Brachycephaly

Brachycephaly is a skull shape characterized by a shortened anteroposterior length of the skull relative to its width, giving a broad, often flattened appearance. In humans this condition can be a normal variation or associated with conditions affecting skull growth. It is distinguished from dolichocephaly, where the head is longer from front to back.

In infancy the most common form is positional (non-synostotic) brachycephaly, resulting from prolonged back-sleeping and limited variation in head position. It can also occur with premature fusion of cranial sutures (craniosynostosis), particularly bicoronal synostosis, which restricts growth in the anteroposterior direction. Brachycephaly may also appear as part of certain craniofacial syndromes.

Diagnosis relies on physical examination and measurement of head shape; imaging such as ultrasound in infancy or CT/MRI is used when craniosynostosis is suspected to determine suture status and guide management.

Management depends on the cause. Non-synostotic brachycephaly is typically addressed with repositioning strategies, increased tummy time, and varied head positioning to encourage growth in multiple planes. In persistent cases, specially designed cranial remolding helmets may be employed. Craniosynostosis often requires surgical intervention to correct suture fusion and allow normal skull growth, followed by postoperative monitoring.

Prognosis for non-synostotic brachycephaly is generally good with appropriate care, and most children reach normal development. Craniosynostosis-associated brachycephaly may involve more complex outcomes and requires multidisciplinary evaluation.

In veterinary contexts, brachycephaly also describes skull shapes in many dog breeds, such as bulldogs and pugs, which can be associated with airway obstruction and related health concerns.