Kalra Ricky, Walker Marion L
Department of Neurological Surgery, Division of Pediatric Neurosurgery, Primary Children's Medical Center, University of Utah, Salt Lake City, UT 84113, USA.
Childs Nerv Syst. 2012 Sep;28(9):1389-93. doi: 10.1007/s00381-012-1784-y. Epub 2012 Aug 8.
Asymmetrical cranial vaults resulting from external forces on an infant's head can be caused by abnormal sutural development (synostotic plagiocephaly) or abnormal external forces acting on an intrinsically normal, developing cranium (deformational plagiocephaly).
The incidence of posterior plagiocephaly has increased dramatically since the initiation of the "Back to Sleep" campaign against sudden infant death syndrome. The majority of cases are due to deformational plagiocephaly, but rigorous diagnostic evaluation including physical examination and radiological imaging must be undertaken to rule out lambdoid synostosis in extreme or refractory cases.
Unique clinical features and radiological examination using computed tomography technology are helpful in confirming the correct cause of posterior plagiocephaly. Plagiocephaly is considered a benign condition, but with the recent increase in cases, new studies have revealed developmental problems associated with cranial vault asymmetries. Treatment of positional/deformational plagiocephaly includes conservative measures, primarily behavior modification, and, in some cases, helmet therapy, whereas lambdoid synostotic plagiocephaly requires surgical intervention, making differentiation of the cause of the asymmetry critical.
婴儿头部受到外力作用导致的颅骨穹窿不对称，可能是由异常的缝发育（骨性斜头畸形）或作用于本质上正常的发育中的颅骨的异常外力（变形性斜头畸形）引起的。
自开展预防婴儿猝死综合征的“仰卧睡眠”运动以来，后位斜头畸形的发病率急剧上升。大多数病例是由于变形性斜头畸形，但在极端或难治性病例中，必须进行包括体格检查和影像学检查在内的严格诊断评估，以排除人字缝早闭。
独特的临床特征和使用计算机断层扫描技术的影像学检查有助于确定后位斜头畸形的正确病因。斜头畸形被认为是一种良性疾病，但随着近期病例的增加，新的研究揭示了与颅骨穹窿不对称相关的发育问题。姿势性/变形性斜头畸形的治疗包括保守措施，主要是行为矫正，在某些情况下还包括头盔治疗，而人字缝骨性斜头畸形则需要手术干预，因此区分不对称的病因至关重要。
