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.
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
The health care provider usually finds macrocephaly during a routine well-baby exam.
The health care provider will take a medical history and will perform a physical examination.
Medical history questions may include:
The distance is measured in centimeters or inches and compared with:
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:
Macrocephaly
Updated 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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