Head Shape 101: Different Kinds of Head Shapes and Cranial Deformity Lingo

Written By Cassie Mathis

Plagio-what? Brachyce-huh? Head shape stuff can be confusing.
No worries - we got you.

The general population has never heard of common head shape language. Terms like plagiocephaly, brachycephaly, and cephalic index are not typically expressed in light conversation. But once you notice your baby’s head shape looks a little off, you’ll likely come in contact with this lingo and it can be helpful to learn how it may relate to your baby and your family.

Head Shape Lingo + Examples

If you aren’t entirely sure what you’re seeing when you look at your baby’s head, we recommend you first check out this blog post: How to Assess Your Baby’s Head For a Flat Spot at Home. It will guide you through a step-by-step process for analyzing head shape in order to better categorize it into one of the shapes that we discuss below.

Note: the dashed lines in the pictures below indicate optimal/symmetrical alignment.

Plagiocephaly [play-jee-oh-seff-a-lee]: Flatness on one side of the head and shifting of the ear, eye, or cheek.

The severity of plagiocephaly is determined by a few things:

  • The measured difference (in millimeters) between the “long” and “short” diagonals of the head - this is called the Transcranial Diagonal Difference (TDD),

  • If there is ear shifting involved,

  • If there is facial involvement (one eye appears larger, jaw shifting, etc).

Brachycephaly [BRAE-key-SEF-o-lee]: Flatness across the back of the head with overall widening; increased slope/height and bulging above the ears.

The severity of brachycephaly is determined by a few things:

  • The Cephalic Index (CI) or Cephalic Ratio (CR), which is a measurement of the width and length and then calculated into a percentage,

  • The degree of flattening of the back of the head,

  • If there is widening above the ears,

  • If there is increased height and sloping to the top of the head.

Asymmetrical Brachycephaly: A combination of plagiocephaly + brachycephaly.

The severity of asymmetrical brachycephaly is determined by the plagiocephaly and brachycephaly measurements/calculations.

Scaphocephaly [SCA-pho-sef-A-lee]: long, narrow head shape.

The severity of scaphocephaly is determined by a few things:

  • A low Cephalic Index (CI) or Cephalic Ratio (CR), which is a measurement of the width and length and then calculated into a percentage,

  • The degree of flattening/narrowing on the sides of the head above/around the ears,

  • If there is a prominent forehead or back of the head.

What Do You Think?

If you feel like your baby’s head shape falls into one of the categories above, the next step is to reach out to a cranial specialist for a thorough assessment and some objective data to help you take the best action.

There are many opportunities to correct head shape whether your baby is 1 month old or 1 year old. Many pediatricians offer the wait-and-see approach, but we truly believe that early intervention is the gold star of treatment. We hear over and over again from parents how much they learn from our consultations and how much peace that appointment offers regardless of treatment recommendations.

If you want to schedule a free consultation or explore all of the services we provide, visit our services page. We are here to help!

Cassie Mathis
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