Presentation
Abnormal shape of the head.
Patient Data
Age: 2 years
Gender: Male
From the case:
Occipital plagiocephaly - unilateral
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Trapezoid shape of the head is noted.
Atrophic changes are noted in bilateral fronto-temporal lobes.
Case Discussion
The differential diagnosis for unilateral occipital plagiocephaly can be positional plagiocephaly (treated without surgery) and unilateral lambdoid synostosis (treated surgically).
- the head is parallelogram shaped when viewed from above
- the ipsilateral ear is displaced anteriorly
- no bony ridge is seen over lambdoid suture
- unilateral occipitoparietal flattening is usually seen though it can be bilateral
- when viewed posteriorly the skull base is horizontal and no occipitomastoid bulge can be seen
- the head is trapezoid shaped when viewed from above
- the ipsilateral ear is displaced posteriorly and inferiorly
- the bony ridge is palpable over the closed lambdoid suture
- unilateral occipitoparietal flattening is seen posteriorly
- when viewed posteriorly there is an ipsilateral occipitomastoid bulge and the skull base appears tilted
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