Macrocephaly Treatment & Management

Updated: Jul 08, 2016
  • Author: Sumaira Nabi, MBBS, FCPS; Chief Editor: Amy Kao, MD  more...
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Treatment

Approach Considerations

The management is variable depending upon the etiology of macrocephaly.

Benign familial macrocephaly does not necessitate treatment and children mostly remain asymptomatic. Periodic monitoring of head size is sufficient in these cases along with regular monitoring for physical growth and neurologic development.

 

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Medical Care

Macrocephalic children with epilepsy require therapy with appropriate antiepileptic medication.

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Surgical Care

Neurosurgical intervention may be warranted in children with hydrocephalus and consequent symptoms of increased intracranial pressure. Various procedures may be considered for drainage of CSF in order to reduce the fluid volume including placement of a extraventricular drain (EVD) or a ventriculoperitoneal (VP) shunt (see image below). [10]

Ventriculoperitoneal shunt in situ. Ventriculoperitoneal shunt in situ.

Another surgery reported in the literature is complete reconstruction of the skull in children with grossly deformed skull architecture. It has been tried in a case of macrocephaly due to hydrocephalus. [11]

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Consultations

Consultation with any of the following may prove helpful:

  • Pediatrician
  • Geneticist
  • Pediatric neurologist
  • Pediatric neurosurgeon
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Long-Term Monitoring

It is recommended to measure and plot the head size monthly for six months to ascertain the growth curve of the child and to compare it to the normal curve. Physical and neurologic examination should be carried out regularly. Neuroimaging is not routinely recommended unless there is abnormal or rapid increase in head size or there is motor, cognitive, or growth retardation or loss of milestones.

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