Positional plagiocephaly

Case contributed by Dalia Ibrahim
Diagnosis certain

Presentation

Abnormal head configuration (abnormally flat right posterior head shape), his physician suspects craniosynostosis.

Patient Data

Age: 3 months
Gender: Male
ct

Right occipitopareital flattening (Positional plagiocephaly).

The 3D reconstruction images clearly illustrates the normal calvarial sutures and fontanels (with no evidence of craniosynostosis).

Widening of the bifrontal and anterior interhemispheric CSF spaces (benign external hydrocephalus)

Annotated image

Comparison between normal infant (at the left) and an infant patient with positional plagiocephaly (at the right)

Case Discussion

Positional plagiocephaly refers to a calvarial deformation that results from external pressure after birth when an infant is consistently placed in the same position for rest and sleep.

It should not be confused with Plagiocephaly refers to a type of craniosynostosis in which there is an asymmetric coronal and/or lambdoid sutures premature closure,

The treatment for positional plagiocephaly and craniosynostosis is completely different with the latter treated surgically while the former treated usually medically.  

Benign external hydrocephalus is benign enlargement of subarachnoid spaces seen in infancy. It usually involves the frontal lobe subarachnoid spaces. 

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