Head

Question 1

What range is a normal head circumference?

Answer 1

35-38cm

Question 2

What assessments should be considered for a small head circumference?

Answer 2

1. Head imaging
2. TORCH infection screen
3. Chromosomal abnormalities

Question 3

Why may the head be flat on top and elongated in the anterioposterior diameter?

Answer 3

Breech. Should improve significantly within a week.

Question 4

Is molding concerning?

Answer 4

No it should resolve spontaneously

Question 5

How is caput diagnosed?

Answer 5

Using firm constant pressure to elicit PITTING.
It can cross over suture lines (since it affects the scalp) however it is often found entirely unilaterally so Pitting is a better diagnostic tool rather than location.

Question 6

What is a cephaloheamatoma?

Answer 6

A collection of blood under the periosteum of a skull bone.

Question 7

How is a cephaloheamatoma differentiated from caput?

Answer 7

A cephaloheamatoma is a collection of BLOOD between the skull bone and the periosteum (bone membrane). Ie on top of the skull bone but under the periosteum. Therefore the blood CANNOT cross suture lines as it is trapped within the bone’s membrane.

Caput is tissue fluid trapped within the subcutaneous layer of the scalp (therefore not restrained to only one bone). It CAN CROSS suture lines. PITTING seen on palpating.

Question 8

What is a subgaleal bleed?

Answer 8

Bleeding between the skull and the scalp, it is a very large space, so is very dangerous as the entire circulating volume could end up here.

The blood is easily moved, a fluid wave can be seen when pressure is applied to the head.

Question 9

Where should hair whorls normally be found? And what could be implied if found elsewhere?

Answer 9

There should be ONE primary hair whorl over the VERTEX

Multiple or unusual locations may suggest abnormal brain growth ie. trisomy 21 etc.