DeGrazia Michele, Ahtam Banu, Rogers-Vizena Carolyn R, Proctor Mark, Porter Courtney, Vyas Rutvi, Laurentys Cynthia T, Bergling Emily, McLaughlin Kara, Grant Patricia Ellen
Cardiovascular and Critical Care, Boston Children's Hospital, Boston, MA, USA.
Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
Child Neurol Open. 2020 Aug 19;7:2329048X20949769. doi: 10.1177/2329048X20949769. eCollection 2020 Jan-Dec.
This case report aims to assess a potential association between cranial asymmetry, brain deformation, and associated developmental delay.
Two infants born at ≥37 weeks pursuing cranial orthotic treatment for severe Deformational Plagiocephaly (DP) (cranial vault asymmetry index >8.75%) underwent developmental assessment using Mullen Scales of Early Learning (MSEL) and non-sedated brain structural and diffusion magnetic resonance imaging (MRI) prior to and following cranial orthotic treatment.
In both infants with DP, tractography results revealed alterations in the white matter pathways of the brain. Both infants also had low to low/normal visual receptivity and fine motor skills. After cranial orthotic treatment, cranial asymmetry improved but did not completely resolve, tractography demonstrated a change toward normalized white matter pathways, and visual receptivity and fine motor skills improved.
These preliminary findings suggest a potential link between DP, altered brain structures, and developmental assessment. Further investigation with a larger sample is warranted.
本病例报告旨在评估颅骨不对称、脑变形与相关发育迟缓之间的潜在关联。
两名孕龄≥37周、因严重变形性斜头畸形（DP）（颅穹不对称指数>8.75%）接受颅骨矫形治疗的婴儿，在颅骨矫形治疗前后使用穆伦早期学习量表（MSEL）进行发育评估，并接受非镇静状态下的脑结构和扩散磁共振成像（MRI）检查。
在两名患有DP的婴儿中，纤维束成像结果显示脑白质通路存在改变。两名婴儿的视觉接受能力和精细运动技能均较低至低/正常水平。颅骨矫形治疗后，颅骨不对称情况有所改善但未完全消除，纤维束成像显示白质通路趋向正常化，视觉接受能力和精细运动技能也有所提高。
这些初步发现表明DP、脑结构改变与发育评估之间可能存在联系。有必要对更大样本进行进一步研究。
