There are many distinctive characteristics of brachycephaly, the most common being that the head is significantly shorter in the front to back length than usual. This can cause the front of the head to look a lot wider than would be expected, there is often a plagiocephaly as well which means that the head shape is asymmetric. The expected outcome of Brachycephaly treatment is dependent on the severity of the condition and the baby’s age – for more information on classifying the severity of brachycephaly, please read our previous post. However, if your child requires a TiMband cranial helmet or is currently undergoing treatment, here are a few key pieces of information that will help give you peace of mind while your little one makes progress.
The skull of a baby can be quite flexible, both in the bone structure and the flexible sutures between the bones. A baby with brachycephaly usually has a flattened back to the head and this often results in the lower bones at the sides of the skull, the temporal bones to become flexed. In an adult, they sit just above the top of the ear, above where the arms of sunglasses sit. It’s not unusual to notice that this area can look wider as these bones can vary in their degree of visibility, depending on the head shape.
During treatment, parents see a significant improvement in head shape, even just a few weeks into treatment and in an infant with brachycephaly, the TiMband allows the head to grow and develop from front to back, improving the overall head shape. As this happens, the flexed temporal bones above the ears might become more noticeable and this is normal. Over time as the head continues to grow and develop throughout childhood, these will become less noticeable as the overall head shape will be brought back to a much more normal shape during treatment.
Treatment for brachycephaly using a TiMband is just as effective as treatment for a plagiocephaly and whatever your baby’s head shape is at assessment, if treatment is started early enough and the helmet is used as prescribed ,we know that we can make a huge and permanent improvement to your baby’s quality of life.
If your child is currently undergoing TiMband treatment and you are concerned by any lumps, ridges or abnormalities that do not seem to be smoothing out, then make sure to show and ask the advice of the clinician at your next progress check-up. If your concern is growing, please feel free to contact us so we can set up an earlier appointment with you and your child.
If you wish to know any more information on the different types of brachycephaly treatment there are, please read our blog post, exploring a variety of different treatments. Alternatively, if you feel that your child may have brachycephaly and would like to book a no-obligation initial consultation, please get in touch.
In many cases, flat head syndrome will self-correct through repositioning, bringing it within the normal range if carried out correctly. However, where infants have a moderate or a severe flat head, this is unlikely to improve significantly without further intervention.
The question is, what constitutes mild, moderate and severe flat head syndrome?
Plagiocephaly is a relatively common condition and many parents usually notice that their babies have developed a flattening at around eight weeks of age. In the UK, it’s not uncommon for parents to be reassured by their Health Visitor (HV) and General Practitioners (GP) that their baby’s head will self-correct over time and not to be concerned, regardless of whether the condition is considered mild or severe.
Health Visitors and GP adhere to NHS guidelines and the general advice that all types of plagiocephaly will self-correct to some degree. With little information provided other than this advice, parents are then left to consider whether their baby has severe flat head syndrome and what other treatment options are available.
Head shapes can be categorised as normal, mild, moderate or severe and this depends on how far the head shape differs from the norm before treatment.
To help parents and clinicians, a scale of deformity, developed by Dr Louis Argenta is used to describe the severity of head shape deformities. This is then used as part of the decision making process of whether to go ahead with helmet treatment.
He has divided the head shapes into two groups. Firstly, plagiocephaly measures the diagonal symmetry from the outside corner of the eye to the high spot on the other side at the back of the head on both sides. The angle from the centre line is usually measured at 30 or 40 degrees from the midline. The difference in measurement can be described as a number by subtracting one from the other, this is known as the Cranial Vault Asymmetry (CVA).
It can also be described as a percentage by dividing the higher number by the lower one and multiplying by 100. The percentage scale, known as the Olbique Diagonal Difference Index (ODDI) is used in continental Europe and the number measurement is used in the UK and USA / North America.
For plagiocephaly there are five classifications:
We carry out a visual inspection of all our patients and use diagonal measurements to calculate the Cranial Vault Asymmetry (CVA) in order to determine the severity of plagiocephaly. This takes into account the difference between the diagonal head shape measurements to establish whether the head can be categorised as either mild, moderate or severe plagiocephaly.
Argenta has also classified a wide head shape, known as brachycephaly and it is not uncommon to see a combination of plagiocephaly and brachycephaly appearing at the same time.
Brachycephaly is described using three classification scales.
In an initial consultation and assessment of a baby’s head shape, three measurements are taken: circumference, width as a percentage of length from front to back, and diagonal difference. We then classify the severity on how much these measurements deviate from what is classed as the population norm.
As the normal standard deviation chart below demonstrates, treatment is recommended for the most severe five percent of infants, who fall within the moderate and severe ranges.
In a normal head shape (normocephaly), the width of the head is 78 to 83 percent of its length, and the diagonal asymmetry is no more than 6mm. If you were looking down on the head from above, the head appears as an egg or pear shape. This is the green image in the top left hand side of the diagram above.
An asymmetry of over 12mm is considered moderate, whilst a difference of over 18mm is regarded as a severe flat head. We often see asymmetries of over 25mm as well as head shapes than are wider than they are long, at significantly over 100%.
The relationship between diagonal asymmetry and width to length ratio varies, with some combinations considered more severe, and therefore more difficult to fully correct, than the milder head shapes.
To make it easy for parents to monitor the progress of their babies’ flat head syndrome, we have devised an app where you can simply upload a picture and check the head shape against outlines of real babies who have been treated.
If you think your baby may have plagiocephaly, this handy tool helps you understand how severe the deformity is. Simply upload a clear photo of the head shape and we will show you a comparison of head shapes including babies who have undergone treatment with us. You can then see the comparison of the head shapes ‘before and after’ treatment to see the results of TiMband treatment. These results are identified on our severity chart so that you can measure the improvement and see just how much improvement a plagiocephaly helmet can make to your baby’s head shape and way of life.
If you think your baby may fall into the moderate or severe plagiocephaly scale or would like a professional observation and diagnosis, Technology in Motion is here to help. We have clinics throughout the UK and offer free, no-obligation consultations and expert advice. Call us on 0330 100 1800 to book an appointment, or browse our website for more information on plagiocephaly.
Brachycephaly is a condition characterised by a flattened area at the back of the skull. Most parents notice their baby’s brachycephalic head shape when their baby is around eight weeks of age, with their baby’s head appearing wider than expected and their ears sometimes being pushed outwards. Brachycephalic head shape can also involve a slight bulging of the forehead and a wide brow. The typical treatment for brachycephaly includes repositioning or a specialist orthotic helmet, which we explain in more detail later in this post.
For babies with brachycephaly, the head is also often higher at the back and the whole back of the head can appear completely flat with the absence of any rounding towards the neck. Brachycephaly is a form of flat head syndrome and can be found either in isolation or in combination with plagiocephaly.
Plagiocephaly and Brachycephaly are two of the most common types of flat head syndrome diagnosed every year in the UK. Although the causes are the same, the two conditions describe very different head shapes and it’s important to differentiate the two in order to achieve the best results for your baby.
This blog post establishes the key differences between Plagiocephaly and Brachycephaly so you can take the next steps in finding the right treatment. (more…)