Hypoxic-ischemic injury results in cytotoxic edema and diffuse brain swelling. Associated findings include poor feeding, decreased muscle tone, respiratory difficulties, and alterations in consciousness. Intracranial hemorrhage can be intraventricular, parenchymal, subarachnoid, or subdural. Associated findings include decreased muscle tone, seizures, decreased hematocrit, vomiting, and alterations in consciousness. Tumors also should be considered in the differential diagnosis of a bulging fontanel.
Dermoid tumors of the scalp are the most frequent lesions presenting over the anterior fontanel and also may be found over the posterior fontanel. A CT scan is necessary to exclude intracranial involvement.
The primary cause of a sunken fontanel is dehydration. Other signs include reduced peripheral perfusion, poor skin turgor, and sunken eyes. Brain tumor. Intracranial hemorrhage. Brain abscess. Lyme disease. Cerebral malaria. Addison's disease. Congestive heart failure. Dural sinus thrombosis. Diabetic ketoacidosis. Electrolyte disturbance. Hepatic encephalopathy. Maple syrup urine disease. Hypervitaminosis A. Lead encephalopathy. Aluminum toxicity.
Brain contusions. Hypoxic-ischemic injury. Coronal synostosis. Dermoid cyst. An abnormal fontanel in an infant can indicate a serious medical condition.
Therefore, it is important to understand the wide variation of normal, how to examine the fontanels, and which diagnoses to consider when an abnormality is found. Consultation with a pediatric neurosurgeon should be considered if the diagnosis or presence of an abnormality is unclear. Already a member or subscriber? Log in. Interested in AAFP membership? Learn more. He graduated from and completed a family medicine residency at the University of Cincinnati College of Medicine.
Belvoir, Va. Address correspondence to Joseph Kiesler, M. Reprints are not available from the authors. The authors indicate that they do not have any conflicts of interest. Sources of funding: none reported. The authors thank Bruce Giffin, Ph. Soames R. Skeletal system. New York: Churchill Livingstone, — Boston: Riverside Publishing Co. Simpson DP. New York: Macmillan, Variation in fontanelle size with gestational age.
Early Hum Dev. Sadler TW, Langman J. Dale J, Maurer PK. Abnormal head. In: Ziai M, ed. Bedside pediatrics: diagnostic evaluation of the child. Boston: Little, Brown, Pediatric approach to craniosynostosis. Pediatr Rev. The skeletal system. The developing human: clinically oriented embryology. Philadelphia: Saunders, — Fletcher MA. Physical diagnosis in neonatology.
Philadelphia: Lippincott-Raven, Haslam R. Neurologic evaluation. Nelson Textbook of pediatrics. Green M. Pediatric diagnosis: interpretation of symptoms and signs in children and adolescents. Philadelphia: Saunders, Sundine MJ. Clinical findings and treatment of children with abnormal head shapes. J Ky Med Assoc. Infantile hydrocephalus: brain sonography as an effective tool for diagnosis and follow-up.
Childs Nerv Syst. Nard J. Abnormal head size and shape. Common and chronic symptoms in pediatrics: a companion to the atlas of pediatric physical diagnosis. Louis: Mosby, 95— Barkovich AJ. Pediatric neuroimaging.
Faix RG. Fontanelle size in black and white term newborn infants. J Pediatr. When you touch the fontanelle, it should feel firm with a slight inward curve. However, while a sunken fontanelle can occur when your baby is severely dehydrated there are many other signs of dehydration that happen before a fontanelle becomes sunken, such as fewer wet nappies and being less alert and responsive. Usually dehydration occurs when the baby is not feeding well or losing fluid through vomiting or diarrhoea.
See your doctor right away if your baby has any of these symptoms. This is not a cause for concern. A bulging fontanelle that does not return to normal may be a sign of a serious condition, such as an infection or swelling in the brain.
See your doctor immediately, especially if your baby has a fever or is unusually sleepy. Learn more here about the development and quality assurance of healthdirect content. Find out some of the essentials for looking after your newborn. Find out when your baby will need to have health checkups and immunisations. There is also lots of information on nappies, giving your baby a bath and teeth development. Excessive crying could be a sign that your baby has colic. Everyone agrees that colic exists but no one knows what causes it.
Some doctors think it's a kind of stomach cramp. Read more on healthdirect website. Colic is a pattern of unexplained, excessive crying in an otherwise healthy and well-fed baby and happens to 1 in 5 Australian babies. Read more on myDr website.
New parents often worry that they don't know what to do. However, there are practical ways to deal with the challenges so you can enjoy your baby more. You must be logged in to post a comment. Skip to content. Post Author: sgg. Skull is the skeletal structure of the head that protects the brain and supports the face. It is divided into two parts: The cranium or neurocranium — part of the skull whose bones form the cranial vault roof of the skull; also known as skull vault, skullcap, or calvaria and the cranial base base of the skull ; together they encase and protect the brain; The facial skeleton or viscerocranium — it supports the soft tissues of the face, determining our facial appearance.
Fontanelles are membraneous areas located in the cranial vault that have not yet ossified ; C ranial sutures are strong, elastic and fibrous joints synarthroses that join the bones of the skull. Human Skull In this post we are going to understand the importance of Fontanelles and cranial sutures, when they close, and what can go wrong if the closure occurs too early.
Why are Fontanelles and cranial sutures important? Leave a Reply Cancel reply You must be logged in to post a comment.
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