[Positional plagiocephaly. Diagnosis and treatment].

Area of Science:

• Pediatric Neurosurgery
• Cranial Deformities
• Developmental Pediatrics

Context:

• Positional plagiocephaly is the most frequent consultation in pediatric neurosurgery in Western countries.
• Existing literature presents confusion regarding terminology, pathophysiology, and differential diagnosis with synostosis.
• A clear protocol is needed for consistent diagnosis and management.

Purpose:

• To clarify concepts surrounding positional plagiocephaly.
• To present a standardized protocol for diagnosis and treatment.
• To improve coordination between pediatricians and neurosurgeons.

Summary:

• A staged treatment protocol is proposed for positional plagiocephaly, classifying severity (mild, moderate, severe) via digital photography.
• Management involves a two-phase approach: a pediatric phase (up to 5 months) focusing on postural changes and physiotherapy, followed by a neurosurgical phase (from 5 months).
• Referral to neurosurgery is recommended only after conservative measures are exhausted by 5 months of age.

Impact:

• Provides a clear, staged treatment pathway for positional plagiocephaly.
• Enhances collaboration between pediatricians and neurosurgeons.
• Offers precise information for healthcare providers and parents, improving patient outcomes.