Correlative vs. causative relationship between neonatal cranial head shape anomalies and early developmental delays

Abstract

Deformational plagiocephaly and craniosynostosis are two of the most common neonatal cranial head shape anomalies. Traditionally, both entities were thought to cause aesthetic concerns solely. Recently, many groups have demonstrated that both conditions are strongly associated with developmental delays. The relationship between the abnormal neonatal cranial shape and early developmental delays manifested in both conditions remains poorly understood. Neonatal cranial head shape anomalies are common and have been attributed to a multitude of factors. Interestingly, despite recent advances in global health care, the incidence of some cranial anomalies has been increasing, making awareness and access to care ever more important. Typically, cranial head shape anomalies are identified in the 1st months of life by primary care providers, who refer these infants to a multi-disciplinary team that specializes in craniofacial disorders. While craniofacial clinics have always been well-suited to manage the aesthetics concerns of cranial head shape anomalies, only recently have concomitant neurodevelopmental delays begun to be addressed in these specialty clinics. Deformational plagiocephaly (DP), also termed positional plagiocephaly, and craniosynostosis (CS) are two of the most common cranial anomalies encountered in craniofacial clinics. Both conditions can significantly distort the closed cranial vault anatomy in which the developing brain presides. Coincidentally, both conditions are associated with neonatal developmental delays yet it remains indeterminate whether the relationship is causative or correlative. This question has focused recent research efforts to study the impact that the cranial vault shape has on normal brain function and development.