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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.

Alternative Names

Macrocephaly

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:

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)?

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:

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.

Updated: 5/10/2013

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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