What Is Positional Plagiocephaly?
Top of head of child with positional plagiocephaly (drawn by Huang MHS)
Positional or deformational plagiocephaly refers to an asymmetric or lopsided head shape typically with flattening in one area caused by an external force or pressure.
The term comes from the Greek plagio (oblique) and cephale (head). The cause of positional plagiocephaly is pressure on the bones of the skull either before or after birth.
It is different from synostotic plagiocephaly, which is caused by early closure of the sutures in the skull and requires surgery.
Positional Plagiocephaly in Children
Plagiocephaly is caused by pressure on the bones of the skull before or after birth produced by such factors as a constricted position in the womb or by a baby's positional preference (how they like to lie) in the first several months of life.
Several risk factors are linked with positional plagiocephaly.
Infants with torticollis (a limited range of motion in the neck due to muscle tightness) have a strong preference to look in one direction and are at increased risk for developing plagiocephaly, since they always rest on the same spot on the back of their head.
Premature infants are also at increased risk because their skull bones are soft and they have reduced spontaneous head movement.
In very premature babies this can result in dolichocephaly of prematurity, a long (dolichos) and narrow head (cephale).
Children from multiple pregnancies (twins, triplets, etc.) and babies born to mothers with unusually shaped wombs or uterine fibroids (benign tumors made of fibrous and muscular tissue) have an increased risk of positional plagiocephaly because they are often crowded in the womb.
Children with multiple medical problems or delayed development may have a hard time changing positions and are at increased risk for developing the condition.
Positional Plagiocephaly at Seattle Children’s
Our Craniofacial Center has a special clinic devoted to evaluating and treating positional plagiocephaly. We evaluate and treat almost 600 children per year for this condition.