title: Longitudinal, three-dimensional analysis of head shape in children with and without deformational plagiocephaly or brachycephaly.
abstract: OBJECTIVE
  To assess 3-dimensional (3D) changes in head shape in infancy and at age 18 months in children with and without plagiocephaly or brachycephaly.
  
  
  METHODS
  Using a longitudinal design, we evaluated head shape using 3D surface imaging. We compared the head shapes of children with (1) diagnosed deformational plagiocephaly or brachycephaly (cases; n=233); (2) unaffected controls, with no evidence of dysmorphology (n=167); and (3) affected controls, who despite having no previous diagnosis demonstrated skull dysmorphology on 3D surface imaging (n=70).
  
  
  RESULTS
  Cases had greater skull flattening and asymmetry than unaffected controls at both time points, as did controls with skull dysmorphology. In all groups, head shapes became less flat and more symmetric over time. Among cases, symmetry improved slightly more for those who received orthotic treatment.
  
  
  CONCLUSIONS
  Although head shape improves over time for children with deformational plagiocephaly or brachycephaly, skull dysmorphology persists relative to unaffected controls. Further research is needed to clarify the extent to which these differences are detectable to clinicians and lay observers.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA. bcollett@u.washington.edu
authors.forename: Brent R
authors.initials: BR
authors.lastname: Collett
authors.forename: Carrie L
authors.initials: CL
authors.lastname: Heike
authors.forename: Indriyati
authors.initials: I
authors.lastname: Atmosukarto
authors.forename: Jacqueline R
authors.initials: JR
authors.lastname: Starr
authors.forename: Michael L
authors.initials: ML
authors.lastname: Cunningham
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Speltz
mesh_terms: D003398:Craniosynostoses / Q000473:pathology*; D005260:Female; D006257:Head / Q000033:anatomy & histology* / Q000254:growth & development / Q000473:pathology; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D059041:Plagiocephaly / Q000473:pathology*
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