Chapter 40: Cranial remolding orthoses

Question 1

What are the greek words of plagiocephaly?

Answer 1

Plagio: Oblique
Cephalo: head

Question 2

The pathogenesis of carnial deformities arise from what three causes?

Answer 2

Abnormalities in brain shape or development
Abnormalities in bone or suture development
Prenatal and postnatal deforming forces.

Question 3

What are some conditions that result in abnormalities in brain shape or development?

Answer 3

Microcephaly
Macrocephaly
Utero cerbrovascular accident.

Question 4

What does carniosynostosis involve?

Answer 4

Premature fusion of one or more cranial sutures, and genetic disorders such as Apert syndrome and Crouzon syndrome

Question 5

Cranial deformities often begin with what?

Answer 5

Restrictive in utero environments, such as multiple births, a large fetus, first pregnancies, or sustained abnormal positioning secondary to conditions such as oligohydramnios, breeching positioning, or early descent into the maternal pelvis.

Question 6

Who are extremely susceptible to cranial deformation?

Answer 6

Premature infants due to the increased plastsicity of the underdeveloped cranial structures.

Question 7

What is the suggested sleeping position of the baby?

Answer 7

Supine because it reduces sudden infant death syndrome but cause more deformity to the head.

Question 8

What is a common variable in plagiocephaly?

Answer 8

Torticollis

Question 9

When a cranial remolding help suggested?

Answer 9

first 3 month after birth.

Question 10

What is deformational plagiocephaly?

Answer 10

Asymmetry of the neurocranium and viscerocranium
Unilateral occipital flattening
Ipsilateral anterior ear progression
Ipsilateral forehead bossing
Contralateral forehead depression
contralateral occipital bossing
fascial asymmetry 
Congenital muscular torticollis

Question 11

What is deformational brachycephaly?

Answer 11

Disproportion of the neurocranium and viscerocranium
Bilateral occipital flattening
bilateral forehead bossing
increased heigh of cranial vault
associated weakness of neck musculature

Question 12

What is deformational scaphocephaly?

Answer 12

Disproportion of the neurocranium and viscerocranium
Bilateral parietal flattening
Anterior forehead bossing
Posterior occipital bossing
associated weakness of neck musculature.

Question 13

What age can cranial remolding helmet be used?

Answer 13

3 to 18 months.

Question 14

What is the average cranial width desired compared to cranial length?

Answer 14

78%

Question 15

patients with deformational brachycephaly have an increased what?

Answer 15

Cephalic index

Question 16

Infants with deformational scaphocephaly have a lower what?

Answer 16

Cephalic index.

Question 17

Deformational plagiocephaly have what type of cephalic index?

Answer 17

Slightly increased.

Question 18

What are the average values of the cephalic indices?

Answer 18

Males 16 days to 6 months: 73.7
Males 6-12 months: 78.0
Females 16 days to 6 months: 73.3
Females 6-12 months: 78.5

Question 19

What degree of difference from the normal cephalic indices indicates deformity?

Answer 19

greater than 3.5%

Question 20

Where is the cranial circumference measured?

Answer 20

Taken at the equator

Question 21

Where is the cranial width measured?

Answer 21

Euryon to Euryon

Question 22

Where is the cranial length measured?

Answer 22

Glabella to opisthocranion

Question 23

Where is the cranial vault, right and left measured?

Answer 23

Frontozygomaticus to contralateral euryon

Question 24

Where is the orbitotragial depth (upper face), right and left measured?

Answer 24

Exocanthion to tragion

Question 25

Where is the cranial base (lower face) measured?

Answer 25

Subnasion to tragion

Question 26

What is the equation for cephalic index?

Answer 26

CI= Cranial width/Cranial length

Question 27

What is the equation for cranial vault asymmetry

Answer 27

CVA= cranial vault (R) - Cranial vault (L)

Question 28

What is the equation for cranial vault asymmetry index

Answer 28

CVAI= [Cranial vault (R) -Cranial vault (L)]/ Cranial vault (R)

Question 29

What is the equation for orbitotragial depth asymmetry?

Answer 29

OTDA= orbitotragial depth (R) - orbitotragial depth (L)

Question 30

What is the equation for cranial base asymmetry?

Answer 30

CBA= cranial base (R) - Cranial base (L)

Question 31

What is the recommended age for treatment with a cranial remolding helmet

Answer 31

4-8 months.