Positional plagiocephaly

Case contributed by Mostafa Elfeky
Diagnosis almost certain



Patient Data

Age: 11 months
Gender: Male

Skull deformation is noted with left occipital flattening, with an ipsilateral anterior shifting of the ear. The flattened left side of the occipital bone is opposed by nearly parallel flat right temporoparietal bones representing symmetrical deformation, mostly of positional plagiocephaly.

Mild diffuse symmetrical atrophic changes of both cerebral hemispheres, with associated secondary thinning of corpus callosum and ectasia of the ventricular system. 

Case Discussion

Positional plagiocephaly is 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 be differentiated from sutural type plagiocephaly which is a type of craniosynostosis, in which there is an asymmetric coronal and/or lambdoid sutures premature closure resulting in an asymmetrical skull deformation.

 Positional plagiocephaly is reversible with conservative measures as changing the infant's sleep position. Also, other non-surgical measures are used like helmet therapy.

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