Craniosynostosis
Overview
Craniosynostosis describes the premature fusion of the skull sutures. The skull then expands in the direction of the remaining non-fused sutures giving rise to an abnormal head shape and facial features.
If untreated, it can lead to elevated intracranial pressure (such as nausea, vomiting, reduced consciousness, seizures, and coma), visual and hearing impairment, poor feeding, and developmental delays.
Investigations
Children with suspected craniosynostosis should be referred to a paediatrician:
- Skull X-ray:
- identifies craniosynostosis
- In some cases, a CT head may be performed
Management
Management may involve watching and waiting or surgical reconstruction. If treated early, most children do not have any long-term complications except for a scar at the top of their head if they have surgery.
Plagiocephaly and Brachycephaly
Overview
Plagiocephaly describes the flattening of the side of the head giving it a parallelogram shape when seen from above. Brachycephaly describes the flattening of the back of the head. They can affect up to 1 in 5 babies.
Both plagiocephaly and brachycephaly have increased in incidence as parents are advised to have their babies sleep on their backs to reduce the risk of sudden infant death syndrome.
- It is essential that the baby still sleeps on their back to keep this risk reduced
Management
As long as craniosynostosis and congenital muscular torticollis (CMT) are ruled out, reassurance is generally enough as the head shape usually returns to normal as the child grows.
CMT may be possible if the baby has difficulty with turning their head and may require physiotherapy.
