Brachycephaly is a skull deformity that can interfere with brain development and intercranial pressure. It can be caused by premature closing of the coronal sutures or a positional deformity. Treatment involves surgery or a wait-and-see approach with padding or a helmet.
Brachycephaly is a type of skull deformity in which the skull appears proportionally wide, with little depth between the front and back of the skull. In addition to looking unusual, this deformity has the potential to interfere with intercranial pressure and brain development, making it dangerous. For this reason, most people choose to have brachycephaly treated.
This condition is usually seen in babies a few months old. Initially the skull may appear normal, but over time it fails to develop evenly. Parents may notice that children have unusually shaped heads, and doctors may take note of abnormal skull development and suggest tests to determine the cause of the unusual head shape.
There are two reasons brachycephaly occurs. The first is craniosynostosis, in which one or more sutures in the skull close prematurely. When people are born, rather than being solid, the skull is made up of several moving pieces of bone. These pieces of bone gradually fuse together, allowing the brain chamber to grow and eventually fuse into a solid skull. The joints between the pieces of bone are known as “sutures”. In the case of brachycephaly, the coronal sutures of the skull fuse too soon, preventing the skull from growing normally.
A closely related condition is plagiocephaly, in which only one of the coronal sutures fuses too soon. Babies with this condition develop swelling on one side of their head. The skull may also develop an elongated shape in scaphocephaly, caused by premature fusion of the sagittal suture.
Treatment for brachycephaly caused by premature closing of the coronal sutures is surgery to separate the sutures again, giving the brain more room to grow. The surgery is performed when the child is less than one year of age and carries certain risks for the patient, including the risks that accompany the anesthesia needed to reduce pain and discomfort for the patient.
Brachycephaly can also be a positional deformity, caused by holding a baby too much on your back. Sleeping on your back is recommended to reduce the risk of Sudden Infant Death Syndrome (SIDS), but it can lead to positional deformities due to pressure on the skull causing it to develop unevenly. The solution to a positional deformity may involve a wait-and-see approach, along with the use of padding to relieve pressure on the skull. For extreme cases, the child may need to wear a helmet for several months which will help the skull develop evenly.
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