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BackgroundPatients with bidirectional cavopulmonary anastomosis have unphysiologically high superior caval vein pressure as it equals pulmonary artery pressure. Elevated superior caval vein pressure may cause communicating hydrocephalus and macrocephaly. This study analysed whether there exists an association between head circumference and superior caval vein pressure in patients with single ventricle physiology.MethodsWe carried out a retrospective analysis of infants undergoing Fontan completion at our institution from 2007 to 2013. Superior caval vein pressures were measured during routine catheterisation before bidirectional cavopulmonary anastomosis and Fontan completion as well as head circumference, adjusted to longitudinal age-dependent percentiles.ResultsWe included 74 infants in our study. Median ages at bidirectional cavopulmonary anastomosis and Fontan were 4.8 (1.6–12) and 27.9 (7–40.6) months, respectively. Head circumference showed significant growth from bidirectional cavopulmonary anastomosis until Fontan completion (7th (0–100th) versus 20th (0–100th) percentile). There was no correlation between superior caval vein pressure and head circumference before Fontan (R2=0.001). Children with lower differences in superior caval vein pressures between pre-bidirectional cavopulmonary anastomosis and pre-Fontan catheterisations showed increased growth of head circumference (R2=0.19).ConclusionsPatients with moderately elevated superior caval vein pressure associated with single ventricle physiology did not have a tendency to develop macrocephaly. There is no correlation between superior caval vein pressure before Fontan and head circumference, but between bidirectional cavopulmonary anastomosis and Fontan head circumference increases significantly. This may be explained by catch-up growth of head circumference in patients with more favourable haemodynamics and concomitant venous pressures in the lower range. Further studies with focus on high superior caval vein pressures are needed to exclude or prove a correlation.

Rapid growth rates of head circumference and body size during infancy have been reported to predict developmental pathologies that emerge during childhood.This study investigated whether growth in head circumference was concordant with growth in body length.Forty infants (16 males) were followed between the ages of 2 days and 21 months for durations ranging from 4 to 21 months (2616 measurements).Longitudinal anthropometric measurements were assessed weekly (n=12), semi-weekly (n=24) and daily (n=4) during home visits. Individual head circumference growth was investigated for the presence of saltatory patterns. Coincident analysis tested the null hypothesis that head growth was randomly coupled to length growth.Head circumference growth during infancy is saltatory (p0.05), characterized by median increments of 0.20 cm (95% confidence interval, 0.10-0.30 cm) in 24-h, separated by intervals of no growth ranging from 1 to 21 days. Daily assessments identified that head growth saltations were coupled to length growth saltations within a median time frame of 2 days (interquartile 0-4, range 1-8 days). Assessed at semi-weekly and weekly intervals, an average 82% (SD 0.13) of head growth saltations was non-randomly concordant with length growth (p≤0.006).Normal infant head circumference grows by intermittent, episodic saltations that are temporally coupled to growth in total body length by a process of integrated physiology that remains to be described.

Background: Postnatal steroid exposure is associated with decreased somatic and head growth as well as neurodevelopmental impairment. DEXamethasone, a potent corticosteroid, has been associated with significant short and long-term side effects. HYDROcortisone has become the preferred steroid but little is known about its effect on growth velocity. Moreover, the effects of hydrocortisone compared to dexamethasone on growth has not been well described in critically ill neonates. Objective: To evaluate and describe growth velocity differences (from term-corrected age through corrected gestational age (CGA) of 6 months) between hydrocortisone (HYDRO) …

Background: Head circumference (HC) trajectories are held to reflect neurological development and the acquirement of intelligence. It is important to assess HC growth accurately because atypical HC growth is an indicator of various developmental disorders. HC growth is determined by both familial and physical factors but, hitherto, no one has considered both factors together. The aim of the present study was thus to investigate the relationship between HC, physical growth, and parental HC. Methods: The study group in the Japan Children's Study consisted of 192 healthy full-term Japanese children. HC (maximum occiptofrontal circumference), height and bodyweight were measured at the ages of 4, 9 and 18 months. Multiple regression analysis were conducted predicting the HC from the body measurements and mid-parental HC (defined as the average of standardized paternal and maternal HC). Results: Adjusted multiple R2 were 0.336, 0.307 and 0.259, measured at the aforementioned three stages. Bodyweight and mid-parental HC predicted the HC on each occasion (P < 0.01). Bodyweight was more relevant than mid-parental HC. Conclusions: HC growth is influenced by physical growth and parental HC; therefore, it is important to consider both physical and familial factors. A formula is herein proposed to assess HC using bodyweight and mid-parental HC.

Introduction Our clinical observation indicates that some children who have a tracheostomy may experience increasing head circumference as they grow and develop. Accurate assessment and interpretation of growth parameters is an essential component of following child development. Appreciation for variations in growth is especially important in special populations, such as children with a tracheostomy. The aim of this study is to define head growth in children with a tracheostomy. Method This retrospective cohort study includes children who underwent tracheostomy tube placement prior to 2 years of age in a respiratory rehabilitation unit within a children's hospital. Serial head circumference measurements were plotted against age on growth charts adjusted for gestational age. The percentage of patients with accelerated head growth, defined as increased head circumference across two major percentiles within 6 months following tracheostomy, was determined. Results Fifty-seven percent (20 out of 35 children) demonstrated increased head circumference across two major percentiles within 6 months following tracheostomy. Discussion Accelerated head growth is associated with the presence of a tracheostomy tube in children in this study. Further investigation is warranted to establish the relationship of head circumference to other growth parameters. In addition, the etiology of this phenomenon requires additional study. Understanding head growth in children with a tracheostomy will promote adequate growth assessment and may lead to improved patient care.

The evolutionary origin of the long neck of giraffes is enigmatic. One theory (the ‘sexual selection’ theory) is that their shape evolved because males use their necks and heads to achieve sexual dominance. Support for this theory would be that males invest more in neck and head growth than do females. We have investigated this hypothesis in 17 male and 21 female giraffes with body masses ranging from juvenile to mature animals, by measuring head mass, neck mass, neck and leg length and the neck length to leg length ratio. We found no significant differences in any of these dimensions between males and females of the same mass, although mature males, whose body mass is significantly (50%) greater than that of mature females, do have significantly heavier (but not longer) necks and heavier heads than mature females. We conclude that morphological differences between males and females are minimal, that differences that do exist can be accounted for by the larger final mass of males and that sexual selection is not the origin of a long neck in giraffes.

The introduction of effective ventriculo-vascular shunt procedures has caused an undoubted improvement in the prognosis of infantile hydrocephalus (Rickham and Roberts 1960, Lorber 1961, Lawrence 1963, Yashon 1963, 1964, Macnab 1964). Nevertheless comparison between various published results is often impossible, and in this review of the experience of one surgical unit using only the Holter valve, we have tried to evaluate the control of head growth and the liability to revision operations in ways that are objective and could perhaps be used by others when reporting their results. SUMMARY 152 consecutive cases of infantile hydrocephalus treated in one unit with Holter valve ventriculo-atrial shunt are reviewed. 109 were associated with spina bifida or cranium bifidum. 73-5 per cent of those associated with spina bifida were alive at final follow-up (minimum period 1 year). 81-5 per cent of the others were alive at final follow-up. 15-8 per cent of all cases and 7 per cent of all operations became infected. The frequency of revision operations is discussed, and an attempt made to present the incidence and the resulting control of head circumference in relation to the length of follow-up. Head circumference is divided into normal, acceptable and unsatisfactory. 95 per cent of cases which were associated with spina bifida in this review were controlled in the normal or acceptable range. 76 per cent of the other cases were in this range at final follow up. RESUME Traitement de l'hydrocephalic infantile par la valve cle Holler: une analyse cie 152 cas conseculifs Les auteurs revisent 152 cas consecutifs d'hydrocephalie infantile traites dans le meme service avec la valve de Holter comme derivation ventriculo-atriale. 109 etaient associes de spina bifida ou cranium bifidum. 73,5 pour cent des cas associes avec spina bifida etaient encore en vie a la derniere visite (periode minimum un an). 81,5 pour cent des autres cas etaient vivants a la derniere visite. 15,8 pour cent de tous les cas et 7 pour cent de toutes les operations se sont infectes. La frequence des operations de revision est discutee et on essaie de presenter l'incidence et le controle en resultant de la circonference de la tete en relation a la longueur de la periode d'observation. La circonference de la tete est classee comme normale, acceptable, non-satisfaisante. 95 pour cent des cas associes avec spina bifida dans cette etude ont ete classifyes dans la serie normale ou acceptable. 76 pour cent des autres cas se rangeaient dans cette classe a la derniere visite. ZUSAMMENFASSUNG Behanclhtng von infaiuilem hydrocephalus mit der Anwendimg der Holter-Klappe: eine Analyse von 152 aufe inanderfolgenden Fallen Es werden 152 aufeinanderfolgende Falle von infantilem hydrocephalus besprochen, die in einer Einheit mit ventriculoatrialer Abzweigungsoperation mit der Holter-Klappe behandelt wurden. 109 traten im Zusammenhang mit spina bifida oder cranium bifidum auf. 73,5 Prozent der mit spina bifida assoziierten waren am Leben bei der endgultigen Nachprufung (Minimum-Periode 1 Jahr). 81,5 Prozent der anderen waren bei der endgultigen Nachprufung am Leben. 15,8 Prozent aller Falle und 7 Prozent alter Operationen bekamen eine Infektion. Die Haufigkeit der Revisions-Operationen wird erortert, und es wird versucht, die HAufigkeit und die resultierende Kontrolle des Kopfumfanges in ein Verhaltnis zu der Dauer der Nachprufung zu stellen. SUMMARY Evidence of pulmonary embolisation was observed in 17 of 31 cases of ventriculo-atrial shunt coming to autopsy. Eleven had bland, and 5 septic emboli, while in one case both were present. These findings in a larger series than any previously published fully confirm earlier observations. The surgical implications of these results are discussed. RESUME Embolisation pulmonaire survenue a la suite de derivations atrio-ventriculaires pratiquEes dans le traitement de l'hydrocephalie Des preuves d'embolisation pulmonaire ont ete observees dans 17 des 31 cas de derivation atrio-ventriculaire parvenus a l'autopsie; 11 avaient des embolies non-septiques et 5 des embolies septiques, tandis que dans un cas les deux types etaient presents. Les resultats de cette etude, plus etendue que toutes celles publicees jusqu'a present, confirment pleinement les observations precedentes. Les implications chirurgicales de ces resultats sont discutees. ZUSAMMENFASSUNG Pulmonare Embolisierung als Komplikation ventriculo-atrialer Seitenanknupfungen bei Wasserkopfoperationen Anzeichen von pulmonarer Embolisierung wurden bei der Autopsie von 17 aus 31 Fallen ventriculo-atrialer Seitenanknupfung festgestellt; 11 hatten milde und 5 septische Embolie, wahrend bei 1 Fall beide auftraten. Diese Befunde, in einer grosseren Serie als irgendeine bisher veroffentlichte, bestatigen vollauf die fruheren Beobachtungen. Die chirurgischen Implikationen dieser Ergebnisse werden erortert. RESUMEN Embolia pulmonar coma complication deuna derivation venlriculo-auricular realizada a causa de hidrocefalia Entre 31 casos de derivacion ventriculo-cardiaca en los cuales se hicieron autopsias, sc encontraron en 17 evidencia de embolia pulmonar. 11 tenian embolos blandos, 5 tenian embolos septicos, y en un caso se encontraron ambos. Estos resultados en una serie mas grande que todas las que se han publicado hasta ahora confirman completamente las observaciones que ya se han hecho. Se discute la importancia quirurgica de los resultados.

SUMMARY The early detection of progressive hydrocephalus in pre-term infants often is a difficult diagnostic problem. In this study, 43 pre-term infants with birthweights between 1000 and 2000g were examined shortly after birth and an estimate of gestational age was made. Individual measurements of head circumference were made weekly for the first month of life and regularly thereafter up to 16 weeks of age. The results indicate that healthy pre-term infants regularly cross percentiles for head circumference in the first months of life, the most rapid rates of growth being observed in the smallest babies. Only infants with significant medical problems in the neonatal period conform to or fall below the expected patterns of growth. A velocity curve for pre-term infants, according to health and gestation, is presented. RESUME Etude de la croissance cephalique longitudinale chez le nourrisson premature. lere partie: taux normaux de la croissance de la tete La detection precoce d'une hydrocephalic progressive chez le nourrisson premature est souvent un probleme diagnostic difficile. Dans cette etude 43 nourrissons prematures (poids de naissance entre 1000 et 2000g) ont ete examines peu apres la naissance et il a ete fait une estimation de 1'âge de gestation. Des mesures individuelles du tour de tete ont ete faites, hebdomadaires durant le premier mois de la vie et mensuelles ensuite. Les donnees recueillies indiquent que les nourrissons prematures ‘en bonne sante’ croisent les lignes de percentile du tour de tete dans les premiers mois de la vie, les taux de croissance les plus rapides s'observant chez les nourrissons les plus petits; seuls les nourrissons ayant presente des problemes medicaux durant la periode neo-natale se conforment a l'allure prevue de croissance ou tombent en dessous. Une courbe de vitesse pour nourrissons prematures selon leur etat de sante et l'âge de gestation est presentee. ZUSAMMENFASSUNG Langzeit-Kopfwachstumsstudien bei Fruhgeborenen I. Teil: Normalwerte fur das Sehadelwaehstum Die fruhzeitige Entdeckung des wachsenden Hydrocephalus beim Fruhgeborenen ist oft ein schwieriges diagnostisches Problem. Bei dieser Untersuchung wurden 43 Fruhgeborene (Geburtsgewicht 1000 bis 2000g) kurz nach der Geburt untersucht und eine Beurteilung des Gestationsalters vorgenommen. Einzelne Kopfumfangsmessungen wurden wahrend des ersten Monats wochentlich und sparer monatlich vorgenommen. Die Daten zeigen, das das ‘gesunde’ Fruhgeborene regular die Percentilen des Kopfum-fanges im ersten Monat kreuzt—die schnellsten Wachstumsraten wurden bei den kleinsten Kindern beobachtet—und nur die Kinder, die wahrend der Neonatal-periode schwer-wiegende medizinische Probleme hatten, folgen den erwarteten Wachstumsmustern oder bleiben hinter ihnen zuruck. Eine Geschwindigkeitskurve (des Wachstums) fur Fruhgebprene, bezogen auf Gesund-heitszustand und Gestationsalter, wird angegeben. RESUMEN Estudios longitudinales del crecimiento de la cabeza en el lactante de pre-termino. la parte: grados normales de crecimiento craneano. La detection precoz de una hidrocefalia progresiva en un lactante de pre-termino es a menudo un problema de diagnostico dificil. En este estudio 43 lactantes pre-teminor (peso del nacimiento de 1000 a 2000g) fueron examinados poco despues del nacimiento y se hizo una estimation de la edad gestacional. Se realizaron mediciones individuales de la circunferencia craneana cada semana durante el primer mes de vida y luego cada mes. Los datos indican que los lactantes pre-termino ‘sanos’ cruzan regularmente los percentiles para la circunferencia de la cabeza en el primer mes de vida (habiendose observado las velocidades de crecimiento mas rapidas en los ninos mas pequenos) y que solamente aquellos ninos que han tenido problemas medicos significativos en el periodo neonatal son los que siguen o quedan por debajo de Ies esquemas esperados de crecimiento. Se presenta una curva de velocidad para lactantes pretermino de acuerdo con la salud y la edad gestacional.

SUMMARY The authors examined the relationship between disproportionate intra-uterine head growth, or a relatively small head, and later development, using data collected as part of the Collaborative Perinatal Project of the National Institute of Neurological and Communicative Disorders and Stroke. Within the population of infants who are normal by conventional criteria (term infants with appropriate weight and head-circumference for gestational age), a group with relatively small heads was defined by each of four different methods. Developmental outcome measures included the Bayley Mental and Motor Scales at eight months, Stanford-Binet IQ at four years and Wechsler Intelligence Scales IQ at seven years. No clinically meaningful differences in developmental outcome were found between the infants with relatively small heads and the remainder of the infants. RESUME Croissance intra-uterine disproportionnee de la tete el devenir du developpement Les auteurs ont examine la relation existant entre une croissance intra-uterine disproportionnee de la tete ou une tete relativement petite, et le developpement ulterieur, utilisant les donnees recueillies au sein du Collaborative Perinatal Project du National Institute of Neurological and Communicative Disorders and Stroke. Dans la population de nourrissons normaux selon les criteres conventionnels (nourrissons nes a terme avec poids en rapport et tour de tete correspondant a l'âge conceptuel), un groupe ayant de relativement petites tetes a ete defini par quatre differentes methodes. Les mesures du devenir du developpement ont inclus les echelles mentales et motrices de Bayley a huit mois, le QI au Stanford-Binet a quatre ans et le QI a l'echelle d'intelligence de Wechsler a sept ans. Aucune difference cliniquement significative dans le devenir developmental n'a ete trouvee entre les nourrissons avec relativement petite tete et les autres nourrissons. ZUSAMMENFASSUNG Unproportionierles Kopfwachstum in utero und spatere Entwicklung Anhand von Daten, die als Teil einer Collaborativen Perinatalen Studie des National Institute of Neurological and Communicative Disorders and Stroke gesammelt worden waren, haben die Autoren die Beziehung zwischen unproportioniertem Kopfwachstum in utero, oder einem relativ kleinen Kopf, und der spateren Entwicklung untersucht. Aus der Population von Sauglingen, die nach den ublichen Kriterien als normal gelten (zum Termin geboren, Gewicht und Kopfumfang dem Gestationsalter entsprechend), wurde durch vier verschiedene Methoden eine Gruppe von Kindern herausgefunden, die einen relativ kleinen Kopf hatten. Als Parameter fur die spatere Entwicklung wurden die Bayley Mental and Motor Scales im Alter von acht Monaten, der Stanford-Binet IQ mit vier Jahren und der Wechsler Intelligence Scales IQ mit sieben Jahren zugrunde gelegt. In der spateren Entwicklung fand sich zwischen den Sauglingen mit relativ kleinem Kopf und den ubrigen Sauglingen kein klinisch relevanter Unterschied. RESUMEN Crecimiento intrauterino desproporcionado de la cabeza y curso posterior del desarrollo Los autores examinan la relacion entre el crecimiemto desproporcionado intrauterino de la cabeza o una cabeza relativamente pequena y el desarrollo posterior como parte del Proyecto Colaborativo Perinatal del Instituto Nacional de Alteraciones de la Comunicacion y el Ictus. Dentro de la poblacion de lactantes que son normales segun los criterios convencionales (lactantes a termino con peso apropiado y perimetro craneal de acuerdo con la edad gestacional) un grupo con cabezas relativamente pequenas fue definido segun cuatro diferentes metodos. El curso posterior del desarrollo incluye las mediciones con las Escalas Bayley Mental y Motora a los seis meses, el CI con el Stanford-Binet a los cuatro anos y el CI con las escalas de inteligencia de Wechsler a los siete anos. No se hallaron diferencias clinicas significativas en el curso del desarrollo entre los lactantes con cabezas relativamente pequefias y el resto de los ninos.

We examine the evolution of variously-sized radio galaxies [i.e., compact symmetric objects (CSOs), medium-size symmetric objects (MSOs), Fanaroff-Riley type II radio galaxies (FRIIs)], by comparing the relation between the hot spot size and the projected linear size with a coevolution model of hot spots and a cocoon. We take account of the deceleration effect by the cocoon head growth. We find that the advance speed of hot spots and lobes inevitably show the deceleration phase (CSO-MSO phase) and the acceleration phase (MSO-FRII phase). This is ascribed to the change of the power-law index of ambient density profile in the MSO phase ($\sim $1 kpc). It is also found that the cocoon shape becomes nearly spherical or disrupted for MSOs, while an elongated morphology is predicted for CSOs and FRIIs. This seems to be consistent with the higher fraction of distorted morphology of MSOs than that of CSOs and FRI. Finally, we predict that only CSOs whose initial advance speed is higher than about 0.1c can evolve into FRIIs, comparing the hot spot speed with the sound speed of the ambient medium., Comment: 12 pages, 8 figures, 4 tables, accepted for publication in ApJ; Table 1 and Table 2 are available at http://yso.mtk.nao.ac.jp/~kawakatu/Kawakatu08.pdf

Preterm hyperglycaemia in the first 2 weeks of life is common under 29 weeks gestation and is associated with increased mortality and morbidity. While the definition of hyperglycaemia is reasonably consistent (>8 mmol/L) the treatment threshold varies widely in clinical practice. Insulin therapy is the most common approach despite international guidance urging caution because of hypoglycaemia. Significant hypoglycaemia is unusual outside studies targeting normoglycaemia. Insulin treatment also forms part of a nutritional strategy aiming to optimise early protein and energy intake so minimising the risk of preterm postnatal growth failure. Early parenteral amino acids also improve blood glucose control. There is some evidence of improved postnatal head growth with this approach but longer term neurodevelopmental studies are required. Glucose reduction is the alternative approach. This compromises early nutritional intake but avoids the potential for long-term cardiovascular and metabolic complications linked with high postnatal nutritional intakes and theoretically, insulin treatment.

AIM This study examined the relationship between head growth and cognitive outcome at the age of five years in preterm infants born at less than 32 weeks of gestation from 2003 to 2009, as previous research has mostly focused on outcomes in toddlers. METHODS The head circumference of 273 very preterm infants born in Tyrol, Austria, was measured at birth, discharge, the corrected ages of three, 12 and 24 months and the chronological age of five years. Suboptimal head size was defined as a head circumference of more than one standard deviation below the mean. Full-scale intelligence quotient (IQ) at five years was determined using Wechsler Preschool and Primary Scales of Intelligence, third edition. RESULTS Infants with a suboptimal head size at the age of three months had a significantly lower median IQ than those with a normal head size (90 [20-122] versus 98 [20-138], p = 0.001) and from three months onwards they were more likely to exhibit cognitive delay. CONCLUSION A suboptimal head size from the age of three months was consistently related to a 10% lower IQ, and this study adds further evidence that head growth failure, especially during the early postdischarge period, is related to impaired cognitive abilities.

BACKGROUND. We hypothesized that in premature infants, retinal vascular growth retardation between birth and postmenstrual age of ∼30 to 32 weeks that initiates retinopathy of prematurity is paralleled by brain growth retardation. METHODS. In a prospective longitudinal study, we measured postnatal head growth, retinopathy of prematurity stage, protein and energy intake, severity of illness and serum insulin-like growth factor-1 levels in 58 preterm infants (mean gestational age at birth: 27.6 weeks) from birth until postmenstrual age of ∼40 weeks. RESULTS. Premature infant head growth decelerates dramatically after birth until postmenstrual age of ∼30 weeks. Head growth retardation coincides with retinal vascular growth suppression. Accelerated growth follows between post menstrual ages of ∼30 to 32 weeks and ∼40 weeks. The degree of head growth retardation up to postmenstrual age of 31 weeks corresponds to the degree of retinopathy of prematurity and to the degree of suppression of serum levels of insulin-like growth factor-1. At postmenstrual age of 31 weeks, if a child’s head circumference SD is below −2.5, then the probability of also developing at least stage 3 retinopathy of prematurity increases fivefold compared with head circumference above −2.5 SD (32% vs 6%) suggesting parallel processes in brain and retina. Serum insulin-like growth factor-1 levels correlate positively with head circumference SD score and with the degree of retinopathy of prematurity. CONCLUSIONS. The correlation between head and retinal growth is consistent with insulin growth factor-1 being one of the postnatal growth factors involved in this multifactorial process and also suggests that factors that contribute to retinopathy of prematurity during this critical period may also affect neurological dysfunction. Additional studies are required to establish this connection.

Previous studies of children with in-utero drug exposure (IUDE) raise concerns that decreased head circumference (HC) at birth increases the child's risk for later compromised cognitive functioning. The purpose of this study was to determine if HC at birth and HC growth change are associated with cognitive functioning (IQ) at 36 months of age in children with IUDE. In-utero drug exposed infants (N = 204) identified following delivery at two urban hospitals were compared with a group of non-exposed children (N = 34) matched for maternal age, gestational age and socioeconomic status. The IUDE infants had significantly smaller HC at birth than the non-exposed infants, however, by age 36 months the HC was comparable between the two groups. At age 36 months, there was no difference detected in the IQ between the IUDE and non-exposed groups, yet both groups scored almost one standard deviation below the mean for IQ and both groups were below but approached the US standard HC mean at the same age. Furth...

Macrocephaly is one of the most consistent physical findings reported in autistic individuals. Previous studies attempted to determine if macrocephaly is associated with risk for autism. This study hypothesizes that an abnormal acceleration in head growth during early development, rather than macrocephaly, is associated with autism risk. To investigate this hypothesis, head circumference data were examined in 251 individuals from 82 multiplex (at least two individuals with autism) and 113 sporadic (no family history) families with autism. This examination included longitudinal measurements for 79 individuals. Nineteen percent of the original 251 individuals were found to have macrocephaly (head circumference >97%). Abnormal acceleration in head growth was defined as an increase of 25 or more percentile points in head circumference between two consecutive measurements. Thirty-five percent of individuals with multiple head circumference records had an abnormal increase in head circumference. Furthermore, autistic individuals with accelerated head growth in early childhood displayed higher levels of adaptive functioning and less social impairment. This study confirms the presence of abnormal acceleration in head growth during the first and second months of life in a subgroup of autistic individuals.

Two glasshouse experiments studied the effect of moisture stress on head and postharvest characters of broccoli. The work demonstrated that moisture stress occurring during head growth affected the postharvest shelf life of broccoli heads. The stage of head development at which moisture stress was applied determined which postharvest character was influenced. This suggests that the genes controlling these characters can be switched on at different times. Moisture stress imposed close to head maturity appeared to have a positive benefit in terms of both head colour and stem turgor.

In order to assess the extent to which children in the United Kingdom (UK) will follow the UK-WHO head circumference standard, we used head circumference data from the Southampton Women’s Survey (SWS; n=3159) and the Avon Longitudinal Study of Parents and Children (ALSPAC; n=15,208) in children age 0-36 months, converted into z-scores using both the UK-WHO or UK1990 references. Rapid head growth was defined as crossing upwards through 2 major centile bands (1.33 SD). The UK-WHO standard identified many more infants with heads above the 98th centile compared to the UK1990 reference (UK-WHO 6% to 16% of infants at various ages, UK1990 1% to 4%). Rapid head growth in the first 6 to 9 months was also much more common using the UK-WHO standard (UK-WHO: 14.6% to 15.3%; UK1990: 4.8% to 5.1%). Practitioners should be aware of these findings to avoid unnecessary referrals.

Objective: Although early brain overgrowth is frequently reported in autism spectrum disorder (ASD), the relationship between ASD and head circumference (HC) is less clear, with inconsistent findings from longitudinal studies that include community controls. Our aim was to examine whether head growth in the first 3 years differed between children with ASD from a high-risk (HR) sample of infant siblings of children with ASD (by definition, multiplex), HR siblings not diagnosed with ASD, and low-risk (LR) controls. Method: Participants included 442 HR and 253 LR infants from 12 sites of the international Baby Siblings Research Consortium. Longitudinal HC data were obtained prospectively, supplemented by growth records. Random effects nonlinear growth models were used to compare HC in HR infants and LR infants. Additional comparisons were conducted with the HR group stratified by diagnostic status at age 3: ASD (n= 77), developmental delay (DD; n= 32), and typical development (TD; n= 333). Nonlinear growth models were also developed for height to assess general overgrowth associated with ASD. Results: There was no overall difference in head circumference growth over the first 3 years between HR and LR infants, although secondary analyses suggested possible increased total growth in HR infants, reflected by the model asymptote. Analyses stratifying the HR group by 3-year outcomes did not detect differences in head growth or height between HR infants who developed ASD and those who did not, nor between infants with ASD and LR controls. Conclusion: Head growth was uninformative as an ASD risk marker within this HR cohort. © 2014 American Academy of Child and Adolescent Psychiatry.

Typical signs of glucocorticoid excess in children are weight gain and poor linear growth. We describe a 2-year-old boy with a cortisol-secreting adenoma who presented with a dramatic decline in head growth. This case underscores concern of adverse effects of excess glucocorticoid on brain growth in very young children.

Background: Extrauterine growth restriction is common among very low birth weight infants (VLBW, BW Objectives: We compared an enhanced postnatal nutrient supply to a standard supply and evaluated the effects on growth velocity, head circumference growth and cerebral maturation - the latter by magnetic resonance diffusion tensor imaging (DTI). We hypothesized increased growth velocity, head circumference growth and decreased mean diffusivity (MD) in cerebral white matter (WM) areas, suggesting improved cerebral maturation among infants on the enhanced nutrient supply. Methods: In this randomized controlled trial, infants on the enhanced nutrient supply received increased amounts of energy, protein, fat, essential fatty acids and vitamin A until discharge. DTI was performed close to term equivalent age. Outcomes were growth velocity, head circumference growth and WM mean diffusivity. Results: Among the 50 included infants, 14 in the intervention group and 11 controls underwent a successful DTI. Infants on the enhanced diet achieved improved growth velocity (16.5 vs. 13.8 g/kg/day, p = 0.01) and increased head circumference (Δz score: 0.24 vs. -0.12, p = 0.15). A significantly lower MD was seen in a large WM area such as the superior longitudinal fasciculi (1.19 × 10-3 vs. 1.24 × 10-3 mm2/s, p = 0.04, adjusted for age when scanned). Conclusions: Enhanced nutrient supply to VLBW infants is associated with improved growth velocity, increased head circumference growth and decreased regional WM mean diffusivity, suggesting improved maturation of cerebral connective tracts.

Environmental factors such as maternal smoking can significantly modulate genetically programmed brain development during foetal life. This review looks at how prenatal smoking exposure modulates brain development, including new evidence on the effects of smoking on foetal brain development and function. Conclusion Smoking during pregnancy exposes the foetus to thousands of health-threatening chemicals, restricting foetal body and head growth. Alterations in brain structure and function have been seen in children exposed to prenatal smoking.

1. Amy Sniderman, MD 1. Cleveland Clinic Foundation Cleveland, Ohio 1. 1. Baxter PS, 2. Rigby AS, 3. Rotsaert M, 4. Wright I Acquired Microcephaly: Causes, Patterns, Motor and IQ Effects, and Associated Growth Changes . Baxter PS, Rigby AS, Rotsaert M, Wright I. Pediatrics. 2009;124:590–595 [OpenUrl][1][Abstract/FREE Full Text][2] 2. 1. Zitelli BJ, 2. Davies HW Central Nervous System Malformations . Zitelli BJ, Davies HW. In: Atlas of Pediatric Physical Diagnosis. 5th ed.Philadelphia, Pa: Mosby/Elsevier; 2007:575–579 3. Head Circumference for Age Tables, Infants Ages Birth–36 Months- Selected Percentiles . Accessed July 2010at: http://www.cdc.gov/growthcharts/ 4. 1. Vertinsky AT, 2. Barnes PD Macrocephaly, Increased Intracranial Pressure, and Hydrocephalus in the Infant and Young Child . Vertinsky AT, Barnes PD. Top Magn Reson Imaging. 2007;18:31–51 [OpenUrl][3][CrossRef][4][PubMed][5] 5. 1. Ashwal S, 2. Michelson D, 3. Plawner L, 4. Dobyns WB Practice Parameter: Evaluation of the Child With Microcephaly (An Evidence-based Review): Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society . Ashwal S, Michelson D, Plawner L, Dobyns WB. Neurology. 2009;73:887–897 [OpenUrl][6][Abstract/FREE Full Text][7] Measurement of the head circumference is a routine yet critical part of newborn, infant, and toddler health supervision care. Abnormal head growth may indicate a medical or developmental problem and often leads practitioners to further evaluation. Normal head circumferences in term infants range from 32 to 38 cm. Microcephaly is defined as a head circumference 2 standard deviations (SDs) below the mean for age and sex or roughly less than the 2nd percentile. Conversely, macrocephaly is defined as a head circumference greater than 2 SDs above the mean or greater than the 98th percentile. Bright Futures recommendations state that head circumference measurements should be obtained at each health supervision visit from birth to 24 months of age, but the Centers for Disease Control and Prevention growth charts extend to 36 months. Microcephaly can present as primary or acquired. Causes of primary microcephaly include autosomal dominant and autosomal recessive genetic disorders; trisomy 13, 18, and 21; various syndromes, including Cornelia de Lange syndrome, Smith-Lemli-Opitz syndrome, and Rett syndrome; inborn errors of metabolism; and hypothyroidism. Acquired microcephaly is distinguished by a normal head circumference at birth, followed by development of microcephaly in subsequent months or years, usually due to lack of brain development or growth. Causes of acquired microcephaly include sequelae from stroke, meningitis, or encephalitis; other infections, such as toxoplasmosis, rubella, cytomegalovirus, and herpes; in utero teratogen exposure; and hypoxic-ischemic encephalopathy. One study from England (Baxter PS, et al, 2009) noted three different patterns of head growth in infants … [1]: {openurl}?query=rft.jtitle%253DPediatrics%26rft_id%253Dinfo%253Adoi%252F10.1542%252Fpeds.2008-2784%26rft_id%253Dinfo%253Apmid%252F19651581%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=pediatrics&resid=124/2/590&atom=%2Fpedsinreview%2F31%2F9%2F382.atom [3]: {openurl}?query=rft.jtitle%253DTopics%2Bin%2Bmagnetic%2Bresonance%2Bimaging%2B%253A%2B%2BTMRI%26rft.stitle%253DTop%2BMagn%2BReson%2BImaging%26rft.aulast%253DVertinsky%26rft.auinit1%253DA.%2BT.%26rft.volume%253D18%26rft.issue%253D1%26rft.spage%253D31%26rft.epage%253D51%26rft.atitle%253DMacrocephaly%252C%2Bincreased%2Bintracranial%2Bpressure%252C%2Band%2Bhydrocephalus%2Bin%2Bthe%2Binfant%2Band%2Byoung%2Bchild.%26rft_id%253Dinfo%253Adoi%252F10.1097%252FRMR.0b013e3180d0a753%26rft_id%253Dinfo%253Apmid%252F17607142%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [4]: /lookup/external-ref?access_num=10.1097/RMR.0b013e3180d0a753&link_type=DOI [5]: /lookup/external-ref?access_num=17607142&link_type=MED&atom=%2Fpedsinreview%2F31%2F9%2F382.atom [6]: {openurl}?query=rft.jtitle%253DNeurology%26rft.stitle%253DNeurology%26rft.issn%253D0028-3878%26rft.aulast%253DAshwal%26rft.auinit1%253DS.%26rft.volume%253D73%26rft.issue%253D11%26rft.spage%253D887%26rft.epage%253D897%26rft.atitle%253DPractice%2BParameter%253A%2BEvaluation%2Bof%2Bthe%2Bchild%2Bwith%2Bmicrocephaly%2B%2528an%2Bevidence-based%2Breview%2529%253A%2BReport%2Bof%2Bthe%2BQuality%2BStandards%2BSubcommittee%2Bof%2Bthe%2BAmerican%2BAcademy%2Bof%2BNeurology%2Band%2Bthe%2BPractice%2BCommittee%2Bof%2Bthe%2BChild%2BNeurology%2BSociety%26rft_id%253Dinfo%253Adoi%252F10.1212%252FWNL.0b013e3181b783f7%26rft_id%253Dinfo%253Apmid%252F19752457%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [7]: /lookup/ijlink?linkType=ABST&journalCode=neurology&resid=73/11/887&atom=%2Fpedsinreview%2F31%2F9%2F382.atom

Using the Swedish Medical Birth Registry, information on 1,362,169 infants born during 1983–1996 was analyzed in order to investigate the relation between maternal smoking during pregnancy and infant head circumference at birth. Infants of smoking mothers were at an increased risk to have head circumference

It is estimated that 20 to 35 per cent of idiopathic microcephaly is hereditary. Common practice dictates that after the birth of such a case, subsequent pregnancies should be monitored ultrasonographically in order to facilitate early antenatal diagnosis, and thus genetic counselling. Two cases are reported to indicate the difficulties encountered. In case 1 head growth appeared to be normal until the 20th week of gestation and then slowed down to 31 cm at birth. In case 2 head growth proceeded normally until the 28th week of gestation; at birth it was 32 cm and over the succeeding months became markedly microcephalic. The accuracy of various ultrasonographic techniques is reviewed, and the limitations are discussed. In the light of these findings it is concluded that reliable prenatal diagnosis of hereditary microcephaly is not available as yet.

SummaryScheduling harvests in broccoli crops by planting at time intervals may cause problems because of the temperature dependent development of the plant. Data from three years of field experiments with four plantings per year, three cultivars and two plant densities were used to estimate the effect of environment on broccoli growth. A quadratic relationship between the logarithm of head diameter and a temperature sum with base 0°C and ceiling 17°C starting at head initiation (diameter of apex 0.6 mm) accounted for 97.3% of the variation in head diameter for pooled data of 68 crops. Including effects of plant density and cultivar significantly improved the fit of the quadratic model (R2: 0.9819). Including accumulated solar radiation from head initiation or planting month as additional explanatory variates could further improve the fit of a quadratic relationship and to the same extent (R2: 0.9843% and 0.9847%). The simple quadratic relationship between broccoli head diameter and temperature sum from he...

Morphological change in artificial vault modification is brought about not by passive tissue retreat but by compensatory neurocranial expansion. During this process, the brain and the cranial vault expand toward unrestricted areas. This chapter pulls together basic notions of human neurological and craniological expansion in natural and restricted growth during infancy. To this end, anatomical and physiopathological information is called upon and used to explain the altered head growth dynamics operating during the compression process. Cranial embryology and postnatal development provide points of departure to explore and discuss natural limitations to externally induced changes in calvarial form and their side effects on the skull’s base and face. We conclude that cranial shaping is only possible during the first years of life. Secondary formational changes in the basicranium and splanchnocranium ensue depending on the degree and technique of the extrinsic forces. Its cultural implementation may also bear aesthetic implications in the form of cranial asymmetry and health risks by bleeding, local infections, or necrosis of the compressed tissue and intracranial hypertension.

Case-control studies have found increased head growth during the first year of life in children with autism spectrum disorder. Length and weight have not been as extensively studied, and there are few studies of population-based samples.The study was conducted in a sample of 106,082 children from the population-based Norwegian Mother and Child Cohort. The children were born in 1999-2009; by the end of follow-up on 31 December 2012, the age range was 3.6 through 13.1 years (mean 7.4 years). Measures were obtained prospectively until age 12 months for head circumference and 36 months for length and weight. We compared growth trajectories in autism spectrum disorder cases and noncases using Reed first-order models.Subjects included 376 children (310 boys and 66 girls) with specialist-confirmed autism spectrum disorder. In boys with autism spectrum disorder, mean head growth was similar to that of other boys, but variability was greater, and 8.7% had macrocephaly (head circumference97th cohort percentile) by 12 months of age. Autism spectrum disorder boys also had slightly increased body growth, with mean length 1.1 cm above and mean weight 300 g above the cohort mean for boys at age 12 months. Throughout the first year, the head circumference of girls with autism spectrum disorder was reduced-by 0.3 cm at birth and 0.5 cm at 12 months. Their mean length was similar to that of other girls, but their mean weight was 150-350 g below at all ages from birth to 3 years. The reductions in mean head circumference and weight in girls with autism spectrum disorder appear to be driven by those with intellectual disability, genetic disorders, and epilepsy.Growth trajectories in children with autism spectrum disorder diverge from those of other children and the differences are sex specific. Previous findings of increased mean head growth were not replicated.

Fetal growth restriction (FGR) can emerge as a complication of placental dysfunction and increases the risk for neurodevelopmental delay. Marked elevations of umbilical artery (UA) Doppler resistance that set the stage for cardiovascular and biophysical deterioration with subsequent preterm birth characterize early-onset FGR. Minimal, or absent UA Doppler abnormalities and isolated cerebral Doppler changes with subtle deterioration and a high risk for unanticipated term stillbirth are characteristic for late-onset FGR. Nutritional deficiency manifested in lagging head growth is the most powerful predictor of developmental delay in all forms of FGR. Extremes of blood flow resistance and cardiovascular deterioration, prematurity and intracranial hemorrhage increase the risks for psychomotor delay and cerebral palsy. In late-onset FGR, regional cerebral vascular redistribution correlates with abnormal behavioral domains. Irrespective of the phenotype of FGR, prenatal tests that provide precise and independent stratification of risks for adverse neurodevelopment have yet to be determined.

To examine the association between neurodevelopmental outcome and head circumference (HC) in a cohort of very preterm infants and in this context to investigate the relevance of suboptimal head size.Somatometric data were obtained at birth, discharge and 3, 12 and 24 months for all infants born in Tyrol32 weeks gestational age. Growth data are presented as z scores. HC was defined as microcephaly (2 SD below mean), suboptimal (1 SD below mean) or normal head size (1 SD below mean). Neurodevelopmental outcome was quantified at 12 and 24 months using the Bayley Scales of Infant Development II.The percentage of infants with suboptimal head size increased until the age of 24 months and was related to adverse outcome. The association was strongest between HC at 3 months and psychomotor and mental outcome as quantified using the Bayley Scales of Infant Development.Poor postnatal head growth was common in our study cohort. Both microcephaly and suboptimal head size were associated with impaired neurodevelopmental outcome. Suboptimal head size at 3 months was found to be particularly associated with adverse neurodevelopmental outcome.

Neuropsychological development and the impact of postnatal head growth were studied in preschool children with asymmetrical intrauterine growth restriction. Examinees born at term with a birth weight below the 10th percentile were matched to the control group according to chronological and gestational age, gender, and maternal education. Fifty children were in each group, with a mean age of 6 years, 4 months. The Touwen neurological examination, the Čuturić developmental test, an imitative hand positions test, and a visual attention test were performed. There were significant differences ( P< .03) in motor variables, the developmental quotient, and the imitative hand positions test. Fine motor skills had the most discriminative power. Relative growth of the head in relation to weight gain was positively correlated to neurocognitive outcome. Intrauterine growth–restricted children with a current head circumference ≤10th percentile had poorer outcomes. Conclusively, intrauterine growth restriction has a negative impact on neurocognitive development. Slow postnatal head growth is correlated with a poorer neuropsychological outcome.

SummaryExperiments over four years measured the extension of the growing point and head growth of the Chinese cabbage cvs Jade Pagoda and Kasumi. In the first three years, three transplantings of plants raised at different temperatures provided data from weekly crop samples to develop simple models of increased growing point height and head weight. Effects on the former established during raising were largely maintained after transplanting. It is suggested that head development and growing point extension differ in their dependency on meteorological variables. Increased field temperature achieves a marketable head weight before the growing point becomes unacceptably high, but this is less likely with increased solar radiation. The models effectively describe independent data from the fourth year.

The objective of this investigation was the development of a modified Neonatal Growth Assessment Score (mNGAS) for use in the evaluation of neonatal growth status. The growth of 74 fetuses at risk for intrauterine growth retardation (IUGR) was followed longitudinally, beginning in the first or early second trimester. Rossavik growth models derived from data obtained in the second trimester were used to predict the weight (WT), crown-heel length (CHL) and head (HC), abdominal (AC) and thigh circumferences (ThC) at birth, which were then actually measured within 24 h after delivery. These measurements were compared to age-specific size curves and used to calculate sets of five growth potential index (GPRIi) values, which in turn were used to calculate five-variable Neonatal Growth Assessment Scores (NGAS5). Neonates were initially classified as normal or IUGR on the basis of NGAS5, GPRIi, and anatomic measurements. A final classification based on principal component analysis and linear discriminant analysis was carried out. The score obtained using the first principal component function was defined to be mNGAS51. The effectiveness of mNGASij values, determined from 1-4 GPRIi values, in separating normal and IUGR neonates was also evaluated. Neonates initially considered to be normal had very few abnormal GPRI values or anatomic measurements, whereas the frequency of these abnormalities in IUGR neonates was significantly increased. However, no single anatomic variable was 100% normal in the normal neonates and 100% abnormal in IUGR neonates. Only 40% of IUGR neonates were small for gestational age. Classification of these neonates using principal component analysis and linear discriminant analysis was essentially the same (98.6%) as that made initially after reclassification of two IUGR neonates as normal. The characteristics of the initial and final normal and IUGR groups were very similar and the mNGAS51 was strongly correlated with the NGAS5 in the IUGR group. The effectiveness of mNGASij in separating normal and IUGR neonates increased with the number of GPRIi values included and the types used. GPRIThC and GPRIWT were the most important, followed by GPRIAC. GPRICHL and GPRIHC were much less important and in some cases detrimental. These findings support the concepts of a decrease in soft tissue mass as the initial step in the development of IUGR and the protection of head growth (brain-sparing). The characteristics of mNGAS51, particularly its comprehensiveness, its independence of differences in growth potential, its weighting of GPRIi values according to their importance in the detection of IUGR and its ability to detect different manifestations of IUGR in different individuals, indicate that this should be a most effective parameter for separating normal and IUGR neonates.

From a neurobiologic perspective, Rett syndrome appears to disrupt the growth of axonodendritic connections among neurons. The cell packing density within the grey matter is increased but the total number of neurons is relatively normal, except for selected neuronal populations such as the nucleus basalis of Meynert (NBM) and the substantia nigra. Neurochemical assays of postmortem brain from patients with Rett syndrome patients demonstrate reductions in choline acetyltransferase (ChAT), the acetylcholine synthetic enzyme localized in NBM nerve terminals. In an animal model, early postnatal injury to the cholinergic pathways projected from the NBM causes permanent disruption of developing cholinergic neurons and a behavioral disorder on maze testing. The results suggest a mechanism by which early deficits in cholinergic and dopamine neurons projecting to the cerebral cortex from the brainstem and basal forebrain could disrupt axonodendritic development in the cerebral cortex. Studies in our laboratory are examining the mechanisms for these effects as well as the distribution and densities of neurotransmitter receptors in postmortem brains from Rett patients.

Background Rett syndrome is a neurodevelopmental disorder that occurs in individuals with a mutation in the X-linked methyl-CpG-binding protein 2 ( 2MECP2 ) gene. 2MECP2 mutations produce a high degree of variability in the clinical phenotypes including the classic Rett features of head growth deceleration, psychomotor regression, deviant communicative ability, hand stereotypes, autonomic dysfunction, and seizures. Atypical forms of Rett such as those with preserved speech do not follow these characteristics. Patient We report a 9-year-old girl with atypical Rett (macrocephaly, preserved speech, and psychiatric manifestations) with a 2MECP2 (P152R) mutation that generally is not associated with these clinical signs. Conclusion This case broadens the genotype-phenotype correlation between the P152R mutation 2MECP2 -associated Rett syndrome.

Objective: To determine the pattern of head growth and the early postnatal nutritional status of microcephalic infants in a low-income country.Materials and Methods: A cohort study in Lagos, Nigeria in which the head growth of full-term singletons within the first postnatal check-up at 6-8weeks was evaluated using the latest World Health Organization (WHO)’s Child Growth Standards (WHO-CGS) for head circumference. Nutritional status of microcephalic infants at follow-up was also determined after adjustments for potential confounders.Results: Of the 452 infants (male: 227) enrolled, microcephalic infants were 32 (7.1%) at birth and 34 (7.5%) at followup. However, while 401 (88.7%) remained normocephalic and 15 (3.3%) remained microcephalic at follow-up, 19 (4.2%) became microcephalic and 17 (3.8%) became normocephalic. Microcephalic infants were significantly underweight (P < 0.001), stunted (P < 0.001) and wasted (P < 0.001) at follow-up.Conclusions: Regardless of their status at birth, microcephalic infants at 6-8weeks are likely to be undernourished by all nutritional indices suggesting that head circumference may serve as a complementary or default screening tool for early detection of undernourished infants in resource-constrained settings.

The organ distribution of radioactivity following intravascular bolus injection of3H-Lys-head growth activator in rats was studied. Two minutes after injection the renal level of radioactivity exceeded the blood level 7-fold; 80% of the total activity was bound with the blood cell membranes. An analysis of chemical derivatives of the labeled peptide in the plasma by means of reverse-phase high-performance liquid chromatography revealed the presence of several groups of radioactive metabolites with different hydrophilic properties. High-performance liquid chromatography of blood extracts obtained from samples taken 0.5, 1, 1.5, 2, 31, and 60 min after injection showed the transformation of initially hydrophobic head growth activator into more hydrophilic fragments. The3H-Lys-head growth activator-associated radioactivity could be reliably detected in the blood onl during the first two minutes after injection. The half-period of blood-to-organ distribution of3H-labeled head growth activator lasted less than 30 seconds.

Head circumference is considered an important parameter of brain growth and development. Syndrome-specific standards for head circumference in Williams-Beuren syndrome (WBS) are not available to date, although mental retardation is a leading manifestation in the syndrome. Therefore, we investigated head growth in 63 girls (251 measurements) and 88 boys (298 measurements) with WBS between birth and adulthood. Most measurements in both sexes were from the first 4 years of life (n = 162 in girls and n = 189 in boys). Mean (+/- SD) head circumference at birth was 33.39 +/- 1.38 cm and 34.02 +/- 1.44 cm for term girls and boys, respectively. Although head growth in WBS girls and boys was at a slower velocity, the pattern of head circumference was similar to that in the normal population. After the age of 3 months, head circumference started to fall below the normal mean in girls (0.5-2 cm). In boys, mean head circumference was below the normal mean already at 1 month of age (2 cm). The deficit increased to 3 cm from 6 months to 4 years. Adult OFC was 52.85 +/- 1.75 cm (n = 16) compared to 55.70 +/- 1.83 cm (n = 46; P0.00001) in WBS women and 55.51 +/- 1.68 cm (n = 30) compared to 57.87 +/- 1.29 cm (n = 31; P0.00001) in WBS men. During development, microcephaly is only seen in about one third of WBS patients.

Background: After intrauterine growth retardation, many minor neurodevelopmental disorders may occur, especially in the motor skills domain, language and speech development, and cognitive functions. Aim: The assessment of language development and impact of postnatal head growth in preschool children born with asymmetrical intrauterine growth retardation. Methods: Examinees were born at term with birth weight below the 10th percentile for gestational age, parity and gender. Mean age at the time of study was six years and four months. The control group was matched according to chronological and gestational age, gender and maternal education with mean age six years and five months. There were 50 children with intrauterine growth retardation and 50 controls, 28 girls and 22 boys in each group. For the assessment of language development Reynell Developmental Language Scale, the Naming test and Mottier test were performed. Results: There were statistically significant differences ( p < 0.05) in language comprehension, total expressive language (vocabulary, structure, content), naming skills and non-words repetition. Statistically significant positive correlations were found between relative growth of the head [(Actual head circumference head circumference at birth)/(Body weight birth weight)] and language outcome. Children with neonatal complications had lower results ( p < 0.05) in language comprehension and total expressive language. Conclusion: Intrauterine growth retardation has a negative impact on language development which is evident in preschool years. Slow postnatal head growth is correlated with poorer language outcome. Neonatal complications were negatively correlated with language comprehension and total expressive language.

Long-term IGF-I treatment changed the craniofacial morphology and increased head circumference (i.e. brain growth) to normal values.

The term "external hydrocephalus (EH)" is used to describe excessively rapid head growth in infants who are found to have enlarged subarachnoid spaces and little or no ventricular enlargement. EH has not yet been described in discordant birth weight twins. We report the cases of two sets of discordant twins with normal neonatal course and normal neonatal brain ultrasound scans who developed an EH in the first months after birth and had a mild neurodevelopmental delay. Our findings suggest that EH may be part of neurologic morbidity in discordant birth weight twins and represents one of the potential complications to look for in the follow-up of these infants.

The auditory space map in the superior colliculus of the guinea-pig requires for its normal emergence at 32 days after birth (DAB) bimodal, auditory and visual experience during a 4-day crucial period (26 - 30 DAB) (Withington-Wray et al., Neurosci. Lett., 116, 280 - 286, 1990d). The need for auditory experience has been proposed to be linked to the rapid changes in the cues for auditory localization brought about by head growth. Head growth is particularly rapid during the first postnatal month but continues more slowly until approximately 70 DAB. This suggests that sensory experience may be required beyond the initial crucial period to accommodate later growth. In this paper the role of auditory experience beyond the crucial period has been investigated. Deprivation of ordinary auditory experience was effected by placement of the animals in an environment in which continuous omnidirectional noise obscured the cues of sound direction. Animals deprived of auditory experience during the crucial period and then allowed normal experience showed limited ability to construct an auditory space map and the resulting map was less accurate than that found in normally reared animals. Auditory deprivation following normal experience during the crucial period caused a profound degradation, of both spatial tuning and topography, of auditory multi-unit receptive fields in the superior colliculus. The spatial tuning and topography of auditory fields from older animals (100 DAB) deprived of ordinary auditory cues for a 4-week period were normal. Thus, in the guinea-pig, susceptibility of the superior collicular space map to deprivation of auditory cues is limited by the age of the animal. The timing of the cessation of vulnerability may, in part, be due to the stabilization of directional cues affected by head growth.