In ∼ 10 % of affected infants with plagiocephaly, there will be a permanent deformity with a mild to
severe cosmetic effect.5 Patients with moderate to
severe asymmetry are often referred to a
craniofacial center for consideration of treatment.
In the recent case series, most infants with probable congenital ZIKV infection were noted to have
craniofacial disproportion (95.8 %) and, to a lesser degree, biparietal depression (83.3 %), prominent occiput (75 %), and excess nuchal skin (47.9 %).38 Features supportive of the FBDS phenotype scattered through published reports include redundant scalp, 27,36,39,41 occipital prominence and / or overlapping sutures,14,20,22 - 24, 26,27,38 and typical
craniofacial appearance with disproportion.13, 27,33,34,40 The FBDS phenotype is also prevalent in ZIKV - related media.47 Among infants with
severe microcephaly, the pattern appears to be consistent, although the degree of cranial vault deformation varies.