small head
Introduction
Introduction The small head is common in small head deformities, which means that the head is 2 standard differences or less lower than normal children. Various harmful factors (infection, malnutrition, poisoning, radiation) in the early stages of pregnancy may affect the development of the fetal brain. Metabolic abnormalities, chromosomal aberrations (such as trisomy 21, trisomy 18, trisomy 13 or other abnormalities) are also often associated with small head deformities, as well as some family hereditary small head deformities. Various causes (hypoxia, infection, trauma) at birth or after birth can also cause brain damage and brain atrophy, and the head circumference becomes smaller, which is called secondary head deformity.
Cause
Cause
There are many reasons for the small deformity of the head. Various harmful factors (infection, malnutrition, poisoning, radiation) in the early pregnancy may affect the development of the fetal brain. Metabolic abnormalities, chromosomal aberrations (such as trisomy 21, trisomy 18, trisomy 13 or other abnormalities) are also often associated with small head deformities, as well as some family hereditary small head deformities. Various causes (hypoxia, infection, trauma) at birth or after birth can also cause brain damage and brain atrophy, and the head circumference becomes smaller, which is called secondary head deformity.
Examine
an examination
Related inspection
Routine physical examination CT scan
Some small, deformed brains are small, but the shape is normal, while others have obvious deformities or are accompanied by enlarged ventricles.
The head of the sick child is small and pointed, the forehead is narrow, the cranial sac is small, the occiput is flat, the face and ears look relatively large, and the anterior and sacral closures are too early, and there may be interosseous ridges.
Physical development and mental development of children with small deformities often lag behind, but not all children with small head deformities are accompanied by mental retardation. About 7.5% of the head circumference is lower than the normal 2 to 3 standard deviations. Some children have convulsions and/or cerebral palsy. CT showed brain atrophy, widening of the ventricles and subarachnoid space, and only showed small brain volume, while other structures were normal.
The other can also be expressed as a small head syndrome called Rett syndrome. The diagnostic criteria developed according to the 1984 Vienna International Symposium are as follows:
1 girl is sick.
2 prenatal and perinatal period is normal, 6 to 18 weeks after birth, neuropsychiatric and motor development is normal.
3 The head circumference is basically normal at birth, and the sexual development is delayed from 6 months to 4 years after birth.
The 41-and-a-half-year-old intelligence gradually regressed, and the contact with the surrounding area decreased.
51 to 4 years old gradually lost the skills of the acquired hand, repeated stereotypes of specific two-handed tapping, washing and twisting action, with paroxysmal hyperventilation, teething or gazing.
6 walking less, gait changes or ataxia.
7 There may be a stable period in the course of the disease, and epilepsy and pyramidal tract signs appear.
Diagnosis
Differential diagnosis
Small head at birth: The main manifestation of this disease is that after brain development is completed, the weight of the brain is significantly lighter than normal, and the brain is too small or has no brain return. The development of the brain is obviously slow, and even when the baby is 3 to 5 months, it stops developing. As a result, the head of the child became small and pointed, the nose was sunken, the ears were large, the forehead was retracted, the forehead was narrow, and the head circumference was extremely small, and the maximum was less than 42 cm. The forehead and occipital area of the sick child are flat, and the cardia and suture are closed early. Physical development is obviously abnormal, and mental development is significantly slow. Some children even have convulsions, stiff limbs or swollen hands and feet.
Head big: Because the big baby eats the inferior milk powder without nutrition, the whole body including the head and face will be swollen. Moreover, these inferior milk powders are not only low in protein content, but also low in other nutrients such as calcium, phosphorus and vitamins. Especially in the absence of vitamin D, it will hinder the body's absorption of calcium, bone calcification, and then infants. There is a high probability of rickets complication, which is characterized by a large head and an uncoordinated body proportion.
Increased skull: The progressive increase of the skull due to increased intracranial pressure is not proportional to the development of the whole body. The forehead protrudes forward, the dome is pressed downward, the double eyeball is down, the eyeball is turned downward, the upper part of the sclera is white, the anterior ankle is enlarged and the tension is increased, other sacs can be enlarged, the skull joint is separated, and the scalp vein is dilated. When the infant is not closed, the skull can be compensated for expansion when the intracranial pressure is increased.
Triangular head deformity: the forehead is closed, the forehead becomes smaller, and the posterior part of the skull grows excessively, which is called a triangular head deformity. Triangular head deformity is a facial symptom of pediatric craniofacial deformity syndrome. Head dysplasia is born with scapular head, triangular head, short head and other deformities, and some may have open cardia, sagittal and herringbone sulcus and brain hypoplasia, facial narrowness, olecranon, small jaw, Small mouth cracks, abnormal auricles, etc., it is also known as the bird face deformity syndrome.
Long-headed giant brain: Pediatric giant brain malformation syndrome is a syndrome in which infants and young children are growing too fast, with large head and mental retardation. The clinical manifestations of this disease have a significant increase in physical development in the neonatal period, and have long-headed giant brain, mental retardation, specific face and limb abnormalities.
