What is Brachycephaly?

Brachycephaly is a type of skull deformity in which the skull appears proportionally wide, with a reduced depth between the front and back of the skull. In addition to looking unusual, this deformity can potentially interfere with intercranial pressure and brain development, making it dangerous. For this reason, most people opt to treat brachycephaly.

This condition is usually noticed in infants who are a few months old. Initially the skull may look normal, but over time, it fails to develop evenly. Parents may notice that the children have unusually shaped heads, and physicians may take note of abnormal skull development and suggest testing to determine the cause of the unusual head shape.

There are two reasons for brachycephaly to occur. The first is craniosynostosis, in which one or more of the sutures of the skull close prematurely. When people are born, rather than being solid, the skull is made from several moving pieces of bone. These pieces of bone gradually fuse together, allowing the brain room to grow and eventually fusing into a solid skull. The joins between the pieces of bone are known as “sutures.” In the case of brachycephaly, the coronal sutures of the skull fuse too early, preventing the skull from growing normally.

A closely related condition is plagiocephaly, in which only one of the coronal sutures fuses too early. Children with this condition develop swelling on one side of the head. The skull can also develop an elongated shape in scaphocephaly, caused by premature fusion of the sagittal suture.

The treatment for brachycephaly caused by premature closing of the coronal sutures is surgery to pull the sutures apart again, giving the brain more room to grow. The surgery is performed when the child is less than one year of age, and it does carry some risks for the patient, including the risks which accompany the anesthesia necessary to reduce pain and discomfort for the patient.

Brachycephaly can also be a positional deformity, caused by keeping an infant on his or her back too much. Sleeping on the back is recommended to reduce the risk of sudden infant death syndrome (SIDS), but it can result in positional deformities as a result of pressure on the skull which causes it to develop unevenly. The solution to a positional deformity can involve a wait and see approach, along with the use of padding to relieve pressure on the skull. For extreme cases, the infant may need to wear a helmet for several months which will help the skull develop evenly.