1 / 25

Head Circumference

Head Circumference. Head Circumference. Average at birth 35cm Normal Growth: 1cm/month for 1 st 6 months ½ cm/month from 6 months to 1 year Especially important first 3 years of age. Head Circumference. Most concerning: 3 Standard Deviations above or below the mean

sondra
Download Presentation

Head Circumference

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Head Circumference

  2. Head Circumference • Average at birth 35cm • Normal Growth: • 1cm/month for 1st 6 months • ½ cm/month from 6 months to 1 year • Especially important first 3 years of age

  3. Head Circumference • Most concerning: 3 Standard Deviations above or below the mean • >97th Percentile: Macrocephaly • <3rd Percentile: Microcephaly • Special Charts • Down Syndrome • Williams Syndrome • Achondroplasia • VLBW

  4. Head Circumference • Microcephaly: Small Head • Macrocephaly: Large Head • Micrencephaly: Small Brain • Megalencephaly: Large Brain • Brain growth determines ultimate cranium size

  5. Microcephaly • 2.5% of all children • Some with no neurologic problems • Asymptomatic familial microcephaly • Family history of small head size • Normal development • Normal neuro exam

  6. Microcephaly • Primary (genetic) • Usually present at birth • Secondary (environmental) • Present at birth • Develop later from postnatal insult

  7. Primary Microcephaly Vera • Autosomal Recessive • Brain is small • Otherwise normal architecture • Mental retardation • Otherwise unremarkable neuro exam

  8. Microcephaly w Anatomic Abnormalities • Abnormal neuroimaging • Holoprosencephaly- failure of forebrain to divide into hemispheres. • Midline facial defects • Disruption of hypothalamic-pituitary axis • Lissencephaly- smooth brain • Seizures, spasticity, global dev delay

  9. Microcephaly: Syndromes Rett Syndrome

  10. Microcephaly: Syndromes Rubenstein Taybi Syndrome Broad Thumb-Hallux Syndrome

  11. Microcephaly: Syndromes Cornelia de Lange

  12. Microcephaly: Syndromes Miller Dieker

  13. Secondary Microcephaly • Prenatal Causes • Drugs and alcohol, irradiation, intrauterine infections • Perinatal asphyxia • Severe malnutrition

  14. Macrocephaly

  15. Hydrocephalus • Presenting signs/symptoms vary with age • Communicating vsnoncommunicating

  16. Hydrocephalus • Benign hydrocephalus • H.C. normal or large at birth • Increases to 98%ile, then parallels chart • Normal neuro exam and development

  17. Megalencephaly • Benign or idiopathic (AKA Familial Macrocephaly) • Normal neuro exam • No increased ICP • No fluid collection • Family history of large heads • May have some subtle difficulty with coordination

  18. Megalencephaly • Metabolic • Inborn errors of metabolism • Most autosomal recessive • Significant dev delay with regression • Mucopolysaccharidoses

  19. Megalencephaly • Anatomic • Increased number of cells • Sotos syndrome (overgrowth syndrome) • Neurocutaneous syndromes • Most with developmental delay

  20. Macrocephaly

  21. Macrocephaly • Must entertain the worst • Space-occupying lesions • Tumor • AVM • Hemorrhage

  22. Imaging • Open fontanelle • Ultrasound • MRI • Gives best information on brain parynchyma • Best at posterior fossa • CT • Intracranial calcifications • Hemorrhage • Skull

More Related