Deformational plagiocephaly is cranial flattening and asymmetry caused by external molding forces on an infant's skull, such as always sleeping on one side of the head. Risk factors include congenital torticollis, positional preference when sleeping, and lower activity levels. Prevention methods include alternating the infant's head position at night and increasing tummy time. Treatment options are repositioning/physiotherapy or molding helmet therapy. Craniosynostosis is premature fusion of cranial sutures and can be primary or secondary. It has a prevalence of 1 in 2,000 births and potential causes include genetic factors or untreated maternal hyperthyroidism. Symptoms seen at birth include skull

1. Deformational plagoicephaly

2. • Also called positional plagiocephaly!
• is the development of cranial flattening and asymmetry in the
infant as a result of extrinsic molding forces placed on the skull,
such as consistently sleeping on the same area of the head

3. • Risk Factors
• Congenital torticollis
• positional preference when sleeping,
• lower levels of activity
• emphasis placed on sudden infant death syndrome and the back
to sleep campaign.
• Prenatal causes of DP include uterine compression and intrauterine
• constraint, such as occurs with oligohydramnios or multifetus gestation

4. • Common in the first 4 months
• Peak at the 2.25 months
• It is also during this time that an infant’s head circumference is
rapidly increasing: about 2 cm/mo in the first 3 mo, 1 cm/mo
from 4-6 mo of age, and 0.5 cm/mo after 6 mo of age

6. • Prevention
• Alternating the infant’s head to face the head and foot of the
crib on alternate nights will allow the infant to sleep facing into
the room without always lying on the same side of the head
• Tummy time 10-15 min at least 3 times a day.

7. • Treatment
• Repositioning and physiotherapy (RPPT)
• Molding therapy (helmet therapy)

9. Craniosynostosis
defined as premature closure of the cranial sutures and is
classified as primary or secondary.
The incidence of primary craniosynostosis approximates 1 in
2,000 live births.
Cause is unknown
• abnormal development of the base of the skull creates
exaggerated forces on the dura that act to disrupt normal
cranial suture development.
• Genetic factors
• Untreated maternal hyperthyroidism

11. c/f
Usually detected at birth
Skull deformity
Palpation of the suture reveals a prominent bony ridge
fusion of the suture may be confirmed by plain skull
roentgenograms, CT scan,or bone scan in ambiguous cases

12. • Scaphocephaly…the most common type
• Frontal plagiocephaly…next most common
• Occipital plagiocephaly
• Triginocephally
• Turricephaly
• kleeblattschädel deformity

14. • The most prevalent genetic disorders associated with
craniosynostosis include Crouzon, Apert, Carpenter, Chotzen,
and Pfeiffer syndromes

15. COMPLICATIONS
• Increased intracranial pressure (ICP) and inhibition of brain growth
• Associated impairments in cognitive and neurodevelopment function,
including global developmental delay, poor feeding, and weight gain.
• Deficits in vision, hearing, and speech due to cranial nerve
involvement.
• Poor self-esteem and social isolation due to the abnormal appearance

16. Management
• Multidisciplinary approach
• Surgical repair
• To prevent icp and improve socialization