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The abnormal fontanel

Joseph Kiesler1, Rick Ricer

  • 1Department of Family Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio 45239, USA. kieslehj@fammed.uc.edu

American Family Physician
|June 27, 2003
PubMed

Insights

Understanding normal fontanel variation is key for diagnosing infants. Abnormalities like large or bulging anterior fontanels can indicate serious conditions such as increased intracranial pressure or developmental disorders.

Area of Science:

  • Pediatrics
  • Neonatology
  • Developmental Biology

Background:

  • Infants are born with six fontanels, crucial anatomical landmarks for clinical assessment.
  • The anterior fontanel, the largest, typically measures 2.1 cm and closes around 13.8 months.
  • Variations in fontanel size and closure time are common and require careful evaluation.

Purpose of the Study:

  • To review the diagnostic criteria for abnormal fontanel presentation in infants.
  • To outline common causes associated with large or delayed fontanel closure.
  • To describe the significance of bulging or sunken fontanels in clinical practice.

Main Methods:

  • Review of existing literature on infant fontanels and their clinical significance.
  • Analysis of common etiological factors for abnormal fontanel findings.
  • Correlation of physical examination findings with diagnostic imaging modalities.

Main Results:

  • Delayed closure or large anterior fontanels are linked to achondroplasia, hypothyroidism, Down syndrome, increased intracranial pressure, and rickets.
  • Bulging fontanels may indicate increased intracranial pressure or tumors; sunken fontanels suggest dehydration.
  • Physical examination guides the selection of appropriate imaging techniques for diagnosis.

Conclusions:

  • Accurate diagnosis of abnormal fontanels relies on understanding normal developmental variations.
  • Prompt identification of fontanel abnormalities is essential for timely intervention and management.
  • Clinical assessment combined with imaging plays a vital role in diagnosing underlying pediatric conditions.

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