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Babies and Toddlers

2 Major causes of abnormally small head (microcephaly) in children and how it affects them

Dr. Tomi



Scientifically known as microcephaly- literally is a condition in which a baby’s head is small i.e. the head circumference is smaller than a certain value for babies of the same age and sex.
Expectedly during pregnancy, a baby’s brain grows and also in the newborn, the brain develops at a rapid rate in the initial period. Its size doubles during the first 6months and quadruples by the first year of life, hence microcephaly can occur because a baby’s  brain has not developed during pregnancy or the brain started to develop correctly and was damaged at some point during pregnancy or stopped growing after birth.
Severity can range from mild to very severe.



Microcephaly can be subdivided into two main groups:
-Primary (genetic) usually occurs with other specific genetic syndromes.
Secondary (non-genetic) results from a large number of noxious agents in the environment that affected the fetus in the womb or infant during period of rapid brain growth particularly in the first 2years of life.

1.Secondary microcephaly; these are environmental factors such as:
-TORCHES INFECTION in the mother during pregnancy.
-Birth asphyxia
-Severe neonatal jaundice
-Neonatal tetanus
-Repeated early neonatal convulsion.
-Maternal phenylketonuria
-Zika virus infection
-Severe malnutrition.
-Toxic chemical.
Craniosynostosis. This is premature closure of the cranial suture due to abnormality of skull development.

2.Primary microcephaly; due to genetic abnormalities. Some examples of syndromes are associated with it are downs syndrome, Edwards syndrome amongst many.


Can be detected during pregnancy and after birth by carrying out the following tests:
Obstetric scan; usually detected by late 2nd trimester or early 3rd trimester.
Serology; blood test to screen for TORCHES infection.
-Maternal serum phenylalanine.
-Fasting plasma or urine amino acid analysis.
-Karyotype for chromosomal analysis.
-Skull radiography; CT scan MRI to detect cerebral atrophy.

SIGNS AND SYMPTOMS (how it affects them)
In microcephaly, as the child grows, there’s a corresponding increase in intracranial pressure leading to gradual loss of bodily function,
-Facial distortion
-Craniosynostosis area evident at birth characterize by skull difficulty and abnormal shape of head depending on which and how many suture closes boat-shaped (scaphocephaly), slopping-shaped (plagiocephalt), triangular-shaped (trigonocephaly), short-head (bradycephaly).
-Development delay.
-Intellectual disability or declining school performance.
-Difficulty in nose breathing, hence mouth breathing.
-Sleep apnea.
-Gradual visual failure, progressive exophthalmos(protruding eyes).
-Hearing loss.
-Feeding problrems.
-Problem with movement and balance.
-Disorder of speech.

Microcephaly is a lifelong condition. There is no known cure or standard treatment. Babies with mild microcephaly often have no health problem besides small head. Their growth and development should be monitored. In severe microcephaly, treatment is focused on managing their other health problems.

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Dr Tomi Sofela (MBChB) is a graduate of Olabisi Onabanjo University in Ogun State registered with the Medical and Dental Council of Nigeria. She is on a mission to pursue fulfillment and enjoys watching movies, reading novels and organizing friends and family get-together.