3: adds forehead deformity (frontal asymmetry)
    • Type 4: adds malar deformity (facial deformity, orbital dystopia)
    • Type 5: adds attempt of brain to decompress vertically or temporally (temporal bossing or posterior vertical cranial growth)
  4. Stages of Brachycephaly
    • Type 1: central posterior skull
    • Type 2: widening of posterior skull lateral to central depression
    • Type 3: attempts to decompress the brain w/ temporal or vertical skull growth
  5. Presentation of an Infant w/ Deformational Plagiocephaly
    • Asymmetrical posterior flattening
    • Anterior & inferior ear shift
    • Forehead bossing on side of flattening
    • Cheek asymmetry
    • Jaw asymmetry (chin deviates to opp side)
    • Open cranial sutures
  6. Other Causes of Persistent Cranial Abnormality
    • Craniosynostosis
    • Demineralization bone disorders
    • Depressed skull fracture
    • Tumor or hydrocephaly
    • Microcephaly
  7. Plagiocephaly Risk Factors
    • Positional preference
    • Non-varying sleep position
    • Diapering and feeding from same side
    • Decreased tummy time
    • In utero constraint
    • Torticollis or cervical imbalance
  8. Possible Outcomes for Children w/ Plagiocephaly
    • Jaw Dysfunction
    • Visual Field Constriction
    • Impaired Auditory Processing
    • Otitis Media
    • Asymmetry/Flatting of Posterior Bran & Cerebellar Vermis
    • Shortening of Corpus Callosum