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Macrocephaly

A congenital disorder characterized by abnormally large-sized head and brain in relation to the rest of the body.

Also called macrocephalia and megalocephaly, macrocephaly is diagnosed when the circumference of the head is more than two standard deviations above average for the child's age, sex, race, and period of gestation. The fontanelle (soft spot) of the newborn is wide, but facial features are usually normal. Macrocephaly is distinguished from hydrocephalus in that there is no intracranial pressure. The disorder can result from a defect in formation during the embryonic stage, or as a result of certain degenerative diseases such as Schilder's disease, Greenfield's disease, or congenital lipoidosis. Mental deficiency, seizures, and movement disorders are common in macrocephalic children.

When mental deficiency and the attendant diseases or disorders are severe, the child may be placed on a life-support system. When the mental deficiency is less severe, the child may be diagnosed with minimal brain dysfunction or as neurologically handicapped. Minimal brain dysfunction can include any or all of the following: memory and language problems, neuromotor functioning problems, and behavior and social problems. The degree of dysfunction will help the parents determine whether the child can continue to live at home and what type of schooling is appropriate. Parents and teachers need to be cognizant of the nature of the child's dysfunction. What was once seen as laziness and lack of motivation on the child's part has now begun to be recognized as a medical condition that can be corrected or modified through psychotherapy. Sometimes, though, a child may suffer several years of frustrating failure and abnormal development or behavior before the problem is recognized and he or she is properly diagnosed.

Before devising a plan of psychotherapy, the mental health professional needs a full record of the child's neurological development. Depending on the child's particular weaknesses, the program might include techniques for enhancing concentration, improving sensory and perceptual learning, and managing anger and violence. Drug therapy may also be prescribed. Anticonvulsant medications can keep seizures under control, and physical therapy can help with movement disorders. Children with attention deficit/hyperactivity disorder (ADHD) are usually given methylphenidate, commonly known as Ritalin. Parents should be aware of the possible side effects of these drugs as well as drug interactions.

For Further Study

Books

Gattozzi, Ruth. What's Wrong with My Child? New York: McGraw-Hill, 1986.

Periodicals

Levine, Melvin D. "Childhood Neurodevelopmental Dysfunction and Learning Disorders." Harvard Mental Health Letter 12, no. 1, July 1995, p. 5.

Organizations

American Association on Mental Retardation
Address: 1719 Kalorama Road, NW
Washington, DC 20009-2683
Telephone: (202) 387-1968; toll-free (800) 424-3688

Association of Birth Defect Children
Address: 827 Irma Avenue
Orlando, FL 32803
Telephone: (407) 245-7035; toll-free (800) 313-2232

Abiding Hearts
Address: P.O. Box 5245
Bozeman, MT 59717
Telephone: (406) 587-7471
FAX: (406) 587-7197

March of Dimes Birth Defects Foundation
Address: 1275 Mamaroneck Avenue
White Plains, NY 10605
Telephone: (914) 428-7100
FAX: (914) 997-4763