Brachycephaly is the shape of a skull shorter than typical for its species. It
is a normal variation in some domesticated dog and cat breeds, and can
be normal or abnormal in other animal species. In humans, the cephalic
disorder is known as flat head syndrome, and results from premature fusion of the
coronal sutures or from external deformation. The coronal suture is the
fibrous joint that unites the frontal bone with the two parietal bones of the
skull. The parietal bones form the top and sides of the skull. This feature can
be seen in Down syndrome. In anthropology, human populations have
been characterized as either dolichocephalic, mesaticephalic, or
brachycephalic. The usefulness of the cephalic index was questioned by
Giuseppe Sergi, who argued that cranial morphology provided a better means to
model racial ancestry. The incidence of brachycephaly in people
has increased dramatically since the advent of sudden infant death syndrome
recommendations for parents to keep their babies on their backs. It is
considered a cosmetic problem. Many pediatricians remain unaware of the
issue and possible treatments. Treatments include regular prone
repositioning of babies. There are also cases of brachycephaly
associated with plagiocephaly, this deformity occurs when there is a
combination of brachycephaly and plagiocephaly present. Brachycephaly
with plagiocephaly is positional and has become more prevalent since the "Back to
Sleep" Campaign.The Back to Sleep campaign began in 1994 as a way to
educate parents, caregivers, and health care providers about ways to reduce the
risk for sudden infant death syndrome. The campaign was named for its
recommendation to place healthy babies on their backs to sleep. Placing babies
on their backs to sleep reduces the risk for SIDS, also known as "crib death."
This campaign has been successful in promoting infant back sleeping and other
risk-reduction strategies to parents, family members, child care providers,
health professionals, and all other caregivers of infants, at a cost of
increasing the incidence of this deformation of the head.
Brachycephaly also describes a developmentally normal type of skull
with a high cephalic index, such as in snub-nosed breeds of dog such pugs and
bulldogs or cats such as the Persian, Exotic and Himalayan.
Treatment Brachycephaly can be corrected with a
cranial remolding orthoses which provide painless total contact over the
prominent areas of the skull and leave voids over the flattened areas to
provide a pathway for more symmetrical skull growth. Treatment generally takes
3–4 months, but varies depending on the infant's age and severity of the cranial
asymmetry. However studies by scientists in the
Netherlands have found there was no significant difference over time between
infants treated with helmets and infants left untreated. All parents of infants
treated with helmets confirmed negative side effects including skin irritation
and sweating. This study focused only on patients with mild to moderate cases,
the participation rate was only 21%, and there was a 73% reporting of fitting
issues, calling into question the validity of the study. Incorrectly fit
devices cannot be expected to yield results. Additionally, independent
published research that examined the effectiveness of helmet therapy conclude
that as many as 95% of patients demonstrate an improvement in head shape
symmetry following helmet therapy, and the American Orthotics and Prosthetics
Association has serious concerns about the relevance and validity of this
study. See also
Craniosynostosis Plagiocephaly
Cephalic index Safe to Sleep
Artificial cranial deformation External links
1295319074 at GPnotebook NINDS Overview
References