dolichocephaly

Dolichocephaly is a skull shape characterized by an elongated head in which the maximum length exceeds the maximum breadth. It is commonly defined using the cranial index, the ratio of head width to head length; dolichocephalic heads typically have a cranial index below about 75 percent, while mesocephalic heads are around 75–80 percent and brachycephalic heads above roughly 80 percent.

In infants, dolichocephaly can be a normal anatomical variant, a result of external shaping pressures during early development (positional or deformational molding), or due to cranial suture anomalies such as sagittal craniosynostosis, which produces a condition known as scaphocephaly and often yields a markedly elongated head.

Diagnosis is based on physical examination and measurement of head dimensions; imaging such as skull radiographs or CT scans may be used when craniosynostosis is suspected to evaluate skull sutures and brain growth.

Management depends on the underlying cause. Most dolichocephalic variants that occur as normal variation require no treatment. When craniosynostosis is present, surgical intervention to release fused sutures may be indicated. For deformational skull shapes, conservative measures such as varied head positioning, supervised tummy time, and, in selected cases, cranial remolding orthoses (helmets) may be used under pediatric specialist guidance to influence skull shape.

Prognosis is generally favorable for non-synostotic dolichocephaly; long-term outcomes are influenced by the underlying etiology and any associated conditions. See also cranial index, scaphocephaly, plagiocephaly.