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Head circumference measurements help spot hydrocephalus early
Monday, 29 November 1999 19:00 | 
| Radiology News - Radiology Articles |
During the first ten months of life, obtaining routine measurements of head circumference is helpful in the early detection of hydrocephalic conditions, but not intracranial tumors, clinicians report.
"During the first ten months of life, obtaining routine measurements of head circumference is helpful in the early detection of hydrocephalic conditions and, to a certain degree, intracranial cysts, but not intracranial tumors, two clinicians from Norway report in the March issue of Pediatrics.
"For intracranial tumors and other expansive conditions, increased head circumference is very rarely the debut symptom that causes suspicion and leads to diagnosis," Drs. Sverre Morten Zahl from Voss Hospital and Knut Wester from University of Bergen report.
There is a "surprising lack of evidence-based support" for the "common and well-established routine" of measuring head circumference for diagnostic purposes, the investigators point out.
This led Drs. Zahl and Wester to look into the role and importance of head circumference measurement in all 298 Norwegian children younger than age five who were hospitalized because of intracranial expansion during a four-year period (1999-2002).
Hydrocephalus was the primary diagnosis in 173 children (58 per cent), intracranial tumors in 57 (19 per cent), and "other primary" diagnoses in 68 (23 per cent), they report. For 46 per cent of children, increased head circumference was the first and main symptom leading to diagnosis.
Increased head circumference, as the symptom that led to diagnosis, was much more common in cases of hydrocephalus (72 per cent) than in cases of intracranial cysts (31 per cent) or tumors (five per cent), Drs. Zahl and Wester report.
For intracranial cysts and tumors, "other symptoms, such as nausea/vomiting, unsteadiness, drowsiness, neurologic deficits, or headache, seem to be more common as the initial symptoms, observations that correspond well to those of earlier studies," they note.
The results of the study also indicate that head circumference measurements are useful mainly during the first ten months of life, the investigators note. "On the basis of our findings the benefits of extending routine measurements beyond the age of one year may be questioned," they say."
"For intracranial tumors and other expansive conditions, increased head circumference is very rarely the debut symptom that causes suspicion and leads to diagnosis," Drs. Sverre Morten Zahl from Voss Hospital and Knut Wester from University of Bergen report.
There is a "surprising lack of evidence-based support" for the "common and well-established routine" of measuring head circumference for diagnostic purposes, the investigators point out.
This led Drs. Zahl and Wester to look into the role and importance of head circumference measurement in all 298 Norwegian children younger than age five who were hospitalized because of intracranial expansion during a four-year period (1999-2002).
Hydrocephalus was the primary diagnosis in 173 children (58 per cent), intracranial tumors in 57 (19 per cent), and "other primary" diagnoses in 68 (23 per cent), they report. For 46 per cent of children, increased head circumference was the first and main symptom leading to diagnosis.
Increased head circumference, as the symptom that led to diagnosis, was much more common in cases of hydrocephalus (72 per cent) than in cases of intracranial cysts (31 per cent) or tumors (five per cent), Drs. Zahl and Wester report.
For intracranial cysts and tumors, "other symptoms, such as nausea/vomiting, unsteadiness, drowsiness, neurologic deficits, or headache, seem to be more common as the initial symptoms, observations that correspond well to those of earlier studies," they note.
The results of the study also indicate that head circumference measurements are useful mainly during the first ten months of life, the investigators note. "On the basis of our findings the benefits of extending routine measurements beyond the age of one year may be questioned," they say."
