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Evaluation of the infant with an abnormal skull shape

Cunningham, Michael L*; Heike, Carrie L*

doi: 10.1097/MOP.0b013e3282f1581a
Genetics: Edited by Nathaniel H. Robin

Purpose of review Atypical skull shapes occur in as many as 20% of infants. The purpose of this review is to discuss the clinical approach to the evaluation of a child with an abnormal head shape. Readers will learn how to identify the head shapes caused by environmental deformation and craniosynostosis. We also review recent findings with regard to the genetics of single-suture craniosynostosis.

Recent findings Healthcare providers can use key aspects of the examination of a child with a head shape abnormality to differentiate positional deformity from craniosynostosis. Overlap between the genetic causes of isolated single-suture craniosynostosis and syndromic forms is discussed.

Summary Pediatricians can identify the causes of the majority of head shape abnormalities by combining their understanding of normal calvarial growth with a careful physical examination. Molecular genetics is playing an increasing role in the evaluation of children with single-suture fusion.

Division of Craniofacial Medicine, University of Washington Department of Pediatrics, Seattle Children's Craniofacial Center, Seattle, Washington, USA

*The authors contributed equally to this manuscript.

Correspondence to Michael L. Cunningham, MD, PhD, Medical Director, Seattle Children's Craniofacial Center, 4800 Sand Point Way, NE, MS W7847, Seattle, WA 98105, USA Tel: +1 206 987 4572; e-mail:

© 2007 Lippincott Williams & Wilkins, Inc.