Positional Plagiocephaly Diagnosis, Prevention, Treatment, Monitoring Referral

1. Positional Plagiocephaly
1. Diagnosis,
2. Prevention,
3. Treatment,
4. Monitoring
5. Referral

2. 1. Diagnosis:
 Head Shape Deformity or Severity
Index Assessment.
 Using Scientific tools
 Not rely only on bare eye observation
and personal judgement.

3. Scientific Cranio Measurement
Tools
Antique
Modern

4. Measurement With European CE
approved Craniometer

5. i) Preparation
1. 2. 3.
Align to the nose for consistent reference

6. ii) Plagiocephaly Measurement
1. 2.Reading (A)
Reading (B)

7. Plagiocephaly Index Calculation
Index = |A – B |
*Note: Example of Calculation
A = 120mm, B= 130mm
Index = |120 – 130|
= |-10|
=10mm
Or Index = 130 – 120
= 10mm
* Simple 

8. Index Severity reference:
Mild, Moderate or severe ?
Based on two factors:
1) Severity index
2) Age of the Baby

9. Age (Month)
Index(mm)
Plagiocephaly Severity Chart
Based on two factors:
1) Severity index
2) Age of the Baby

10. Age (Month)
Index(mm)
Plagiocephaly Severity Chart
Example:
Index = 10mm
Age = 4 Month
Severity

11. 2-3) Prevention, Treatment and
Maximum Recovery
Base on the Severity index and Age of
the baby

12. Babies Head Grows from WHO
1) Baby’s head grow rapidly at the 1st 18month of life.
2) Also the head skull is still soft and malleable
3) Therefore …see next page

13. 3) Therefore deformity regrow opportunity is great following this “Maximum recovery curve”
• Example: Max recovery expected
• at 4m = 19mm
• at 9m = 7mm

14. Protocol and Guideline for Treatment
Again base on the severity index and Age:
• Health professional advice for natural intervention and treatment for index within the zone
• Standard Natural treatment including the following
1. repositioning
2. Tummy time to play
3. Back to Sleep with Pressure distribution Mimos Medical pillow

15. 4. Monitoring
*Progressive measurement and follow-up for reassurance
• Repeat the measurement every 2 weeks
• Record the reading on the chart
The reading will normally follow the curve as below example
This will reassure all the mention treatment techniques works

16. 5. Referral
** If the reading do not show improvement,
-> Referral to paediatric or Neurosurgeon for evaluation.
This is to rule out the possibility for Craniosynostosis
• Note:
• Orthotic helmet treatment may be required, but cannot start before 6 month of age.
• If torticollis involve, please get help physiotherapist or Cranio osteopathy.

17. Brachycephaly and Scaphocephaly
Measurement
1. 2.

18. Brachycephaly Index
*Cranial Index (CI)
Note: CI varies slightly from male to
female and amongst races we can
safely consider 78% as a general
average
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19. Age (Month)
CI(%)