Abstract
Macrocephaly was defined as a head measuring larger than 98 th percentile. We have evaluated CT findings and head growth curves in 25 infants with large heads. Ten (40%) of 25 infants with large heads were normal developmentally and neurologically. Five (20%) of those were mentally retarded. The other 10 infants (40%) included hydrocephalus (4 cases), malformation syndrome (3 cases), brain tumor (1 case), metabolic disorder (1 case) and degenerative disorder (1 case). Their head growth curves were typed as (I), (II) and (III): Type (I) (excessive head growth curve to 2 SDs above normal); Type (II) (head growth curve gradually approached to 2 SDs above normal); Type (III) (head growth curve parallel to 2 SDs above normal).
Ten of macrocephaly with normal psychomotor development were studied clinically and radiologically in details. They were all male. CT pictures of those showed normal or various abnormal findings: ventricular dilatations, wide frontal and temporal subdural spaces, wide interhemispheric fissures, wide cerebral sulci, and large sylvian fissures. CT findings in 2 of those, which because normal after repeated CT examinations, resembled benign subdural collection. CT findings in one of those were external hydrocephalus. Head growth curves were obtained from 8 of those. Six cases revealed type (II) and two cases did type (III). The remaining 2 cases could not be followed up.
We consider that CT findings of infants showed macrocephaly with normal psychomotor development reveals normal or various abnormal (ventricular dilatations, benign subdural collection, external hydrocephalus) and their head growth curves are not at least excessive.
Infants with mental retardation showed similar CT findings and head growth curves as those with normal psychomotor development. It was difficult to distinguish normal from mentally retarded infants by either CT findings or head growth curves.
The present study suggests that it is important to know whether infants with large heads are normal or not so as to avoid unnecessary examinations in the future.
