![]() However, most studies suggest that a properly fitted helmet orthosis corrects asymmetry more rapidly and to a greater degree than repositioning. Repositioning education is effective in affording some degree of correction in virtually all infants with positional plagiocephaly. The management of positional skull deformation is nonsurgical and involves ruling out craniosynostosis and determining the timing and need for intervention such as physical therapy or helmet orthosis. MRI has no role in the diagnosis of positional plagiocephaly. Imaging ultimately may be necessary in unusual cases.ĬT scan is the gold standard for diagnosis of craniosynostosis and should be used sparingly in cases when the benefit of the diagnosis is worth the radiation exposure. If it is not clear from the clinical examination, referral to an expert in cranial deformities is warranted. The diagnosis of positional plagiocephaly is made clinically. They can be perpetuated by postnatal sleeping position and exacerbated by concurrent torticollis or other neuromuscular conditions. Positional skull deformities can result from intrauterine constraint or extrauterine deformation. In the guidelines, the term positional plagiocephaly encompasses both positional occipital plagiocephaly (unilateral flattening of parieto-occipital region, compensatory anterior shift of the ipsilateral ear, bulging of the ipsilateral forehead) and positional brachycephaly (symmetric flattening of the occiput, foreshortened anterior-posterior dimension of the skull, compensatory biparietal widening) and the combination of both of these deformities. The guidelines are published in CNS’ journal Neurosurgery and have been endorsed by the Academy. The task force made 10 recommendations pertaining to imaging diagnosis, repositioning, physical therapy and helmet orthoses. Nearly 400 abstracts were reviewed yielding 110 articles for full review 60 were deemed relevant. A multidisciplinary task force conducted a systematic review of the literature from 1966 to October 2014 on pediatric plagiocephaly. The incidence has increased since the Academy initiated the Back to Sleep campaign in 1994 to prevent sudden infant death syndrome.ĭue to practice variation in diagnosis and treatment paradigms for this common condition, the Joint Section on Pediatric Neurosurgery of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons (CNS) sought to develop evidence-based management guidelines. infants has some degree of positional plagiocephaly. Positional plagiocephaly is a common condition encountered by pediatricians and referred to pediatric subspecialty physicians such as neurosurgeons and plastic surgeons.Ībout one in four U.S.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |