Posted by: Racoon | 2012/12/05


Large head

Dear Prof

I though I was going to park this finding for the next 6 months, but here I am after all to ask - my 2 yo son''s head circumference has increased from the 50th percentile at 6 months, to the 97th percentile now at 27 months. Our pediatrician did mention it and wants to re-check in 6 months time. We do have big heads in the family (my sister is off the charts and perfectly normal otherwise - all brains). What would the symptoms of hydrocephalus be? when is an MRI indicated? i am ofcourse more wary due to his older brother who has Chiari.

many thanks!

Expert's Reply



While I agree with you that this may just be a familial tenedency,it is unusual for a baby's head circumference to increase from the 50th to the 97% line.One explanation is that the first measurement may not have been done correctly at the time.The signs of hydrocephalus are an obviously very large head, failure of the fontanalle and the skull bone sutures to close and the so-called sunset sign of the eyes, with the whites of the eye visible above the irises but not below. The question to ask your paediatrician is if he is certain that there is no clinical evidence of hydrocephalus and whether it is safe to wait another 6 months.

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