Not strictly trauma but....

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In a message dated 05/14/2008 13:15:26 Central Daylight Time,  
topcmt at hotmail.co.uk writes:

My  sister in law has just approached me with my young Nephew and has told me 
she  is concerned with the size of his head. Her GP has said it is "two 
lines"  bigger than it should be. He did not elaborate on what that meant and did 
not  schedule a follow up appointment.


 
one of the tricks of the peds growth curves (esp the ones published by Mead  
Johnson and used by most US family docs and pediatricians- not sure what the  
Brits would be using), is that they show both the 'normal' curve as well as  
various 'deviations from normal'...IIRC, the secondary curves are +/- 15, 25, 
35  and 45% (e.g., 5, 15, 25, 35, 50, 65, 75, 85 and 95% lines).
 
so if a kid was 'two lines' bigger than the 50% curve, he'd only be in the  
75% range (top 25% of his age group).
 
As long as his body size (height/weight/proportional curves) were also  above 
normal, I'd not worry too much about it.
 
Where we used to flag was when the head circumference was more than three  
lines/curves different from the height/weight proportional curve OR if there was 
 more than two curves difference AND a developmental delay OR if there was a  
plateau in the curves that lasted more than 3 months if the child was under 
age  36 months.
 
ck
Charles S. Krin, DO FAAFP



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