Torticollis of Babies
Causes of torticollis of babies:
The causes of congenital muscular torticollis are not completely clear. The probable causes can include abnormal compression of fetus in the womb during development or difficulty during labor which causes injury to the sternocleidomastoid muscle of the baby and causes bleeding of the muscle. The hematoma then in turn causes lack of circulation of blood, fibrosis (hardening of the tissues), and shrinkage of the muscle.
Babies of 1 to 2 weeks old with congenital torticollis often show a bulging piece of muscle on one side of the neck. The muscle is slightly hard and not sensitive to pressure. The head tilts to the injured side and the chin points at the healthy side. After 2 to 4 months the swollen mass will gradually begin to subside due to the re-absorption of the hematoma. If you force the head into a central position rather than a tilted position, you can feel the affected sternocleidomastoid muscle because it is tight like a rubber band.
If not treated, the tilting can gradually become more serious. The face of the affected baby will gradually appear to be asymmetrical because lack of circulation affects normal development of the muscle. The blockage also affects the blood circulation of the brain. The head will become flatter on one side because of the injured baby favors lying on one side. At about one and half year old the development of the affected side of the face is slower; thus it becomes smaller. The cervical vertibrae can actually begin to protrude secondarily (because of the injured neck muscle) to the healthy side. Usually after two to four months, the hematoma will oftentimes be re-absorbed but the head will continue to tilt to the injured side and the chin will point to the healthy side without treatment. Usually the torticollis will not be outgrown, without treatment.
Treatments are based on the baby's age. (More will be uploaded)
After the second week after birth, it is important to carefully turn the baby's head, 3 to 4 times a day. Using small sand bags or bean bags can help to steady the baby's head during sleep. Using a warm herb decoction massage is very useful in helping to re-absorb the hematoma; this treatment is effective for mild injuries. If the baby is over six months old, and if these methods are ineffective, after excluding other possible causes (such as bone injuries), usually surgery is being performed on the sternocleidomastoid (neck muscle). Often if treated earlier, surgery is usually not necessary.
頸部有一對重要的肌肉 叫胸鎖乳突肌，左右各一塊，一些嬰兒出生後常常發現頭部偏向一側，俗稱“歪脖”，這是怎麼回事呢?除了頸椎骨的先天性畸形外，常見的原因就是頸部一側的胸 鎖乳頭肌發生攣縮，使頭部向患側偏斜所致，故稱為先天性肌性斜頸。
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Last update: Jan 11, 2012; 11:53 a.m. LAH