Macrocephaly: differential diagnosis

Macrocephaly Differential Diagnoses - Medscap

Macrocephaly is defined as head circumference more than two standard deviations (SDs) above the mean value for a given age and gender. Macrocephaly can be the first manifestation of various congenital and acquired neurologic conditions or may be just a familial trait The Child With Macrocephaly: Differential Diagnosis and Neuroimaging Findings Macrocephaly is a common clinical finding in children. Increased volume of one of the intracranial compartments can enlarge the head either prenatally or postnatally while the cranial sutures are open The Child With Macrocephaly: Differential Diagnosis and Neuroimaging Findings Emanuele Orrù 1 Sonia F. Calloni2 Aylin Tekes3 Thierry A. G. M. Huisman3 Bruno P. Soares3 Orrù E, Calloni SF, Tekes A, Huisman TAGM, Soares BP 1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore. Differential Diagnosis. When dealing with an infant with macrocephaly, it is important to differentiate isolated macrocephaly from other possible head shapes. Plagiocephaly refers to a flattening of one area of the skull and is often seen in children with a history of lying with the head in one position

The inheritance pattern of benign macrocephaly is autosomal dominant with incomplete penetrance with a male to female preponderance of 4:1. Differential diagnosis should include consideration of overgrowth syndromes, which may be due to single-gene disorders The overgrowth conditions are well represented in any differential listing of conditions associated with macrocephaly in combination with generalized somatic overgrowth, and include the syndromes of Sotos, Weaver, Simpson-Golabi-Behmel, Beckwith-Wiedemann and others Macrocephaly is defined as [an occipitofrontal circumference or head circumference, OFC ] of > 2 standard deviations above the mean or above the 97th percentage for a given age, and gender, or when serial measurement shows progressive enlargement, crossing of one or more major percentiles, or when there is an increase in OFC > 2 cm/month in the first 6 months of life Macrocephaly is a clinical and radiological term that refers to a generalized increase in the size of the cranial vault

  1. The measurement of head circumference (also called occipitofrontal circumference [OFC]) is a direct reflection of head growth and an important step in the evaluation of childhood growth and development. The etiology and evaluation of macrocephaly in infants and children will be discussed here. The etiology and evaluation of microcephaly are.
  2. Measurement of the head circumference is vital to detect associated microcephaly or macrocephaly (caused by hydrocephalus). The differential diagnosis of posterior plagiocephaly: true lambdoid.
  3. Macrocephaly is defined as an occipitofrontal circumference (OFC) 2 SD or more higher than the mean for age, gender, and ethnicity measured over the greatest frontal circumference. From: Swaiman's Pediatric Neurology (Sixth Edition), 201
  4. Differential diagnosis Macrocephaly with white matter disease, characteristic for Canavan disease, can also be found in Alexander disease, benign megalencephaly with leukodystrophy, Krabbe disease, adrenoleukodystrophy, and vacuolating leukodystrophy
  5. Macrocephaly refers to an overly large head. It's often a symptom of complications or conditions in the brain. There's a standard used to define macrocephaly: The circumference of a person's head..
  6. Megalencephaly-capillary malformation syndrome (MCAP), formerly known as macrocephaly-capillary malformation, is a complex disorder that involves many organ systems including the skin, blood vessels, connective tissue, brain and others, and that usually manifests at birth. Comparisons may be useful for a differential diagnosis
  7. Macrocephaly is customarily diagnosed if head circumference is greater than two standard deviations (SDs) above the mean. Relative macrocephaly occurs if the measure is less than two SDs above the mean, but is disproportionately above that when ethnicity and stature are considered

[Transient neonatal macrocephaly. The differential diagnosis of abnormally fast-growing skull in newborn infants]. [Article in German] Marty H, Zurbrügg RP. In a twin baby of low birth weight a transient abnormally increased growth velocity of the head circumference could be observed 431770003 - Fetal macrocephaly Look For. Subscription Required. Diagnostic Pearls. Subscription Required. Differential Diagnosis & Pitfalls. Cutis marmorata telangiectatica congenita (CMTC) - Presents at birth in a reticulated, depressed, serpiginous pattern. Can have atrophy of the dermis and subcutis

The finding of macrocephaly or an enlarging OFC raises the strong possibility of a medical diagnosis other than child abuse, as illustrated in these 6 cases. Measurement of the OFCs of the parents is also indicated as it might reveal a familial macrocephaly if one of the parents has a large OFC. 2 Differential diagnosis. Differential diagnoses include Hemimegalencephaly (HMEG), Megalencephaly - polymicrogyria Antenatal diagnosis. Findings of prenatal ultrasound include marked fetal overgrowth and progressive macrocephaly in the absence of maternal hyperglycemia or fetal hyperinsulinemia, ventriculomegaly, hydrocephalus, frontal. Macrocephaly (MC), increased intracranial pressure (ICP), and hydrocephalus (HC) are common related conditions that lead to cross-sectional imaging of the infant and young child. Imaging plays a central role in establishing the diagnosis and guiding disposition and treatment of these patients Microcephaly is an important neurologic finding. Deviations from normal head growth may be the first indication of an underlying congenital, genetic, or acquired problem Affected individuals often have macrocephaly. Proteus-Like syndrome (PLS). Individuals with PLS have been found to have mutations in PTEN and clinically resemble Proteus syndrome. This is a variable group of clinical entities and diagnosis of an individual can be challenging unless a provider is experienced with the condition

Causes and differential diagnosis: Causes of macrocephaly are categorized according to different classifications. According to the pathological process underlying the cause (infection, genetic, familial..etc) or According to the anatomical structure that led to macrocephaly. In general, the causes of macrocephaly are Tan AP, Mankad K, Gonçalves FG, et al. Macrocephaly: Solving the Diagnostic Dilemma. Top Magn Reson Imaging. 2018 Aug;27(4):197-217; Orrù E, Calloni SF, Tekes A, Huisman TAGM, Soares BP. The Child With Macrocephaly: Differential Diagnosis and Neuroimaging Findings. AJR Am J Roentgenol. 2018 Apr;210(4):848-859; Sniderman A. Abnormal head growth Differential Diagnosis. Brain. Macrocrania/Macrocephaly

Macrocephaly - StatPearls - NCBI Bookshel

  1. Diagnosis Macrocephaly is a neurological pathology that can be detected during the gestation phase. Routine health checks through ultrasound ultrasound are able to detect abnormalities in cranial growth during the early stages of gestation, when macrocephaly presents a congenital or prenatal origin
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  3. The article deals with the problem of differential diagnosis of macrocephaly in pediatric neurology practice. Based on the analysis of contemporary literature, there is presented a detailed description of the clinical picture, approaches to the diagnosis and treatment of conditions associated with macrocephaly. Special attention is paid to the combination of macrocephaly with genetic diseases.

The differential diagnosis of macrocephaly includes familial macrocephaly, chromosome duplications and deletions, metabolic disorders and complex somatic mosaic conditions including CLOVES, MCAP and MPPH. Single gene disorders with macrocephaly include those in the Noonan syndrome spectrum (RASopathies) Macrocephaly is not a primary identifying characteristic but relative macrocephaly may be present. In infancy, the OFC tends to be above the mean but occasionally absolute macrocephaly is identified (Fig. 2F). Hence, Fragile X syndrome should be considered in the differential diagnosis for infants with macrocephaly

Macrocephaly Fetology: Diagnosis and Management of the

What Causes Macrocephaly? PediatricEducation

Gingival enlargements: Differential diagnosis and review

Differential diagnosis. The differential diagnosis for macrocephaly is wide including neoplastic and non-neoplastic causes. The rapidly enlarging head circumference in this case raises concern for obstructive hydrocephalus, possible causes of which include a tumour, but also intracranial haemorrhage, infection or an underlying non-tumoural structural lesion such as aqueductal stenosis We were able to reach a prenatal diagnosis in five fetuses: deletion of the long arm of chromosome 3 (46XX del[-3q] 26.1-27.1); vermian dysgenesis in a patient with a sibling with Joubert syndrome; achondroplasia; hemimegalencephaly; and polymicrogyria with polydactyly, with a differential diagnosis between macrocephaly-capillary malformation.

Macrocephaly Radiology Reference Article Radiopaedia

  1. Differential diagnosis of macrocephaly in an infant. Differential diagnosis of macrocephaly in an infant Hydrocephalus—obstructive or communicatingExtra-axial fluid collectionsThickened skullMegalencephaly. Differential diagnosis for seizures during childbirth
  2. Macrocephaly may be due to megalencephaly (true enlargement of the brain) or due to other conditions such as hydrocephalus or cranial thickening and is a common reason for referral to the genetics clinic. Macrocephaly is associated with many genetic disorders and this panel can be used for their differential diagnostics
  3. Differential diagnosis of macrocephaly in an infant. Differential diagnosis of macrocephaly in an infant Hydrocephalus—obstructive or communicatingExtra-axial fluid collectionsThickened skullMegalencephaly. Differential diagnosis of parasellar tumors in children
  4. imally increased ventricular size and who have a parent with macrocephaly, have a good developmental prognosis and a characteristic pattern of neuromotor development in the first year. Differential diagnosis. chronic.
  5. The disorder formerly known as macrocephaly-cutis marmoratatelangiectatica congenital (M-CMTC) is a distinct genetic disease and is now called macrocephaly-capillary malformation (M-CM/MCAP) Virtually all cases of CMTC occur randomly for no apparent reason (sporadically). Comparisons may be useful for a differential diagnosis
  6. Diffuse capillary malformation with overgrowth (DCMO) is a subset of capillary malformations (CM) associated with hypertrophy, i.e. increased size of body structures.CM can be considered an umbrella term for various vascular anomalies caused by increased diameter or number of capillary blood vessels. It is commonly referred to as port-wine stain, and is thought to affect approximately 0.

Café-Au-Lait Macules and Macrocephaly in a 19-Month-Old: Diagnostic Considerations Beyond Neurofibromatosis. for this report is a desire to raise awareness of this syndrome so that clinicians increasingly consider it in their differential diagnosis in appropriate settings, as accurate diagnosis of Legius syndrome has important implications. A few disorders have substantial overlap with GCPS. The acrocallosal syndrome comprises preaxial polysyndactyly, macrocephaly, agenesis of the corpus callosum, mental retardation, seizures, and hernias . It is inherited in an autosomal recessive pattern; however, this fact is of little use in the differential diagnosis of a simplex case Signs of increased intracranial pressure, rapidly increasing head size, or neuroimaging findings consistent with hydrocephalus, subdural hematoma, or thickened skull on bone windows or radiographs may direct the diagnosis away from megalencephaly and toward other causes of macrocephaly (30; 46). The differential diagnoses for macrocephaly are. In summary, the phenotype resulting from TCF20 sequence variants is an important novel differential diagnosis to several known syndromes with overgrowth, macrocephaly and ID/ASD such as Weaver.


Differential diagnosis. For accurate diagnosis of cutis marmorata telangiectatica congenita, several disorders must be ruled out . This can generally be accomplished by thorough screening for associated anomalies. The most common lesion presenting with a reticular erythematous patch is cutis marmorata Frontal-bossing & Macrocephaly Symptom Checker: Possible causes include Mucopolysaccharidosis. Check the full list of possible causes and conditions now! Talk to our Chatbot to narrow down your search [1] Orrù E, Calloni SF, Tekes A, Huisman TAGM, Soares BP (2018) The Child With Macrocephaly: Differential Diagnosis and Neuroimaging Findings. American Journal of Roentgenology 210(4):848-59 (PMID: 29470161 Approach to prenatal diagnosis. lumbar lordosis, short hands and fingers, macrocephaly with frontal bossing and depressed nasal bridge. Download a 200K clip of achondroplasia. The three syndromes that should be considered part of the differential diagnosis include the VATER association (vertebral segmentation, ventricular septal defect. With this information alone a differential diagnosis could be macrocephaly/autism syndrome (Online Mendelian Inheritance in Man (OMIM) #605039) caused by heterozygous PTEN variants. It is characterised by macrocephaly, facial dysmorphism, ID and autism spectrum disorder, importantly it is not associated with the CS-related tumours.1

This is a broad category of differential diagnoses with variable symptomatology depending on the specific diagnosis. a. Obsessive compulsive disorder (OCD) - The obsessive thoughts and repetitive actions seen in OCD can appear very similar to the ritualistic behaviors and motor stereotypes seen in ASD. b Macrocephaly refers to an abnormally enlarged head inclusive of the scalp, cranial bones, and intracranial contents. Macrocephaly may be due to megalencephaly (true enlargement of the brain parenchyma), and the 2 terms are often used interchangeably in the genetic literature (reviews by Olney, 2007 and Williams et al., 2008)

Various permutations and combinations were tried, using select handles. The use of the combination of search handles hypertelorism + bifid ribs + macrocephaly leads to five differential diagnoses . The clinical phenotype of each was matched with our patient. The most probable diagnosis appeared to be GS It is the association of capillary vascular malformation affecting the skin supplied by one branch of the trigeminal nerve of the face with defects in the underlying tissues. These may result in a shrunken brain, calcification inside the skull, seizures, meningeal angioma and eye abnormalities ( glaucoma, optic atrophy ) Diagnosis becomes precise when 2 of the 7 criteria of diagnosis identified by international health institute are noticed (NF 1988). But, a discriminating diagnosis is required according to many other syndroms distinguishing themselves by asymmetric neoplasm [1-3]. In those syndroms, especially Proteus has an importance [4-9] Hydrocephalus is a common neonatal neurological disorder, affecting approximately 1.1 per 1000 infants. Enlarged head circumference may be an isolated finding, or there may also be clinical manifestations, such as poor feeding and irritability. Clinically, macrocephaly is observed if there is significant hydrocephalus Toxoplasmosis. Other (Syphilis). Rubella. CMV. HSV. Background. TORCH infections are a group of congenitally acquired infections that cause significant morbidity and mortality in neonates. These infections are acquired by the mother and passed either transplacentally or during the birth process

Early diagnosis of Canavan syndrome: how can we get there

Craniosynostosis - American Family Physicia

It is important for clinicians to differentiate benign macrocephaly from pathologic processes, which would warrant appropriate evaluation. The differential diagnosis for macrocephaly can include benign conditions such as familial macrocephaly or benign external hydrocephalus (BEH) A Swedish study found 0.5% of the population had macrocephaly (74). A study showed that the prevalence of macrocephaly can vary by age--only 67% of fetuses diagnosed with macrocephaly had enlarged heads at birth, and in later childhood only 35% still had large heads (12) Therefore, we agree with recent publications that this condition be renamed Macrocephaly-Capillary Malformation (M-CM). The differential diagnoses for patients with M-CMTC include Klippel Trenaunay Syndrome (KTS) and Proteus or Proteus-like syndromes In this article we review the feasibility of prenatal diagnosis of disorders of brain proliferation: microcephaly, macrocephaly, hemimegalencephaly and neoplastic and non-neoplastic abnormal cell types. We discuss the differential diagnosis and offer a stepwise approach to the diagnosis of the more common disorders

Macrocephaly - an overview ScienceDirect Topic

The differential diagnosis for increased bone density includes sclerosing bone dysplasias such as osteopetrosis, pyknodysostosis, and craniodiaphyseal dysplasia (in order of increasing rarity). Pyknodysostosis can be distinguished from the others by the thick calvaria, wide lambdoid sutures and fontanelles, and multiple wormian bones The major criteria for the diagnosis of Cowden syndrome have 5 factors. These are cancer of the endometrium, cancer of the breast, cancer of the thyroid particularly follicular thyroid carcinoma, Lhermitte-Duclos disease and macrocephaly of not less than 97 percent. Minor criteria. Minor criteria for the diagnosis of Cowden syndrome have 7 factors The diagnosis of abusive head trauma (AHT) is complex and neuroimaging plays a crucial role. Our goal was to determine whether non-neuroradiologists with standard neuroradiology knowledge perform as well as neuroradiologists with experience in pediatric neuroimaging in interpreting MRI in cases of presumptive AHT (pAHT). Twenty children were retrospectively evaluated Binder syndrome has rarely been diagnosed during the prenatal period. Cook et al. [] described a case diagnosed at 21 weeks of gestation during the routine second-trimester scan. 2D ultrasound identified nasal hypoplasia with reduced nasofrontal angle and mild hypertelorism.The karyotype was normal (46,XY). After discussion with geneticists, the leading differential diagnosis was Binder syndrome Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Megalencephaly With Leukoencephalopathy and Cyst

Nevertheless, it should be noted that the patient with the OBSL1 variant exhibited relative macrocephaly at least at the age of 2 years 5 months, and our case confirms that 3-M syndrome is a relevant differential diagnosis of SRS . Genes causing phenotypes overlapping with SRS (Table 1c Return to Article Details Differential Diagnosis of Macrocephaly (Megalencephaly) in Children Download Download PDF Differential Diagnosis of Macrocephaly (Megalencephaly) in Children Download Download PD Because macrocephaly is a feature of the syndrome, cerebral gigantism was an early term for this condition. Interestingly, a note in the pediatric records of our patient stated that clinical features of cerebral gigantism were absent (age 10 years). In addition to Sotos syndrome, the differential diagnosis for acromegaly/pituitary. Conclusion: Although it is rare but macrocephaly can be a presenting symptom of T-cell ALL and this should be considered in differential diagnosis. Keywords: Macrocephaly; T-cell acute lymphoblastic leukemia; Bicytopenia Introduction T-cell ALL is the most prevalent cancer in childhood [1,2]. It ca

Macrocephaly: Causes, Symptoms, and Treatment

plexiform neurofibroma

Video: Megalencephaly-Capillary Malformation - NORD (National

Macrocephaly - Wikipedi

[Transient neonatal macrocephaly

minor trauma, as well as adding a diagnosis to the differential of the etiology of macrocephaly. Particularly for children with a history of chronic URI's or cor pulmonale, pediatricians should be mindful of the increased risk for BESS and the potential associated comorbidities including increased risk for hemorrhag Differential diagnosis The differential diagnosis for macrocephaly is wide including neoplastic and non-neoplastic causes. The rapidly enlarging head circumference in this case raises concern for obstructive hydrocephalus, possible causes of which include a tumour, but also intracranial haemorrhage, infection or an underlying non-tumoural. characteristics of the differential diagnosis be­ tween benign enlargement of the subarachnoid spaces and subdural collections. Materials and Methods MR was performed in 19 children with macrocephaly, defined as excessively rapid increase of head circumferenc • Know the differential diagnosis of macrocephaly • Know the causes and management of abnormal head shape. Other CNS Disorders -Learning Objectives Cerebral Palsy • Recognize the clinical features of cerebral palsy, including classification

Macrocephaly-capillary malformatio

Introduction. Macrocephaly in infants is defined as a head circumference (HC) greater than 2 standard deviations above the mean, or above the 97.7 th percentile. Since the differential diagnosis of macrocephaly includes neurosurgical conditions, macrocephaly is commonly encountered by primary care physicians with frequent referral to pediatric neurosurgeons, as there is no guidance including. These were predominantly surrounded by white matter T2 hyperintensities associated with macrocephaly. Cystic lesions on MR imaging in Bannayan-Riley-Ruvalcaba syndrome are prevalent, and knowledge of this differential diagnosis can allow the radiologist to suggest a diagnosis of this condition in a child with macrocephaly Plensdorf S, Martinez J. Common pigmentation disorders. Am Fam Physician. 2009 Jan 15. 79(2):109-16.. Abeliovich D, Gelman-Kohan Z, Silverstein S, et al. Familial café au lait spots: a variant of. Szczałuba, K., Obersztyn, E. & Mazurczak, T. Microcephaly as a frequent symptom in clinical practice—Differential diagnosis taking into account its etiopathegenesis. Child Neurol. 30, 41-50.

The Significance of Macrocephaly or Enlarging Head

A new case presented herein demonstrates the natural evolution of the syndrome in infancy and early childhood. Since the macrocephaly is likely to be the initial manifestation, the syndrome should be considered in the differential diagnosis of infants with unexplained macrocephaly. (AJDC 1984;138:821-823 Discuss differential diagnosis. 3. Outline treatments for each movement disorder. Following the program, the participant will be able to: 1. Define specific criteria for microcephaly and its differential diagnosis. 2. Define specific criteria for macrocephaly aand its differential diagnosis. 3

Megalencephaly-capillary malformation syndrome Genetic

Syndrome Description: Conditions With Overlapping Features

epileptic seizures, megalencephaly, macrocephaly, large head, anatomic megalencephaly. A differential diagnosis between idiopathic MEG and anatomic, non-syndromic MEG is not simple prior to the onset of clinical signs. Developmental delays, although usually mild and moderate, and dysmorphisms, if not severe, may be useful for a diagnosis.. Antenatal diagnosis Findings of prenatal ultrasound include marked fetal overgrowth and progressive macrocephaly in the absence of maternal hyperglycemia or fetal hyperinsulinemia, ventriculomegaly, hydrocephalus, frontal bossing, polydactyly, limb asymmetry, polyhydramnios, hydrops fetalis and pleural effusions Global developmental delay (GDD) and intellectual disability (ID) affect up to three per cent of the paediatric population [] [].The diagnosis of GDD is limited to children younger than 5 years old, but these children often evolve to meet diagnostic criteria for ID and probably represent the same population ().Because the etiological diagnoses of GDD and ID overlap, it is natural that. The differential diagnosis of entities related to PTEN hamartoma must be considered. Some characteristics of CS are similar to BRRS, such as macrocephaly, gastrointestinal hamartomas, cognitive impairment, and pigmented macules on the penis

Molecular testing for Diagnosis not confirmed 11p15 and upd(7)mat‡ Positive Positive Negative Negative Molecular diagnosis confirmed — the patient has SRS Does the patient have relative microcephaly? No No No Yes Yes Yes|| Diagnosis not confirmed Consider differential diagnosis (Table 3) Molecular testing as per differential diagnosis. Macrocephaly, which is defined as a head circumference greater than or equal to + 2 standard deviations, is a feature commonly observed in children with developmental delay and/or autism spectrum disorder. Although PTEN is a well-known gene identified in patients with this syndromic presentation, other genes in the PI3K-AKT-mTOR signalling pathway have also recently been suggested to have. These clinical findings include: shortened limbs especially of upper arms and legs, macrocephaly, abnormally shaped skull, flat face and abnormal maxilla [2]. The particular pattern of long-bone growth is specific to achondroplasia [2] [11]. Diagnosis of achondroplasia may also be made using prenatal ultrasonography to detect the skeletal. Differential diagnoses Hydrocephalus ex vacuo. Definition: Hydrocephalus ex vacuo is often classified as a form of hydrocephalus, however, this is a misnomer as it is not a true hydrocephalus. The ventricles and subarachnoid space appear enlarged secondary to loss of brain tissue; however, intracranial pressure and flow of cerebrospinal fluid. Differential diagnosis: Poren­cephaly, stenosis of interventricular foramen, supratentorial ara­chnoid cyst. Prognosis: Mild to severe mental retardation, poor vision, mild to severe seizures, developmental delay. Occasional report of normal physical and neurodevelopmental assessment. Recurrence risk: No reported figures given in the literature

Porencephaly Differential Diagnosis. There are a number of health conditions that show signs and symptoms similar to that of Porencephaly. While determining the diagnosis for this disorder, doctors should differentiate against similar-appearing conditions for a better judgment of the medical status of patients Congenital infections are caused by pathogens transmitted from mother to child during. pregnancy. (transplacentally) or delivery (peripartum). They can have a substantial negative impact on fetal and neonatal health. The acronym TORCH stands for the causative pathogens of congenital infections: Toxoplasma gondii. , others (including Macrocephaly predominated in males. Schreier et al. (1974) found 10 persons in 3 generations of a family with presumed megalencephaly. An additional 2 members were considered to have true hydrocephalus. Megalencephaly in children: clinical syndromes, genetic patterns, and differential diagnosis from other causes of megalocephaly Differential diagnoses include osteogenesis imperfecta II, achondrogenesis, achondroplasia, hypophosphatasia, camptomelic dysplasia, and skeletal ciliopathies [2, 3]. Parameters to aid with differential diagnosis include degree of bone mineralization, bowing, presence of fractures, number of digits, and associated anomalies

evelopmental delay. Six developed body asymmetry and three had internal arteriovenous malformations. Syndactyly of the second and third toes and/or the third and fourth fingers or toes was commonly seen. All of the cases were sporadic. This condition is easily recognizable and should be considered in the differential diagnosis of patients presenting with overgrowth and macrocephaly. for clinicians to differentiate benign macrocephaly from pathologic processes, which would warrant appropriate evaluation. The dif-ferential diagnosis for macrocephaly (Fig 1) can include benign conditions such as familial macrocephaly or benign external hy-drocephalus (BEH). The pediatric population is unique given that infants and chil

Acting on macrocephaly in the neonatal period: anDifferential diagnosis III: osteogenesis imperfectaTeaching NeuroImages: Megaloencephalic leukoencephalopathy