Clinical approach to the child with a large head.

Majority of children has head size that is appropriate for age and gender. But a few have either too small or too large head at birth or may be of postnatal acceleration. Abnormality of head circumferences is determined by brain size, including any malformations and space occupying lesions, cerebrospinal fluid (CSF) and blood volume, presence of subdural fluid and thickness of skull bones and overlying tissue scalp. Macrocephaly is used when the head size exceeds the mean by more than two standard devotions of age and gender. Macrocephaly is seen in association with several cranioskeletal dysplastic conditions.

Ischemic strokes in children.

Ischemic stroke is an uncommon, but significant cause of disability in childhood. Children with strokes present with predictable deficits as adults do; however, fever and seizures at stroke onset are more common in children than in adults. Strokes in children have diverse etiologies and require extensive evaluation. Etiology remains obscure in up to half of the patients. Prognosis in childhood stroke is not benign and up to 50% of pediatric stroke patients have chronic sequelae. Emerging therapies may alter prognosis in certain populations of children at risk for stroke, but more research is necessary.