Plagiocephaly Flashcards
Cranial Deformities Develop
In response to prenatal and postnatal Forces acting on the infant skull
Does NOT affect brain development
History
Increase in cases over the last 10-15 years when the “Back to Sleep” program was initiated to reduce the incidence of SIDS
3 Patterns
Plagiocephaly
Brachycephaly
Scaphocephaly
Force on the skull due to
Reduced tummy time
Multiple birth
First-born
Premature birth
Vacuum/forceps assisted delivery
Torticollis
Positional sleep preference
Slow motor development
Plagiocephaly
Flattened side corresponds with anterior positioning of the ipsilateral ear and forehead
Measurements:
Long oblique Short oblique Med-lat Ant-post Head circumference
Discrepancy= Long oblique - short oblique
Severity
0-3mm = normal
6-10mm = mild
10-15mm = moderate
> 15mm = severe
Bradycephaly
Diagnosis: flattened occipital area only
Head has a trapezoidal shape to it
Critical Measurements:
Med-Lat
Ant-post
Head circumference
Long oblique, short oblique = usually within normal limits (0-3mm)
Discrepancy: med-lat vs ant-post
Severity Ant-post = med-lat = severe Ant-post + 5mm = moderate Ant-post + 10mm = mild Ant-post + 15 to 20 mm = Normal
Scaphocephaly
Elongation of cranial vault
Least common of all types
Critical Measurements
med-lat
ant-post
head circumference
Long oblique, short oblique = very difficult to measure
Focus on controlling the length and allowing the width to improve
Craniosynostosis
Fusion of the sagittal suture resulting in elongation for the cranial vault
Head has a long narrow appearance to it
Helmet is not indicated as the fused suture will prevent any correction
Options: Surgery is the only option with the possibility of using a helmet to help with final correction
Best time to treat
under 3-4 months = repositioning is equally effective
4-6 MONTHS - appropriate for those who have not seen improvements with repositioning
-BEST time for orthotic intervention due to rapid growth and malleability of skull
8-12 months - correction occurs at a much smaller rate
12-15 months - improvements with helmet less likely as skull becomes progressively less malleable
15> Very slow correction if any
How cranial helmets work for plagiocephaly
Passive function:
Orthotist modifies cast to create a space between the helmet and skull over the short dimension
Infant’s head grows in path of least resistance
Worn 24 hours per day
Skin redness and rotation are largest complications
More info: Clinician’s Guide to Positional Plagiocephaly
Different Companies
Cranial Technologies
Starband- Orthomerica (use STARscanner)
