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Lekovic, Gregory P. M.D., Ph.D., J.D.; Baker, Brenda J. Ph.D.; Lekovic, Jill M. M.D.; Preul, Mark C. M.D.

doi: 10.1227/01.NEU.0000255462.99516.B0

INTRODUCTION: Throughout history, prehistoric and even some contemporary civilizations have practiced various forms of intentional and unintentional cranial deformation. Plagiocephaly can be the result of craniosynostosis, infant positioning, or other unintentional or intentional deformation.

MATERIALS: We reviewed the medical and anthropological literature and utilized the anthropological collections of Arizona State University and the San Diego Museum of Man for evidence of cranial deformation and its possible physiological and cognitive side effects. Evidence of cranial shaping was also sought among art or stone work from representative cultures.

RESULTS: The anthropological record and literature attest to the presence of much more severe forms of deformation than that seen as a result of contemporary infant positioning. Despite this evidence, there is no anthropological evidence as to the possible cognitive effects that such deformation may have, although some evidence is reviewed that suggests a possible physiological mechanism for the same.

CONCLUSION: Because we can only view these cultures through the relics of time, any conclusions one might draw from the anthropological and historical record regarding the cognitive effects of head deformation can only be inferred through generalized observations and are tenuous. Nevertheless, there does not seem to be any obvious evidence of negative effect on the societies that have practiced even very severe forms of intentional cranial deformation (e.g., the Olmec and Maya). On the other hand, the physical anthropology and the contemporary developmental literature suggest possible mechanisms for such an effect.

Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona (Lekovic)

Department of Anthropology, Center for Bioarchaeological Research, School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona (Baker)

Department of Pediatrics, St. Joseph's Hospital and Medical Center, Phoenix, Arizona (Lekovic)

Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona (Preul)

Reprint requests: Mark C. Preul, M.D., c/o Neurosurgery Research, Barrow Neurological Institute, 350 W. Thomas Road, Phoenix, AZ 85013. Email:

Received, September 14, 2006.

Accepted, January 31, 2007.

Copyright © by the Congress of Neurological Surgeons