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Newborn and Infant Care

Big headed baby

04/20/2007

Question:

i took my son to the doctor and when they measured his head they said that his head is big, but he has always had a kinda big head but has never been any concern. he weighs 17.2 lbs he is 26 inches long and his head is 19inches she wants him to get a ct scan done on his head. im kinda freaking out him being my baby and all. my dads side of the family all have big heads my brothers, my dad, my grandpa, and my babys father has a big head also. my sons head looks fine its big but not large and it doesnt look funny on his body. is his head too big? is there a big concern for me to worry about him having excessive brain growth or water on the brain? if so is there any way at all that you can tell that he would have these problems other then gettin a ct scan done? is there signs like how his head will look or how it is suppose to look ? i would really like some advice that you.

Answer:

Without knowing how old your son is, I can't plot his measurements on a growth chart and provide you with feedback. I think the good news is that you know larger heads do run in the family. This increases the likelihood that your son's head is entirely normal for him given his genetic heritage. Of course, as you have pointed out, and as your baby's doctor wants to rule out, it is possible that a larger head means their is excess water in the ventricles to can press on the healthy brain tissue and impair its functioning. It is possible to check for this condition with ultrasound, which does not require sedation and is painless. However, the CT scan would provide more information about the overall normality of his brain.

There really are not any other ways to confirm the normality of your son's brain. However, there would be cause to do the CT scan sure if your son was behind in his developmental milestones, he sleeps more than 16 hours total each day, he vomits a fair amount of his feedings, or he has a high, pitched cry or any combination of these problems.

If you feel strongly about not exposing your son to the radiation and sedation of a CT scan, and your son is developing normally with none of the problems listed above, you have two choices. You could refuse imaging altogether and wait and see how he does, or you could agree to the ultrasound but not the CT scan unless the ultrasound shows a problem.

I know this has to be a scary decision for you. On the good side is that you have a caring, thoughtful doctor for your son and CT scans are far faster and carry less radiation exposure risk that in previous years. It is also a pain-free test. However, I understand your concern about unnecessary testing. If all is well with your son physically and developmentally, there is no clearcut best choice. The decision is really yours to pursue or refuse testing. I know you will decide to do what you believe in your heart is best for your son.

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Response by:

Mary M Gottesman, PhD, RN, CPNP, FAAN Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University