Definition: Brachycephaly refers to the condition where the head is disproportionately wide (see cranial index).  Brachycephaly can result from the premature fusion of the coronal sutures (see craniosynostosis) or from external deformation (most commonly prolonged lying on the back -- a positional deformity).  The head flattens uniformly, causing a much wider and shorter head. Increased head height is also common in children with brachycephaly.

Brachycephaly--resulting from early closure of the coronal sutures (i.e., craniosynostosis)--is also present in many syndromal abnormalities, such as Apert, Crouzon, Pfeiffer, Saethre-Chotzen and Carpenters syndromes.

Images of brachycephaly provided courtesy of Cranial Technologies, Inc.

Incidence:

Diagnosis: The diagnosis begins with an examination by a pediatrician, pediatric neurosurgeon or craniofacial surgeon. A primary objective of the examination is to rule out craniosynostosis (a condition that requires surgical correction). The initial examination involves questions about gestation, birth, in utero and post-natal positioning (for example, sleeping position). The physical examination includes inspection of the infant's head and may involve palpation (carefully feeling) of the child's skull for suture ridges and soft spots (the fontanelles). The physician may also request x-rays or computerized tomography (a CAT scan, a series of photographic images of the skull). These images provide the most reliable method for diagnosing premature fusion of the coronal sutures (craniosynostosis). In addition, the physician may make (or order) a series of measurements from the child's face and head [more on cranial anthropometry]. These measurements will be used to assess severity and monitor treatment.

Treatment: The treatment of brachycephaly depends upon the etiology (cause) of the condition:

• Brachycephaly resulting from fusion of the coronal sutures (craniosynostosis) must be treated surgically. Parents should consult a pediatric neurosurgeon or a craniofacial surgeon to discuss treatment option.
  
• Depending upon severity, brachycephaly resulting from external/positional deformation can be treated with repositioning and/or head banding. Parents should consult a pediatrician, a pediatric neurosurgeon or a craniofacial surgeon for information on repositioning and/or for referral and a prescription for head banding.

Support Groups:

• Plagiocephaly Parents Support
• CAPPS Kids
• CranioChat.org
• Apert listserv
• Crouzon Support Network

Parent/Child Experiences

• If you have a website with an experience you wish to share, please contact

Recommended Links:

• An image of the skull of a newborn showing the location of major bones and sutures [source: Medline Plus]