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Increased head circumference
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Increased head circumference

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Macrocephaly

Increased head circumference is when the measured distance around the widest part of the skull is larger than expected for the child's age and background.

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  • Considerations

    A newborn's head is usually about 2 centimeters larger than the chest size. Between 6 months and 2 years, both measurements are about equal. After 2 years, the chest size becomes larger than the head.

    Measurements over time that show an increased rate of head growth often provide more valuable information than a single measurement that is larger than expected.

    Increased pressure inside the head (increased intracranial pressure) often occurs with increased head circumference. Symptoms of this condition include:

    • Eyes moving downward
    • Irritability
    • Vomiting
  • Causes

    • Benign familial macrocephaly (family tendency toward large head size)
    • Canavan disease
    • Hurler syndrome
    • Hydrocephalus (congenital, post-traumatic, or obstructive)
    • Intracranial bleeding
    • Morquio syndrome
  • When to Contact a Medical Professional

    The health care provider usually finds macrocephaly during a routine well-baby exam.

  • What to Expect at Your Office Visit

    The health care provider will take a medical history and will perform a physical examination.

    Medical history questions may include:

    • Time pattern
      • When did you first notice that the baby's head seemed large?
      • Does the baby's head size seem to be increasing faster compared to the growth of the body?
    • Location
      • Does the head seem larger all over?
      • Is the head growing more in a front-to-back pattern or in a side-to-side pattern?
    • Other
      • What other symptoms are present (especially changes in brain or nervous system functions)?

    A careful physical exam will be done. Other milestones for growth and development will be checked.

    In some cases, a single measurement is enough to confirm that there is a size increase that needs to be tested further. More often, repeated measurements of the head circumference over a period are needed to confirm that the head circumference is increased and the problem is getting worse.

    Diagnostic tests that may be ordered include:

    • Head CT scan
    • MRI of the head

Related Information

  Increased intracra...Fontanelles - bulg...    

References

Cohen MM Jr. Overgrowth syndromes. In: Gilbert-Barness E, Kapur RP, Oligny LL, et al., eds. Potter's Pathology of the Fetus, Infant and Child. Phildelphia, PA: Elsevier Mosby; 2007:chap 41.

Kinsman SL, Johnston MV. Congenital anomalies of the central nervous system. In: Kliegman RM, Stanton BF, St. Geme JW III, et al., eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 585.

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Review Date: 5/10/2013  

Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. editorial team.

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