RT Journal Article
SR Electronic
T1 Occipital plagiocephaly: unilateral lambdoid synostosis versus positional plagiocephaly
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 152
OP 157
DO 10.1136/archdischild-2014-305944
VO 100
IS 2
A1 Christian Linz
A1 Hartmut Collmann
A1 Philipp Meyer-Marcotty
A1 Hartmut Böhm
A1 Jürgen Krauß
A1 Urs D Müller-Richter
A1 Ralf-Ingo Ernestus
A1 Johannes Wirbelauer
A1 Alexander C Kübler
A1 Tilmann Schweitzer
YR 2015
UL http://adc.bmj.com/content/100/2/152.abstract
AB Objective We defined parameters that could differentiate between positional and synostotic plagiocephaly and defined a diagnostic chart for decision making. Design Prospective study. Setting We examined 411 children with non-syndromic skull abnormalities between January 2011 and December 2012. Participants A total of 8 infants under 1 year of age with proven unilateral non-syndromic lambdoid synostosis (LS) and 261 children with positional deformity were examined to outline the specific clinical features of both diagnoses. After clinical examination, an ultrasound revealed either a closed suture suggestive of LS or a patent lambdoid suture suggestive of positional deformity. For patients with synostosis, plain radiographs, MR imaging and follow-up examinations were performed. In cases of open sutures, only follow-ups were completed. Main outcome measure Clinical, imaging, genesis and treatment differences between positional plagiocephaly and LS. Results In all 8 cases of unilateral LS and 258 cases of positional plagiocephaly, the diagnosis was established by clinical examination alone. In three cases of positional plagiocephaly, diagnosis was determined after an additional ultrasonography. MR imaging revealed a unilateral tonsillar herniation in five of the eight children with LS and hydrocephalus in one child. Conclusions We have suggested a list of clinical features that specify the underlying cause of posterior plagiocephaly. An additional ultrasound scanning confirmed the diagnosis without any risks of ionising radiation or sedation as in a CT scan.