Head size Flashcards
What is Microcephaly?
An occipital-frontal circumference < 2nd centile
What are the pathological causes of microcephaly?
- congenital infection
- perinatal brain injury e.g. hypoxic ischaemic encephalopathy
- fetal alcohol syndrome
- syndromes: Patau
What are the other possible causes of microcephaly?
- normal variation e.g. small child with small head
- familial e.g. parents with small head
- craniosynostosis
What is Craniosynostosis?
Premature fusion of skull bones
skull sutures close prematurely.
What can happen if craniosynostosis is left untreated?
It will lead to raised intracranial pressure
What are the symptoms that can present with raised ICP?
Developmental delay Cognitive impairment Vomiting Irritability Visual impairment Neurological symptoms Seizures.
What are the other presenting features of Craniosynostosis?
- Anterior fontanelle closure before 1 year of age
* Small head in proportion to the body
What is the first line investigation for
Skull x-ray
What is used to confirm the diagnosis of
CT head with bone views
What is the management of mild cases of Craniosynostosis?
monitored and followed up over time.
What is the management of more severe cases of Craniosynostosis?
More severe cases require surgery for surgical reconstruction of the skull.
What is the prognosis of Craniosynostosis?
Good with proper management.
They will have a lifelong scar on the scalp where the surgery was performed.
What are the different types of Synostosis?
Saggital Synostosis
Coronal Synostosis
Metopic Synostosis
Lambdoid Synostosis
What are the features of saggital Synostosis?
Affects the Saggital suture
Long and narrow from front to back
What are the features of Coronal Synostosis?
Coronal suture
Bulging on one side of the forehead
What are the features of Metopic Synostosis?
Metopic suture
Pointy triangular forehead
Lambdoid Synostosis Lambdoid suture Flattening on one side of the occiput
What are the features of Lambdoid Synostosis?
Lambdoid suture
Flattening on one side of the occiput
What is Plagiocephaly?
Flattening of one area of the baby’s head.
What is Brachycephaly?
Flattening at the back of the head, resulting in a short head from back to front.
Why do Plagiocephaly and Brachycephaly occur?
The baby had a tendency to rest their head on a particular point, resulting in the skull bones and sutures moulding with gravity to create an abnormal head shape.
When do tend to occur?
Baby aged 3 – 6 months
Why do brachycephaly and and Plagiocephaly occur?
Baby had a tendency to rest their head on a particular point, resulting in the skull bones and sutures moulding with gravity to create an abnormal head shape.
What do patients with brachycephaly and Plagiocephaly tend to have a history of?
Preferring to sleep on one side of their head.
What is important to exclude immediately?
Craniosynostosis
What are some simple measures can be taken to encourage the baby to avoid resting on the flattened area
- Positioning them on the rounded side for sleep
- Supervised tummy time
- Using rolled towels or other props
- Minimising time in pushchairs and car seats
