Can Large Head Circumference Predict Brain Damage or Cerebral Palsy?

When you have a baby, you will notice that his or her head circumference is measured routinely – generally until they reach toddler age.  Head circumference has always been an important part of documenting your child’s overall health, but new research is asking – “Can large head circumference predict brain damage or cerebral palsy?”

New research published in Obstetrics and Gynecology International is addressing this question with new research conducted on more than 4,700 infants.  Read on to learn more about the research and why it is important for families impacted by birth injuries or cerebral palsy.

Research Suggests Head Circumference Can Predict Brain Damage, Cerebral Palsy

White matter is a part of the brain consisting of nerve fibers linked to the spinal cord.  It is called white matter because of its pale appearance compared to other parts of the brain.  It is well documented that damage to the white matter of the brain is one of the leading risk factors for developing cerebral palsy, primarily in infants born prematurely.  New research, however, suggests a correlation between large head circumference and damage to the white matter, which can help predict brain damage or cerebral palsy among infants born at or near term.

One previous study described the traumatic birth injury and subsequent stroke suffered by a newborn.  She suffered from severe deformities in her face and head, and there was a clear depression on the upper left jaw and parietal bone.  Researchers noted that her head circumference at birth was large, placing her in the 90th percentile.  This finding helped researchers hone in on the correlation between large head circumference and damage to the white matter in the brain.

In the more recent study, researchers reviewed 4,725 ultrasound screenings of term-born infants.  Screenings were taken from day one to day 30.  Using this information, researchers created a morphometric index (MMI), which measured length, weight, and head circumference.  The MMI measurement was found to be a solid predictor for risk of damage to the white matter as compared to other clinical indicators.

Important Findings on Head Circumference

Of all the infants studied, 61 were found to have damage to the white matter.  The only factor closely associated with damage to the white matter was head circumference.  The findings were as follows:

  • Infants with a head circumference placing them in less than the 10th percentile, or greater than the 75th percentile, were up to 10 times more likely to have brain damage.
  • Infants in the 90th percentile or greater had 10 times or more the risk of brain damage to the white matter.
  • Among infants in the highest risk, boys were far more likely to have brain damage than girls, accounting for 74 percent of those studied.
  • The primary risk among newborns with a large head circumference was prolonged or complicated delivery, which can result in brain deformations or damage.
  • Among the newborns found to have brain damage, researchers noted the following:
    • 38 percent were placed in intensive care with symptoms of asphyxia
    • 62 percent of infants with brain damage exhibit no clinical signs, and bypass routine diagnosis or treatment, which may account for so many unexplained cases of cerebral palsy or developmental delays in childhood.
    • There was no significant correlation between the MMI index and brain hemorrhages, premature breaking of the amniotic sac, intra-amniotic infection, bleeding during pregnancy, or miscarriage.

What this Research Means for Babies and Families

Around 28,000 birth injuries are reported in the U.S.  each year – many of them include brain damage.  Brain damage can range from mild with few symptoms, to severe causing lifelong disability.  It is important for healthcare providers to understand the risks of brain damage and take appropriate action to prevent injuries from occurring.

One of the most promising elements of these research findings is the narrowing of infants who may be at risk for having damage to the white matter of the brain.  Using the MMI index, healthcare providers can select infants born with a head circumference in less than the 10th percentile or greater than the 90th percentile for further imaging.  Infants in these percentiles may not exhibit signs of brain damage, but may benefit from additional testing to be certain.

Early detection and intervention is one of the best ways to improve outcomes for infants with brain damage.  This research offers hope and practical recommendations for healthcare providers that may help infants with brain damage get the diagnosis and treatment needed as soon as possible.  Researchers recommend risk management strategies for infants measuring with a large head circumference during sonograms or ultrasounds during pregnancy, to help avoid prolonged or difficult labor.

Learn More about Infant Brain Damage

If your child has suffered brain damage during pregnancy or at birth, your world may feel upside down.  One of the best ways that you can start advocating for your child is to learn as much as you can about infant brain damage and birth injuries.  You may want to explore whether your child’s injury was due to congenital factors, or was a result of negligence.  You may also find it helpful to explore your options for financial and other support or assistance.

To find out more, view our Infant Brain Damage topics, or contact Brown & Brothers to speak with one of our skilled birth injury attorneys.  Or, to schedule a free case review, fill out our online form.