Skull Shape Deformities in Babies

Quick answer: Skull shape deformities in babies are divided into two main groups: positional deformities (plagiocephaly, brachycephaly, scaphocephaly) that develop due to external pressure, and synostotic deformities (craniosynostosis) caused by premature fusion of cranial sutures. Treatment ranges from repositioning and helmet therapy to surgery, depending on the type.

What Is Skull Deformity?

Skull shape deformities in babies include positional deformities (plagiocephaly, brachycephaly, scaphocephaly) that develop due to external pressure and synostotic deformities (craniosynostosis) caused by the premature fusion of cranial sutures. Depending on the type, treatment ranges from repositioning and helmet therapy to surgical intervention.

Positional Deformities

Positional skull deformities occur when a baby’s soft skull is subjected to prolonged pressure in one direction. Because a newborn’s skull bones have not yet fused, they can be shaped by external forces. These deformities are not dangerous in themselves, but if left untreated they can become permanent.

• Plagiocephaly: Asymmetric oblique flattening. One side of the back of the head flattens and, as a result, the ear and forehead on the same side shift forward. It often accompanies torticollis.
• Brachycephaly: Symmetric flattening of the back of the head. The entire back of the skull becomes flat and the head widens to the sides. The cephalic index exceeds 86.
• Scaphocephaly: The head is elongated front-to-back and narrow. It occurs because the baby lies on their side all the time, or in premature babies who spend prolonged periods in incubators.

Synostotic Deformities (Craniosynostosis)

Unlike positional deformities, synostotic deformities arise from the early fusion (synostosis) of one or more of the suture lines between the skull bones. This restricts the normal growth of the brain and skull.

• Craniosynostosis: General term for premature fusion of any cranial suture. Surgical intervention is usually required.
• Sagittal Craniosynostosis: Premature fusion of the sagittal suture running across the top of the skull. The head elongates front-to-back (scaphocephaly / dolichocephaly).
• Trigonocephaly – Metopic Synostosis: Premature fusion of the metopic suture at the front of the skull. The forehead takes on a triangular appearance and the temples narrow.

Positional vs Synostotic: How to Tell Them Apart

The most important distinction between the two groups concerns whether the cranial sutures are open or closed.

• Positional deformities: All sutures are open. Treatment with repositioning, tummy time, or helmet therapy is possible.
• Synostotic deformities: One or more sutures are fused. Surgical treatment is required. The earlier it is diagnosed, the better the surgical outcomes.

Diagnosis is made through clinical examination, cranial measurement (cephalometry), and if necessary imaging methods (ultrasound, CT). A key point: if there is raised intracranial pressure, severe neurological symptoms, or abnormal fontanelle findings alongside skull deformity, a paediatric neurosurgeon should be consulted immediately.

Treatment Overview

For comprehensive information about head shaping methods, please see our Head Shaping Methods for Babies article.