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Microcephaly

Microcephaly is a condition in which a person's head size is much smaller than that of others of the same age and sex. Head size is measured as the distance around the top of the head. A smaller than normal size is determined using standardized charts.

Causes

Microcephaly most often occurs because the brain does not grow at a normal rate. The growth of the skull is determined by brain growth. Brain growth takes place while a baby is in the womb and during infancy.

Conditions that affect brain growth can cause smaller than normal head size. These include infections, genetic disorders, and severe malnutrition.

Genetic conditions that cause microcephaly include:

Other problems that may lead to microcephaly include:

Becoming infected with the Zika virus while pregnant can also cause microcephaly. The Zika virus is present in Brazil and other parts of South America, along with Mexico, Central America, and the Caribbean.

When to Contact a Medical Professional

Most often, microcephaly is diagnosed at birth or during routine well-baby exams. Talk to your health care provider if you think your infant's head size is too small or not growing normally.

Call your provider if you or your partner has been to an area where Zika is present and you are pregnant or thinking about becoming pregnant.

What to Expect at Your Office Visit

Most of the time, microcephaly is discovered during a routine exam. Head measurements are part of all well-baby exams for the first 18 months. Tests take only a few seconds while the measuring tape is placed around the infant's head.

The provider will keep a record over time to determine:

  • What is the head circumference?
  • Is the head growing at a slower rate than the body?
  • What other symptoms are there?

It may also be helpful to keep your own records of your baby's growth. Talk to your provider if you notice that the baby's head growth seems to be slowing down.

If your provider diagnoses your child with microcephaly, you should note it in your child's personal medical records.

References

Centers for Disease Control and Prevention website. Zika virus. www.cdc.gov/zika/index.html. Updated November 9, 2017. Accessed November 12, 2017.

Johansson MA, Mier-Y-Teran-Romero L, Reefhuis J, Gilboa SM, Hills SL. Zika and the risk of microcephaly. N Engl J Med. 2016;375(1):1-4. PMID: 27222919 www.ncbi.nlm.nih.gov/pubmed/27222919.

Kinsman SL, Johnston MV. Congenital anomalies of the central nervous system. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 591.

Mizaa GM, Dobyns WB. Disorders of brain size. In: Swaiman KF, Ashwal S, Ferriero DM, et al, eds. Swaiman's Pediatric Neurology: Principles and Practice. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 28.

  • Skull of a newborn

    Skull of a newborn - illustration

    The sutures or anatomical lines where the bony plates of the skull join together can be easily felt in the newborn infant. The diamond shaped space on the top of the skull and the smaller space further to the back are often referred to as the soft spot in young infants.

    Skull of a newborn

    illustration

  • Microcephaly

    Microcephaly - illustration

    Microcephaly is a head size (measured as the distance around the top of the head) significantly below the median for the infant's age and sex. Significantly below is generally considered to be smaller than three standard deviations below the mean, or less than 42 cm in circumference at full growth. It most often occurs because of failure of the brain to grow at a normal rate.

    Microcephaly

    illustration

  • Ultrasound, normal fetus - ventricles of brain

    Ultrasound, normal fetus - ventricles of brain - illustration

    This is a normal fetal ultrasound performed at 17 weeks gestation. The development of the brain and nervous system begins early in fetal development. During an ultrasound, the technician usually looks for the presence of brain ventricles. Ventricles are spaces in the brain that are filled with fluid. In this early ultrasound, the ventricles can be seen as light lines extending through the skull, seen in the upper right side of the image. The cross hair is pointing to the front of the skull, and directly to the right, the lines of the ventricles are visible.

    Ultrasound, normal fetus - ventricles of brain

    illustration

    • Skull of a newborn

      Skull of a newborn - illustration

      The sutures or anatomical lines where the bony plates of the skull join together can be easily felt in the newborn infant. The diamond shaped space on the top of the skull and the smaller space further to the back are often referred to as the soft spot in young infants.

      Skull of a newborn

      illustration

    • Microcephaly

      Microcephaly - illustration

      Microcephaly is a head size (measured as the distance around the top of the head) significantly below the median for the infant's age and sex. Significantly below is generally considered to be smaller than three standard deviations below the mean, or less than 42 cm in circumference at full growth. It most often occurs because of failure of the brain to grow at a normal rate.

      Microcephaly

      illustration

    • Ultrasound, normal fetus - ventricles of brain

      Ultrasound, normal fetus - ventricles of brain - illustration

      This is a normal fetal ultrasound performed at 17 weeks gestation. The development of the brain and nervous system begins early in fetal development. During an ultrasound, the technician usually looks for the presence of brain ventricles. Ventricles are spaces in the brain that are filled with fluid. In this early ultrasound, the ventricles can be seen as light lines extending through the skull, seen in the upper right side of the image. The cross hair is pointing to the front of the skull, and directly to the right, the lines of the ventricles are visible.

      Ultrasound, normal fetus - ventricles of brain

      illustration


     

    Review Date: 10/18/2017

    Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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