Re-evaluation of the approach to an enlarging head in infancy

Computerized axial tomography is a safe, non-invasive technique for measurement of ventricular size. A review of 44 children without myelodysplasia who were evaluated for inappropriately enlarging heads, documented a group of 20 children presenting at five months to two years of age with megalencephaly or mild communicating hydrocephalus. Of these, only two required shunts. At their most recent examination, the great majority of these children are developmentally normal. Serial neurological examination, developmental evaluation and head-circumference measurements, in association with computerized axial tomography, have proved effective in the assessment and management of this particular group of children with large heads.