10month old male child with h/o bulging of anterior fontanelle noted for last 10days after the baby has got ritual head shave..h/o occasional excessive cry +..no h/o fever .. developmentally normal child..accepting feed s well..pupils nsrl..tone n power normal..hc 41cm..af tense bulge n pulsatile..antenatal n natal history uneventful..post.font closed..wt 7kg..kindly discuss the approach..h/o bil inguinal hernia noticed 6mons back

LikeAnswersShare
Hypervitaminosis A Plz ask for administration of large dose vitA Better to do cranial USG to r/o initial stage of hydrocephalus For bilteral IH pediatric surgeon opinion
AF bulge when child is agitated is expected. But if present otherwise too (and examined in sitting posture) then consider pseudotumor cerebri or hydrocephalus.. In the second picture, bilateral inguinal hernia with left probably extending inside scrotum, is present. Please do a thorough examination of the local area
Do cranial ultrasound TSH ultrasensitive Ionized calcium Wrist x RAY to rule out rickets Phosphate, mg level At age of nine months may be given vitamin A , least possibility ,because parents told since last 10 days and age is 10 months with out complaints of vomiting For hernia surgery needs
Tq sir
0

View 1 other reply

I shall do a CT head, if it shows chink like ventricles, I shall go ahead with a lumbar puncture which will be both diagnostic ( to exclude other causes) and therapeutic for benign intracranial hypertension (which is my clinical impression too)
10 Months Infant with Bulging A.F. NSG : TO R/O ANY STRUCTURAL ANOMALIES OF THE BRAIN. IF SUSPICIOUS ABOUT ULTRASOUND MRI BRAIN IS INDICTED. IF NORMAL BRAIN STRUCTURES, THEN ONE HAS TO DX : PSEUDO-TUMOR CEREBRI.
Can bulge while crying, vomiting Transient bulging after measles Vaccine Hydrocephalus, encephalitis, meningitis Shaken baby syndrome Pseudotumor cerebri (nalidixic acid, vit A high doses) Cranial usg --
Child is developing Hydrocephalus , early stage . MRI will help to diagnose . Paediatric surgeon/ neurosurgeon need to be consulted . May need Shunt operatipn , if confirmed .
Pseudutumour cerebri with b/l inguinal hernia
I agree with Dr A. Pareek.
Pseudo tumour cerebri
Load more answers

Cases that would interest you