Skip to main content
SpringerLink
Log in

Definition and Classification

  • Chapter
  • First Online:
Positional Plagiocephaly

Abstract

Positional plagiocephaly and postural torticollis are the most frequent and often associated asymmetries of posture and movement in newborns and infants. The term “plagiocephaly” derived from Greek (oblique head) describes the asymmetry of the shape of the skull. Plagiocephaly is usually distinguished as anterior or frontal and posterior or occipital, according to the cranial portion concerned. The habit of putting infants to sleep in the supine position led to a higher prevalence of the occipital type, with a more frequent involvement of the half right side of the head. Although several methods have been used to quantify and classify positional plagiocephaly, such as computed tomography (CT) or anthropometric measurements, the clinical observation constitutes the most simple and reliable method. Argenta’s classification of positional plagiocephaly distinguishes five types according to the increasing severity of the deformation. It is based on clinical findings and provides a safe and reliable method of classification.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 16.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Hanson M, Mulliken JB (1994) Frontal plagiocephaly: diagnosis and treatment. Clin Plast Surg 21:543–553

    Google Scholar 

  2. Cheng JCY, Tang SP, Chen TMK, Wong MW, Wong EM (2000) The clinical presentation and outcome of treatment of congenital muscular torticollis in infants – a study of 1,086 cases. J Pediatr Surg 35:1091–1096

    Article  CAS  PubMed  Google Scholar 

  3. Ellenbogen RG, Gruss JS, Cunningham ML (2000) Update on craniofacial surgery: the differential diagnosis of lambdoid synostosis/posterior plagiocephaly. Clin Neurosurg 47:303–318

    CAS  PubMed  Google Scholar 

  4. Paine R (1961) Neurologic conditions in the neonatal period. Pediatr Clin North Am 8:577–610

    CAS  PubMed  Google Scholar 

  5. Looman WS, Flannery AB (2012) Evidence-based care of the child with deformational plagiocephaly, Part I: assessment and diagnosis. J Pediatr Health Care Off Publ Natl Assoc Pediatr Nurse Assoc Pract 26(4):242–250

    Google Scholar 

  6. Dias MS, Klein DM (1996) Occipital plagiocephaly: deformation or lambdoid synostosis? II. A unifying theory regarding pathogenesis. Pediatr Neurosurg 24(2):69–73

    Article  CAS  PubMed  Google Scholar 

  7. Behrman RE, Kliegman RM, Jenson HB (2000) Scoliosis, craniosynostosis, torticollis. In: Behrman RE, Kliegman RM, Jenson HB (eds) Nelson textbook of pediatrics, 16th edn. W.B. Saunders Company, Philadelphia, pp 1812–1813, 2082–2086, 2089–2091

    Google Scholar 

  8. Peitsch WK, Keefer CH, Labrie RA, Mulliken JB (2002) Incidence of cranial asymmetry in healthy newborns. Pediatrics 10:e72

    Article  Google Scholar 

  9. Golden KA, Beals SP, Littlefield TR, Pomatto JK (1999) Sternocleidomastoid imbalance versus congenital muscular torticollis: their relationship to positional plagiocephaly. Cleft Palate Craniofac J 36:256–261

    Article  CAS  PubMed  Google Scholar 

  10. Bruneteau RJ, Mulliken JB (1992) Frontal plagiocephaly: synostotic, compensational, or deformational. Plast Reconstr Surg 89(1):21–31; discussion 32–33

    Article  CAS  PubMed  Google Scholar 

  11. Rout PG, Price C (1978) Plagiocephaly. Br J Oral Surg 16(2):163–168

    Article  CAS  PubMed  Google Scholar 

  12. Bredenkamp JK, Hoover LA, Berke GS, Shaw A (1990) Congenital muscular torticollis. Arch Otolaryngol Head Neck Surg 16:212–216

    Article  Google Scholar 

  13. Cheng JCY, Tang SP (1999) Outcome of surgical treatment of congenital muscular torticollis. Clin Orthop 362:190–200

    PubMed  Google Scholar 

  14. Cheng JCY, Tang SP, Chen TMK (1999) Sternocleidomastoid pseudotumor and congenital muscular torticollis in infants: a prospective study of 510 cases. J Pediatr 134:712–716

    Article  CAS  PubMed  Google Scholar 

  15. Tang S, Liu Z, Quan X, Qin J, Zhang D (1998) Sternocleidomastoid pseudotumor of infants and congenital muscular torticollis: fine-structure research. J Pediatr Orthop 18:214–218

    CAS  PubMed  Google Scholar 

  16. Boere-Boonekamp MM, van der Linden-Kuiper LT (2001) Positional preference: prevalence in infants and follow-up after two years. Pediatrics 107:339–343

    Article  CAS  PubMed  Google Scholar 

  17. Robinson S, Proctor M (2009) Diagnosis and management of deformational plagiocephaly. J Neurosurg Pediatr 3:284–295

    Article  PubMed  Google Scholar 

  18. Glasgow TS, Siddiqi F, Hoff C, Young PC (2007) Deformational plagiocephaly: development of an objective measure and determination of its prevalence in primary care. J Craniofac Surg 18:85–92

    Article  PubMed  Google Scholar 

  19. Argenta LC, David LR, Wilson JA, Bell WO (1996) An increase in infant cranial deformity with supine sleeping position. J Craniofac Surg 7:5–11

    Article  CAS  PubMed  Google Scholar 

  20. Argenta LC (2004) Clinical classification of positional plagiocephaly. J Craniofac Surg 15:368–372

    Article  PubMed  Google Scholar 

  21. Mawji A, Vollman AR, Hatfield J, McNeil DA, Sauvé R (2013) The incidence of positional plagiocephaly: a cohort study. Pediatrics 132(2):298–304

    Article  PubMed  Google Scholar 

  22. Captier G, Dessauge D, Picot MC, Bigorre M, Gossard C, El Ammar J, Leboucq N (2011) Classification and pathogenic models of unintentional postural cranial deformities in infants: plagiocephalies and brachycephalies. J Craniofac Surg 22:33–41

    Article  PubMed  Google Scholar 

  23. Spermon J, Spermon-Marijnen R, Scholten-Peeters W (2008) Clinical classification of deformational plagiocephaly according to Argenta: a reliability study. Rhe J Craniofac Surg 19:664–668

    Article  Google Scholar 

  24. Hall JG, Allanson JE, Gripp KW, Slavotinek AM (2012) Special section. Syndrome-specific growth charts. Am J Med Genet A 158A(11):2645–2646

    Article  PubMed  Google Scholar 

  25. van Vlimmeren LA, Helders PJ, van Adrichem LN, Engelbert RH (2006) Torticollis and plagiocephaly in infancy: therapeutic strategies. Pediatr Rehabil 9:40–44

    PubMed  Google Scholar 

  26. van Adrichem LN, van Vlimmeren LA, Cadanová D, Helders PJ, Engelbert RH, van Neck HJ, Koning AH (2008) Validation of a simple method for measuring cranial deformities (plagiocephalometry). J Craniofac Surg 19:15–21

    PubMed  Google Scholar 

  27. Wilbrand J-F, Wilbrand M, Pons-Kuehnemann J, Blecher J-C, Christophis P, Howaldt H-P, Schaaf H (2011) Value and reliability of anthropometric measurements of cranial deformity in early childhood. J Cranio-Maxillofac Surg 39:24–29

    Article  Google Scholar 

  28. Farkas LG (1994) Anthropometry of the head and face, 2nd edn. Raven, New York

    Google Scholar 

  29. Riphage JM, van Neck JW, van Adrichem LN (2008) 3D surface imaging in medicine: a review of working principles and implications for imaging the unsedated child. J Craniofac Surg 19:517–524

    Article  Google Scholar 

  30. Schaaf H, Malik CY, Streckbein P, Pons-Kuehnemann J, Howaldt H-P, Wilbrand JF (2010) Three-dimensional photographic analysis of outcome after helmet treatment of a nonsynostotic cranial deformity. J Craniofac Surg 21:1677–1682

    Article  PubMed  Google Scholar 

  31. Spitzer MJ, Kramer M, Neukam FW, Nkenke E (2011) Validation of optical three-dimensional plagiocephalometry by computed tomography, direct measurement, and indirect measurements using thermoplastic bands. J Craniofac Surg 22:129–134

    Article  PubMed  Google Scholar 

  32. Plank LH, Giavedoni B, Lombardo JR, Geil MD, Reisner A (2006) Comparison of infant head shape changes in deformational plagiocephaly following treatment with a cranial remolding orthosis using a noninvasive laser shape digitizer. J Craniofac Surg 17:1084–1091

    Article  PubMed  Google Scholar 

  33. Hutchison BL, Hutchison LA, Thompson JM, Mitchell EA (2004) Plagiocephaly and brachycephaly in the first two years of life: a prospective cohort study. Pediatrics 114:970–980

    Article  PubMed  Google Scholar 

  34. Hutchison BL, Stewart AW, De Chalain TB, Mitchell EA (2010) A randomized controlled trial of positioning treatments in infants with positional head shape deformities. Acta Paediatr Int J Paediatr 99:1556–1560

    Article  Google Scholar 

  35. Bialocerkowski AE, Vladusci SL, Wei NC (2008) Prevalence, risk factors, and natural history of positional plagiocephaly: a systematic review. Dev Med Child Neurol 50:577–586

    Article  PubMed  Google Scholar 

  36. van Vlimmeren LA, van der Graaf Y, Boere-Boonekamp MM, L’Hoir MP, Helders PJ, Engelbert RH (2008) Effect of pediatric physical therapy on deformational plagiocephaly in children with positional preference: a randomized controlled trial. Arch Pediatr Adolesc Med 162:712–718

    Article  PubMed  Google Scholar 

  37. Xia JJ, Kennedy KA, Teichgraeber JF, Wu KQ, Baumgartner JB, Gateno J (2008) Nonsurgical treatment of deformational plagiocephaly: a systematic review. Arch Pediatr Adolesc Med 162(8):719–727

    Article  PubMed  Google Scholar 

  38. Wilbrand JF, Schmidtberg K, Bierther U, Streckbein P, Pons-Kuehnemann J, Christophis P, Hahn A, Schaaf H, Howaldt HP (2012) Clinical classification of infant nonsynostotic cranial deformity. J Pediatr 161(6):1120–1125

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Preventive Medicine, ASL Milano, Via Statuto, 5, Milan, 20122, Italy

    Maria Vittoria Meraviglia

  2. Child and Adolescent Neuropsychiatry Department, Ospedale Niguarda Ca’ Granda, Piazza Ospedale Maggiore, 3, Milan, 20162, Italy

    Donata Villani & Pasquina Meghi

Authors
  1. Maria Vittoria Meraviglia
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Donata Villani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Pasquina Meghi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maria Vittoria Meraviglia .

Editor information

Editors and Affiliations

  1. Child and Adolescent Neuropsychiatry Department, Ospedale Niguarda Ca’ Granda, Milan, Italy

    Donata Villani

  2. Department of Preventive Medicine, ASL Milano, Milan, Italy

    Maria Vittoria Meraviglia

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Meraviglia, M.V., Villani, D., Meghi, P. (2014). Definition and Classification. In: Villani, D., Meraviglia, M. (eds) Positional Plagiocephaly. Springer, Cham. https://doi.org/10.1007/978-3-319-06118-4_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-06118-4_2

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-06117-7

  • Online ISBN: 978-3-319-06118-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation