Learn all about dolichocephaly definition, pictures, symptoms, causes and treatment. Dolichocephaly is also known as dolichocephalism, cymbocephaly, tectocephaly, sagittal synostosis, scaphocephalis, scaphocephalism, mecocephaly, and scaphocephaly. About 1 out of 4200 babies is born with dolichocephaly. There is a 3:1 male predominance.
Historically, a dolichocephalic (elongated) head shape was the norm. Currently the norm has changed to a more brachycephalic (shorter and broader) shape. Since the American Academy of Pediatrics’ Back to Sleep Campaign, the incidence of positional plagiocephaly has increased dramatically with a concurrent rise in the incidence of torticollis.
Technically, dolichocephaly is a mild cranial deformity in which the head has become disproportionately long and narrow, due to mechanical forces associated with breech positioning in utero. This change in shape is more commonly associated with primiparity (first babies), larger babies, oligohydramnios, and posterior placentas, all of which result in greater forces applied to the fetal head. Dolichocephaly is not always serious, since the condition ranges from mild to severe. In fact, most children who are treated for dolichocephaly with surgery go on to lead normal lives. However, dolichocephaly is associated with dozens of developmental disabilities that can result in mental retardation.
It can present be in cases of Sensenbrenner syndrome, Crouzon syndrome, Sotos syndrome as well as Marfan syndrome. Although dolichocephaly may be associated with some other abnormalities, alone it is just a normal variation; unless symptomatic, it is not a cause for concern. Early diagnosis can be made by X-ray or ultrasonography. Treatment is not essential in some cases.
Researchers suggested that the deformity was preventable with the use of air or water pillows. Limited emphasis was placed on body position (i.e. supine, side lying or prone) in these articles. Since this period of time, the use of positioning aids and developmental positioning has been used to decrease the occurrence of dolichocephaly during hospitalization. Despite these interventions, some infants have dolichocephaly at hospital discharge. Although neurological damage can occur in severe cases, most children have normal cognitive development and achieve good cosmetic results after surgery. Early diagnosis and treatment are keys.
What is Dolichocephaly?
Dolichocephaly is a condition in which one has an abnormally long head. A “perfectly round” head measures the same distance between the ears as it does from the nose to the back of the head. In dolichocephaly, the front to back measurement is longer than the side-to-side measurement.
Dolichocephaly comes from the Greek word “dolichos” meaning “long,” and the Greek word “kephale” meaning “head”. Having a relatively long head; having a head whose width is less than 76 percent of its length from front to back. Dolichocephaly is a condition where the head is longer than would be expected, relative to its width. In humans, scaphocephaly is a form of dolichocephaly.
The primary symptom of dolichocephaly is primarily long skull. In mild cases this malformation is only an aesthetic issue. This condition can also cause delayed growth or development of brain cortex. The abnormal shape of head can lead to trouble breathing and chewing food. Such patients are likely to develop auditory issues and vision disorders. Dolichocephaly also features an inverted curvature of parietal and temporal bones with convexity oriented to surface of cortex.
- A misshapen skull, with the shape depending on which of the sutures are affected
- An abnormal feeling or disappearing fontanel on your baby’s skull
- Development of a raised, hard ridge along affected sutures.
Dolichocephaly is a mild cranial deformity in which the head has become disproportionately long and narrow, due to mechanical forces associated with breech positioning in utero. If one or more sutures close early, it will cause the skull to expand in the direction of the sutures that remain open, which can result in an abnormal head shape. In dolichocephaly, the sagittal sutures (which run from the front of the head to the back) close together too early. This closure prevents the skull from expanding in width, and the skull begins to expand towards open sutures (such as the coronal sutures that run down the side of the head). Abnormal skull shapes can occur due to positioning of the developing baby during pregnancy, abnormal sleeping position, or from neck tightness. Association with other diseases, syndromes:-
- Marfan Syndrome
- Sotos Syndrome
- Crouzon Syndrome
- Sensenbrenner Syndrome
- Proteus Syndrome
- Bloom Syndrome
- Yunis-Varon Syndrome
- Deletion of 10q
Dolichocephaly treatment is not needed in all cases. Successful treatment of positional plagiocephaly and dolichocephaly includes systematic positioning changes to overcome the mechanical forces of repetitive positioning, physical and/or occupational therapy to treat underlying muscle or developmental challenges, and in some cases, molding helmet therapy. Variations in head shape are often seen in the neonatal intensive care unit (NICU). Term and preterm infants may develop abnormal head shapes due to medical treatment, nursing care practices, positioning limitations, and underlying muscle tone abnormalities. But sometimes surgery may be needed.