Paediatric neurology (head shape & size) Flashcards
This is a normal bebeys skull - identify the different parts
The fontanelles in a baby’s skull close (obviously) - when do they do this?
Posterior fontanelle closes first - at about 2-3 months old
Anterior fontanelle closes between 1-3 years of age
Clinically - how do we measure head sizes?
OFC - Occiptiofrontal circumference
Then plot on WHO growth standards graph
Give an overview of the assessment of head size and shape…
a) When is it done?
b) What are the indications for it?
c) What specifically is measured and examined?
a) When is it done?
- Between birth - 3 years
b) Indications?
- Routine (so always done)
- Also indicated with neurological symptoms or developmental complaints
c) What is measured and examined?
- OFC (head size)
- Head shape
- Sutures & fontanelles
- Facial asymmetry
What is microcephaly?
What OCF measurement?
Microcephaly = small head
Usually indicates microancephaly = small brain
Mild microcephaly - <2 SD*
Moderate/severe - <3 SD*
*this means >2 SD below the mean value
What is macrocephaly?
What OCF readings?
Abnormally large head (does not = large brain)
OCF >2 SD
What physical features may be present alongside macrocephaly?
Facial features
Hepatosplenomegaly
Bony deformities
When do head shape abnormalities present?
Define each of the following head shape abnormalities:
a) plagiocephaly
b) brachycephaly
c) scaphocephaly
d) craniosynostosis
Tend to present in the first year of life
a) Plagiocephaly - flat head
b) Brachycephaly - short head + flat at back
c) Scaphocephaly - boat shaped head
d) Craniosynostosis - premature fusion of sutures
What are the features of deformational plagiocephaly?
When viewed from above:
- ipsilateral frontal bossing
- contralateral occipital bossing
- ipsilateral anterior ear displacement
- ipsilateral occipitoparietal flattening
This gives the head a parallelogram shape from above (see picture)
Heres a diagram of the different types of craniosynostosis
:3
