Skull Malformation


My son is 6 months old. The plate in the back of his skull is not formed into a normal position. His doctor said to get a CT to see if they are fused. If so, an operation would be needed to correct it. How dangerous is this operation, and is there any real threat in not having it done?

Dr. Greene's Answer

When we recognized that kids sleeping on their backs were much less likely to have a problem with SIDS, we started seeing more and more babies with skull malformation – the back of the skull flattened from spending so much time on it. This is a condition called plagiocephaly and will usually stop getting worse and start improving when kids start to spend most of the day up out of that position. Often it corrects all the way on its own and if not, it is just a cosmetic issue.

But there is a different condition called craniosynostosis where the bones in the skull fuse together too early. This gets worse over time and sometimes it is just cosmetic, but sometimes it can decrease the space for the brain to grow (usually this means a lot of fusing). If your child does have this fusing, it would be important to evaluate how much worse it is likely to get over time.

Consulting with a pediatric neurosurgeon, or craniofacial surgeon, is a good way to do that, depending on when your child starts spending most of the day off of the back of his head.

It might be worth talking with your doctor about waiting a month or two before the CT to see if the condition is improving, or at least not getting worse. Another approach would be to seek specialty surgical referral before getting the CT. On the other hand, sometimes the diagnosis is clear from the exam. Your doctor may have good reason to suspect that it is craniosynostosis. If it is, the earlier you correct it the easier it is.

Evaluation by a neurosurgeon and CT scanning are necessary to determine the severity of the problem. These steps do not mean that you are on an inevitable path to surgery. Most kids in this situation do not need surgery in the end.

Last medical review on: April 01, 2008
About the Author
Photo of Alan Greene MD
Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.
Get Dr. Greene's Wellness RecommendationsSignup now to get Dr. Greene's healing philosophy, insight into medical trends, parenting tips, seasonal highlights, and health news delivered to your inbox every month.
Add your comment

Recent Comments

My baby was born premature at 35 weeks old. She was warded in Neo natology for 2 weeks solely to monitor her breathing and regulate her temperature. Otherwise my daughter is healthy. She was born on 14th Jan 2015.

From the time she was abt 3.5 months onwards, she was crying a lot and now she is abt 4 mths old. Her paediactrician said to increase her milk intake to 150 ml every 3 hours.

My baby has also been asked to go for early stimulation to correct her posture because she likes to stretch her neck and body like a ‘C’

The paed has advised us to do an encephelogram of her brain and if not conclusive have to do an MRI scan to determine if there is any infection in the brain due to my baby being born premature.

Please advise further if there is anything else we can do for our daughter.

Thank you