Head shape differences are typically recognized at birth or shortly thereafter. There are three main causes of an abnormal head shape in infants. The most common are those children who have positional changes due to external pressure on the head. This is called deformational or positional plagiocephaly. Craniosynostosis is another cause, which is due to fusion of the internal fibrous joints (cranial sutures) between the skull bones. A more rare cause involves infants born with craniofacial syndromes, such as Apert, Antley-Bixler, Crouzon, Seathre-Chotzen, Carpenter, Pfeiffer, Munke, and craniofrontonasal dysplagia. No matter the diagnosis, Dr. Snider brings her specialized craniofacial training and expertise in treating complex syndromes to treat your child with any head shape concern.
Deformational, or positional, plagiocephaly and brachicephaly develop when a baby has a large flat spot on one or both sides of the back of the head. It is thought to be first caused by the positioning of the baby in the womb, but may not be fully perceptible at birth. After birth, the flattened area may initially worsen due to the baby’s sleeping position or because of tight neck muscles (torticolis) that result in preferential head-turning. Positional plagiocephaly can mimic craniosynostosis; however, there is no abnormal fusion of the skull bones and it does not require surgical intervention for correction. Positional plagiocephaly typically improves within the first year of life as the baby grows and develops rapidly. Dr. Snider will provide you with the most up-to-date information and treatment plan based on your child’s needs.
Since the start of the Back to Sleep campaign in 1992, which recommends placing babies on their backs when sleeping to reduce the risk of sudden infant death syndrome, there has been a dramatic increase in the number of children affected by positional plagiocephaly. Cranial orthosis, or helmet therapy, has therefore become increasingly popular. The idea being that the helmet prevents further external pressure, and the rapidly growing brain corrects the flat spot from internally. Helmet therapy typically begins before 6 months of age and last for 6 months. Dr. Snider will work with you and your family to create an individualized plan for the treatment of your child’s head shape changes.
Craniosynostosis is a condition in which the skull bones fuse at one or more cranial suture lines. This is thought to occur due to the positioning of the baby in the womb, which leads to increased compression of the baby’s head. When craniosynostosis occurs, it results in an asymmetric head shape that is distinctly characteristic for each specific suture that fuses. This fusion of the skull bones can have an impact on your child’s future head growth and development and often requires surgical intervention to place the bones in the proper position. Dr. Snider believes in the upmost safety of your child from day one, and therefore, she limits the use of x-rays or radiation-induced CT scans. If your child has craniosynostosis, Dr. Snider will create an individualized plan to limit the number of diagnostic tests and procedures, while maximizing your child’s safety, growth, development, and long-term result.
Syndromic craniosynostosis can be identified in children born with specific gene mutations that cause syndromes such as Apert, Antley-Bixler, Crouzon, Seathre-Chotzen, Carpenter, Pfeiffer, Munke, and craniofrontonasal dysplagia. These gene mutations, typically FGFR1, FGFR2, FGFR3, TWIST1, or EFNB1, cause problems with bone development in the skull and face, as well as the hands and feet. There are variances of gene expressivity, but typically, bicoronal craniosynostosis is present which causes the head to be taller than average and flat in the front. The face can have a scalloped appearance with prominent eyes. In some syndromes, the fingers and toes are fused (syndactyly). Treating these complex syndromes requires a thorough multidisciplinary approach often including a pediatric neurosurgeon, geneticist, and other specialties such as pediatric surgery and otolaryngology. Dr. Snider will help facilitate the ideal team for your child, and work closely with you and your family to create the best short and long-term plan to reform and restore your child’s appearance and functional abilities. Your child’s bone structure will require surgical intervention during a time of growth and development, and therefore, it is imperative to have a strategic plan regarding the type and timing of each procedure for the greatest safety, success and lasting result. Dr. Snider is devoted to providing a lasting positive contribution to you and to the life of your child.
“Children are remarkably resilient and courageous. I want to soften the burden for those children born with congenital medical conditions and give them as normal of a life as possible. Doing the right procedure at the right time can lessen the burden and provide better lasting results.”