Abstract
Answer C. Routine referral to a paediatrician
Head size is different for females and males and is dependent on age. In the United Kingdom, it is routinely measured in all babies. Head circumference needs to be assessed in the context of a detailed medical history including maternal pregnancy and use of alcohol and drugs as well as perinatal history. Infants are measured in the community by general practitioners and health visitors. Children with persistent abnormal measurements and growth trends need further investigation and should be referred routinely to a paediatrician. However, children with any of the following red flags should be referred urgently to the paediatric team.
Abnormal head shape Skull bridges Signs of increased intracranial pressure Developmental delay Abnormal neurological findings Neurocutaneous stigmata Dysmorphic features Failure to thrive/short stature Abnormal spine Ocular abnormalities
Monitoring further or asking the health visitor to see him would not be appropriate now and the patient should be referred to secondary care.
InnovAiT article: Abnormal head growth in children. DOI: