Welcome to today's Live Chat Event! Dr. Dias from Penn State Hershey Children's Hospital is joining us to answer your questions about brain tumors in children, and neurosurgical treatment for children with Spina Bifida, Chiari Malformations, cerebral palsy, craniosynostosis, traumatic brain injury, and skull molding from positioning. Please submit your questions by clicking COMMENT, typing in your name or initials, then sign in and ask your question! Our panelists will review all questions and answer them as they are able. Follow-up comments and questions are encouraged.
One question we frequently get relates to flattening in the back of the head of an infant. This is known as occipital flattening or deformational plagiocephaly. Because the infant skull is moldable during the first several months of life, their heads get flat on the back when they lie on their backs to sleep. Lying on their backs is incredibly important to prevent Sudden Infant Death Syndrome (SIDS) but it does contribute to this flattening, which is a cosmetic issue only (it doesn't seem to cause any other conditions). Two-thirds of affected infants are boys, 80% are right sided, and about 15-20% have torticollis (where the neck muscles are tight). Treatment usually involves simply repositioning the infant to alternate their head positions while they sleep, keeping them off the back of their heads as much as possible by, for example, lying them on their stomach when they are awake and you are in the room with them, and placing them in a Bumbo chair to keep pressure off their heads. Although molding helmets are recommended by some, particularly for more severe cases, recent research has cast doubt on their effectiveness in correcting this condition long term beyond what would be achieved by simply repositioning the infant. We see many children with occipital plagiocephaly in our craniofacial clinic; for the majority we recommend simply repositio
ning the baby.
Another topic of interest relates to children with birthmarks on their backs. These can be purple or pink marks, focal hairy patches, or dimples overlying the spine. If they are midline and overlying the lower spine below the neck, they could be associated with underlying congenital abnormalities of the spinal cord. Ask your pediatrician about these. Dimples that are within the butt crack (where you need to part the butt cheeks to see them) are NOT generally associated with these spinal cord abnormali
ties though, so you can rest easy if your child has one of them and is otherwise having no problems.