Concepts on childhood microcrania: a clinical overview for the neurosurgeon who is evaluating a child with a small head.

PURPOSE: Infants and children with microcrania are referred to pediatric neurosurgeons for evaluation and treatment of possible craniosynostosis and other disorders. We present an approach to these children to facilitate the appropriate clinical evaluation and management.

METHODS

We reviewed our experience and the literature on infants and children with microcephaly, and developed a management strategy for these children when seen in the University of Florida Division of Pediatric Neurosurgery.

RESULTS

We request the same sex parent to accompany the child for their consultation. If the head circumference of the child matches that of the same sex parent in percentiles, and there are no other abnormalities, no further assessment or studies are performed. If there is a disproportionate head size to that of the same sex parent and/or other structural abnormalities are present, the child is referred to clinical genetics for further assessment.

CONCLUSIONS

When patients are referred to pediatric neurosurgery for microcrania, their head size should be compared to that of the same sex parent. This will facilitate the diagnosis of familial microcephaly, and if no other abnormalities are noted, no further studies or surgical interventions are necessary.