A few days ago we talked to him about something that is customary to do to the baby from birth to 3 years approximately. This practice involves taking head measurements and comparing them with normal parameters. Control this measure allows early detection of brain growth disorders.
Head circumference: what it is and how it is measured
The head circumference is the circumference that passes through forehead and occiput. To measure it, use a non-stretch tape, circle it looking for the largest contour and repeat the measurement at least 2-3 times to minimize errors.
Growth is dynamic: in the first months the PC can increase rapidly and then slows down. The trajectory in the curves matters, not just an isolated value. Values ​​above or below 2-2,5 standard deviations require assessment.
In addition to size, considerations are given to weight and size, neurological development and the PC of the parents to discern benign family forms.
What a larger head circumference (large head) can mean
- Meningitis: inflammation of the membranes of the brain and spinal cord by germs.
- Internal bleeding of the head.
- Hydrocephalus: accumulation of CSF that dilates ventricles and can raise pressure.
- Brain tumors.
- Macrocephaly (includes familiar forms and by megalencephaly).
- Canavan disease hereditary white matter disease.
- Morquio syndrome.
- Hurler syndrome.
Other tables to consider: benign hyperplasia of the subarachnoid space, arteriovenous malformations and bone thickeningWarning signs of intracranial hypertension: irritability, vomiting, tense fontanelle, or rising sun eyes.
What a smaller head circumference (small head) can mean
- microcephaly: due to reduced brain growth (genetic, infectious or nutritional).
- Poor brain development.
- Malnutrition.
- Early fusion of the cranial bones (craniosynostosis).
Can be congenital (from birth) or postnatal (PC stagnates or falls in percentile). Investigate in utero exposures, infections, syndromes, and dysmorphic features.
When to consult and how to study
Check if the PC is >2 SD or <-2 SD, if jumps percentiles rapidly or there are neurological symptoms. The evaluation includes history, examination, measure parental PC, and according to findings, transfontanellar ultrasound, CT or MRI. In selected cases, tests genetic and metabolic.
An altered PC does not always imply disease, but requires follow-up growth and neurodevelopment, informing the family about warning signs.