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..

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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...
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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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