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Common causes of macrocephaly in children according to time of clinical presentation

Common causes of macrocephaly in children according to time of clinical presentation
Early infantile (birth to 6 mo of age) Hydrocephalus (progressive or "arrested")
Induction disorders Spina bifida cystica, cranium bifidum, Chiari malformations (types I, II, and III), aqueductal stenosis, holoprosencephaly
Mass lesions Neoplasms, atrioventricular malformations, congenital cysts
Intrauterine infections Toxoplasmosis, cytomegalic inclusion disease, syphilis, rubella
Perinatal or postnatal infections Bacterial, granulomatous, parasitic
Perinatal or postnatal hemorrhage Hypoxia, vascular malformation, trauma
Hydranencephaly  
Subdural effusion
Hemorrhagic, infectious, cystic hygroma  
Normal variant (often familial)
Late infantile (6 mo to 2 yr of age) Hydrocephalus (progressive or "arrested")
Space-occupying lesions Tumors, cysts, abscess
Postbacterial or granulomatous meningitis  
Posthemorrhagic Trauma or vascular malformation
Dandy-Walker syndrome
Subdural effusion
Increased intracranial pressure syndrome
Pseudotumor cerebri Lead, tetracycline, hypoparathyroidism, corticosteroids, excess or deficiency of vitamin A, cyanotic congenital heart disease
Primary skeletal cranial dysplasias (thickened or enlarged skull)
Osteogenesis imperfecta, hyperphosphatemia, osteopetrosis, rickets  
Megalencephaly (increase in brain substance)
Metabolic central nervous system diseases Leukodystrophies (eg, Canavan, Alexander), lipidoses (Tay-Sachs), histiocytosis, mucopolysaccharidoses
Proliferative neurocutaneous syndromes von Recklinghausen tuberous sclerosis, hemangiomatosis, Sturge-Weber
Cerebral gigantism Sotos syndrome
Achondroplasia
Primary megalencephaly May be familial and unassociated with abnormalities of cellular architecture, or associated with abnormalities of cellular architecture
Early to late childhood (older than 2 yr of age) Hydrocephalus (progressive or "arrested")
Space-occupying lesions  
Preexisting induction disorder Aqueductal stenosis
Postinfectious  
Hemorrhagic  
Chiari type I malformation  
Megalencephaly
Proliferative neurocutaneous syndromes  
Familial  
Pseudotumor cerebri
Normal variant
Reproduced with permission from: Child Neurology, 7th ed, Menkes JH, Sarnat HB, Maria BL (Eds), Lippincott Williams & Wilkins, New York 2005. Copyright © 2005 Lippincott Williams & Wilkins. www.lww.com.
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