Premature infants are prone to the development of which cranial shape abnormality?

• A. Dolichocephaly
• B. Plagiocephaly
• C. Craniosynostosis
• D. Microcephaly

Answer: (A)

Premature infants have skull bones that are extremely pliable and the sutures remain open longer. After birth, the head shape is largely influenced by external forces and rapid brain growth. This combination often leads to a longer, narrower head in the front-to-back direction, known as dolichocephaly. It reflects molding of the soft infant skull in the setting of prematurity. This is different from plagiocephaly, which is an asymmetrical flattening usually from positional forces; craniosynostosis involves premature fusion of sutures causing a fixed deformity; and microcephaly refers to a small head size, not a shape change. So the elongated head shape is the pattern most commonly seen in preterm infants.