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Clinical approach to the child with a large head
1Section of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Insights
Most children have normal head sizes. However, some infants may have abnormally large heads (macrocephaly), often linked to cranioskeletal conditions.
Area of Science:
- Pediatric neurology
- Developmental biology
Background:
- Head circumference is a key indicator of healthy child development.
- Abnormal head sizes, both small and large, can occur at birth or develop postnatally.
- Head circumference abnormalities are influenced by brain size, fluid volumes, and skull structure.
Purpose of the Study:
- To define macrocephaly and its association with cranioskeletal dysplasias.
- To highlight the factors determining head circumference in children.
Main Methods:
- Review of pediatric head circumference data.
- Clinical assessment of head size against age and gender norms.
- Correlation analysis with brain size, fluid dynamics, and skull morphology.
Main Results:
- Macrocephaly is defined as head size exceeding the mean by over two standard deviations for age and gender.
- Abnormal head circumferences can result from variations in brain size, cerebrospinal fluid (CSF) volume, blood volume, subdural fluid, and skull bone thickness.
- Macrocephaly is frequently observed in conjunction with various cranioskeletal dysplastic conditions.
Conclusions:
- Macrocephaly in children warrants further investigation into underlying causes.
- Understanding the determinants of head circumference is crucial for diagnosing developmental abnormalities.
- Cranioskeletal dysplasias are significant associated conditions with macrocephaly.
Abstract:
Majority of children has head size that is appropriate for age and gender. But a few have either too small or too large head at birth or may be of postnatal acceleration. Abnormality of head circumferences is determined by brain size, including any malformations and space occupying lesions, cerebrospinal fluid (CSF) and blood volume, presence of subdural fluid and thickness of skull bones and overlying tissue scalp. Macrocephaly is used when the head size exceeds the mean by more than two standard devotions of age and gender. Macrocephaly is seen in association with several cranioskeletal dysplastic conditions.
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