Anterior plagiocephaly: epidemiology, clinical findings,diagnosis, and classification. A review.

Abstract

INTRODUCTION:

Anterior plagiocephaly due to the early unilateral fusion of the coronal suture is associated to a clinical phenotype characterized by the unilateral flattening of the frontal bone and the orbit and by the distortion and maldevelopment of adjacent cranial and facial bones. Homolateral anterior displacement of the ear and contralateral deviation of the nasal pyramid and mandible are other prominent clinical features. The differential diagnosis includes a variety of conditions characterized by facial asymmetry, namely, due to muscular alterations, anomalies of the visual function, congenital anomalies of the cervical spine and craniovertebral junction, abnormal pregnancy, and birth injuries. Anterior plagiocephaly is the direct cause of oculomotor anomalies, with a characteristic strabismus, and of progressive asymmetrical maldevelopment of the face, craniovertebral junction, and cervical spine.

METHODS:

The medical literature was reviewed in regard to the epidemiology, clinical features, and radiological findings. Different categorization of the affected infants in specific subtypes according to the severity of the condition was analyzed. The aim was to contribute to a practical clinical classification to be utilized for the surgical indication and for predicting the prognosis according to the severity of the condition at presentation.

CONCLUSIONS:

Anterior plagiocephaly represents the most challenging simple suture craniosynostosis. The clinical differential diagnosis with other forms of cranial asymmetry is possible on the grounds of mere clinical findings. A classification system is necessary not only for the establishment of surgical planning but also to predict the late cosmetic and functional outcomes.

• Authors: Concezio Di Rocco, Giovanna Paternoster, Massimo Caldarelli, Luca Massimi, Gianpiero Tamburrini
• Journal: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery (Childs Nerv Syst) Vol. 28 Issue 9 Pg. 1413-22 (Sep 2012) ISSN: 1433-0350 [Electronic] Germany
• PMID: 22872257 (Publication Type: Journal Article, Review)

Topics

• Databases, Factual (statistics & numerical data)
• Diagnosis, Differential
• Female
• Frontal Bone (abnormalities, pathology)
• Humans
• Imaging, Three-Dimensional
• Male
• Plagiocephaly (classification, diagnosis, epidemiology)
• Pregnancy
• Prenatal Diagnosis
• Tomography, X-Ray Computed