What is microcephaly and how is it caused?

In pediatric check-ups, not only is the weight and height of the baby checked, but one of the most important measurements that is made is that of the head circumference to determine if brain growth is normal.

The cranial perimeter is one of the routine measurements that are carried out on the baby from birth, even in utero, which offers a lot of very valuable information on the development of the components of the skull (brain parenchyma, cerebrospinal fluid, and bone and connective content). These measurements are made with a tailor’s meter in the pediatrician’s office and compared using standardized growth charts with the percentiles of other children of the same age and sex.

What happens when a macrocephaly is determined? Macrocephaly means ‘big head’ and it occurs when there is an alteration in the circumference of the head, and that this is larger compared to other boys and girls of the age to which that measurement corresponds. This can happen from birth and even from inside the womb, which is why the circumference of the fetus is measured in ultrasound check-ups.

What are the causes of macrocephaly?

It is a variable measurement, that is, there is no universal measurement that defines it, but it is the pediatrician who will diagnose it along with other factors of the child’s development or, if known, the cause that caused it.

There are several causes that produce macrocephaly. It may be due to a developmental malformation of the brain inside the uterus, where the cerebrospinal fluid does not drain well, which is called hydrocephalus and the fluid is under tension. Likewise, it may be related to situations such as dwarfism, neurofibromatosis… and other syndromes. There is also benign familial macrocephaly, where the child has a large head but also the father or mother have it, and absolutely nothing happens.

Diagnosis and prognosis of macrocephaly

The diagnosis can be made from within the uterus by measuring the circumference of the skull of the future baby or once they are born, in routine visits to the pediatrician and also by what is called the clinic. The pediatrician from experience already sees that the child has a large head and even so, the percentiles are measured and compared to make the diagnosis.

For this reason, reviews must be very complete and ask parents for all kinds of information about both prenatal and perinatal history, such as: possible intrauterine infections, exposure to radiation, drugs, gestational age, complications during childbirth… As well as its development. psychomotor at the motor, social and cognitive level.

For a good prognosis, it is important to know the cause, to know if it is related to a syndrome and, of course, to work on the intellectual retardation that some may have. And it is that, close to half of patients with macrocephaly have some neurological intellectual delay that must be worked on. Physically, as the child grows, he compensates and the difference in size is less evident.

What is the treatment for macrocephaly?

Since macrocephaly can be due to multiple causes, both the physical examination and knowing how to detect certain warning signs in the psychomotor development of the child can help to diagnose more serious causes early, such as hydrocephalus, which the doctor previously commented on. The sooner any of these alterations is detected, the sooner the most appropriate treatment can be given, always indicated by the pediatrician or by the specialist in question.

Similarly, treatment depends on the cause. If it is a hydrocephalus, sometimes you have to put shunt drains to release that intracranial pressure in the child, which can have consequences. And, of course, if it is related to a syndrome, said syndrome will be worked on. The issue of aesthetics, if the child is neurologically normal, nothing needs to be done. For his part, if there is a neurological cognitive delay, it will have to be worked on with what is called early stimulation, educational psychologists, because of the delay, not because of the aesthetic issue.