Small head at birth

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.

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.

an examination

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 As a result, the head of the child became small and pointed, the nose was sunken, the ears were large, the forehead was retracted, the forehead was narrow, and the head circumference was extremely small, and the maximum was less than 42 cm.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.

Differential diagnosis

The identification of severe ADHD and small head deformity: the head deformity is more than 2 standard differences lower than normal children. The clinical development and mental development of children are often backward. The clinical manifestations are large hands, wash and twist. , gait changes or ataxia, need to be distinguished from Ataxia with severe ADHD, while small head deformity is generally less mentally retarded, and has a special head shape, CT examination shows small brain volume or brain atrophy, ventricle And arachnoid widening, and children with severe ADHD generally have normal intelligence, although attention is not concentrated, excessive activity affects academic performance, but the intellectual impact is not significant, and CT examination has no positive signs.

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. According to the 1984 Vienna International Symposium, the diagnostic criteria are as follows: 1 girl onset; 2 prenatal and perinatal period, normal neuropsychiatric and motor development 6 to 18 weeks after birth; 3 normal head circumference at birth, after birth 6 months to 4 years old with sexual development retardation and a small head; 41 years and a half to 4 years old, the intelligence gradually declines, and the contact with the surrounding is reduced; 51 to 4 years old gradually lose the skills of the acquired hand, the appearance of repeated stereotypes Hands flapping, washing and twisting action, with paroxysmal over-ventilation, teething or gaze; 6 walking reduction, gait change or ataxia; 7 can have a stable period in the course of the disease, and then epilepsy and pyramidal tract signs.

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