Abnormal shape of head

Question 1

Brachycephaly definition and causes

Answer 1

Definition - Decrease AP diameter of head and increased the transverse one

1. Downs
2. Hypotonic infants due to prolonged immobility
3. Bilateral fusion of coronal sutures, associated with mental retardation, cerebral anomalies, cleft palate, Syn/ polydactyly

Question 2

Plagiocephaly definition and causes

Answer 2

Asymmetric suture fusion

1. Hypotonia or MD due to prolonged immobility/ Preterm infants
2. Infantile idiopathic scoliosis
3. Premature fusion of coronal suture on one side

Question 3

Scaphocephaly definition and causes

Answer 3

Increased AP diameter

1. Fusion of sagittal sutures
2. Preterm infants
3. Hurler’s Syndrome
4. Marfan’s Syndrome

Question 4

Trigonocephaly definition and causes

Answer 4

Wedge-shape skull with pointing anteriorly

1. Fusion of metopic sutures
2. Maternal Barbiturates in early pregnancy
3. Associated with Hypoplasia of forebrain and Hypotelorism

Question 5

Acrocephaly definition and causes

Answer 5

Due to premature of sagittal, Coronal and Lambdoid sutures so that skull points upwards- increased height

1. Acrocephalo-syndactyly - Apart’s; Pfeiffer Syndrome
2. Acrocephalo-polysyndactyly - Carpenter; Noack Syn
3. Craniofacial dysostosis - Crouzon Syn

Question 6

Steps in Clinical examination of Abnormal shape of skull

Answer 6

1. Note the abnormal shape of skull
2. Examination of head as usual - Comment if with evidence of raised ICP
   a. Note
   Size; Shape; Dilated veins; Sun-set eyes; Propotosis; Cataract; Nystagmus; Any Scars
   b. Feel:
   Measure the head circumference
   Sutures- Widening; Overlapping
   Fontanelles (Ant and Posterior)- Tension ?bulging
   Consistency of skull
   VP Shunt
   c. Auscultate for cranial bruits
3. Note any facial dysmorphism
4. Examine hands for anomaly
5. Access one’s neurological and developmental status