Increased head circumference

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.

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.

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

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

See also: Bulging fontanelles

Causes

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)?

The distance is measured in centimeters or inches and compared with:

  • Past measurments of a child's head circumference
  • Normal ranges for a child's sex and age (weeks, months) -- based on normal growth rates of infants' and children's heads

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 of time are needed to confirm that the head circumference is increased and the problem is getting worse.

Diagnostic tests vary depending on the cause, but often include:

Alternative Names

Macrocephaly

Update Date: 5/1/2012

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, Medical Director, A.D.A.M., Inc.

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