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Deformational plagiocephaly is a flattened, misshapen or asymmetrical head caused by repeated pressure to the same area of the skull. Deformational brachycephaly is symmetrical flattening of the head.


Deformational plagiocephaly may be present at birth but can also occur after birth. If children tend to favor one side repeatedly when they are put to sleep on their backs, flattening can occur due to the repeated pressure on that one side of the skull. Tightness of the neck on one-side (torticollis) can also lead to deformation plagiocephaly. Deformational plagiocephaly is very common, and can usually be diagnosed with a thorough physical evaluation by a clinician who specializes in treating craniofacial differences. Sometimes, imaging may be done to rule out other causes of abnormal head shape (craniosynostosis). These conditions often require surgical treatment, and if left untreated, may result in pressure in the brain.


In most babies whose deformational head shape is due to sleeping position, simple repositioning of the child to place them off the flattened area and treatment of torticollis if present will resolve the problem. Torticollis treatment involves physical therapy referral for neck exercises. If repositioning is not successful, or if the condition is moderate or severe then helmet therapy may be required. Helmet therapy works by fitting the skull tightly with a specially designed helmet in all areas except where it is flat. Leaving extra room around the flat area of the head allows the skull and brain to grow back into the normal shape. As the head grows, adjustments are made to the helmet every few weeks. Fortunately to date, no studies have shown that the flattened area of the skull leads to any compromise in brain function.