3m pt visited for common cold. o/e noticed intermittent slight down rolling of eyes, OFC 40cm, no other complaint... Cranial usg and CT head reports attached... discuss..



Regular OFC monitoring advice to patients attendants taught them and told how to measure and maintain a diary and regular follow up to you I think it is a keen incidental finding if child development is normal and no significant antenatal perinatal event putt on calcium and vit d

Any history of prenatal Asphyxia or recurrent hypoglycemia? Torch profile status? , consanguinity? If possible a MRI Head study.

May an evolving normotensive hydrocephalus- C.atrophy early signs/ Torch infections/

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There is bilateral frontoparietal cerebral atrophy and hence the prominence of CSF spaces. There would be definitely an element of perinatal brain injury especially perinatal depression. Kindly get a MRI, BERA done, a detailed tonal assessment, a DASII, Fundus and Visual acuity testing and put the baby on Physiotherapy and occupational therapy which should be done regularly at least 5 times a day at home. Regular neurological assessment and developmental assessments at 6, 9, 12,18, 24 , 30 months.

Seems a case of evolving hydronephrosis. Advised serial CT scan or USG head to note progress.

Watch for head circumference regularly, Was there history of documented hypoglycemia? Vit D and calcium supplemens as per recommendations And off course sometimes it can be normal variant

This case @Dr. Sree Harsha sir and @Dr. Ashok Pareek sir...

Here bwlow comment u can see updaye of case...

Follow up the case with Neurosonogram at intervals.

How's the baby development.if it is appropriate for age , nothing to worry. BESS is most common cause of familial macrocephaly. Only serial clinical examination is needed

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