Head Size/Shape

Question 0

Hydrocephalus

Answer 0

frontal bossing, excessively wide sutures
thin scalp w/dilated veins
“sunsetting sign” (impaired upward gaze so lower part of iris hidden beneath lower eyelid)
*irritability, hypertonia, N/V
*impaired EOM/upward gaze

Question 1

Macrocephaly Causes

Answer 1

Hydrocephalus
Congenital Infection (toxo, CMV, syphilis)
Mass Lesion
Hydranencephaly
Increased ICP
Skeletal Cranial Dysplasia
Megalencephaly

Question 2

Craniosynostosis Associations

Answer 2

Apert
Crouzon 
Pfeiffer
(all mostly bicoronal brachycephaly)
--Hyperthyroidism
--Hypophosphatasia

Question 3

Craniosynostosis Types

Answer 3

*scaphocephaly (most common)
AP elongation d/t sagittal suture closure
*brachycephaly
L-R widening d/t coronal suture closure
coronal sutures can also&raquo_space;
acrocephaly (taller in front, slope downward towards back)
oxycephaly (taller w/shorter front-back and side-side)
turricephaly (tall skull)
*plagiocephaly
asymmetric d/t unilateral coronal or lamboidal
*trigoncrphaly
narrow triangle w/ridged forehead d/t metopic suture
*Kleeblattschaedel
cloverleaf deformity d/t b/l coronal, lamboidal and metopic

Question 4

Craniosynostosis Causes

Answer 4

70% sporadic
simple sagittal (scaphocephaly) most common
- almost always sporadic
- 4:1 male:female
- low risk ICH
- can affect ant or post more&raquo_space; frontal or occipital bossing

Question 5

Cranial Sutures

Answer 5

Coronal: side-side anteriorly
Sagittal: front-back on top
Lamboidal: side-side posteriorly (last to fuse
Metopic: down middle of forehead (fuses ~7mos)

Question 6

Benign Macrocephaly

Answer 6

> 98th %ile for age
often parents w/big heads
often born w/nl HC but quickly increase during 1st 6mos