Rapid Head Growth Research Articles

A Novel Modular Headmount Design for non-invasive Scalp EEG Recordings in Awake Animal Models.

We have designed and developed a novel, noninvasive modular headmount to be used for awake animal scalp electroencephalography (EEG). The design is based on a developing rat that will accommodate rapid head growth. Desired characteristics include non-invasiveness, adjustable quantity and positioning, light weight, and tolerability by the animal. Axial Dependent Modular Electrode Mount (ADMEM), as designed here, addresses the aforementioned constraints by using light-weight and adjustable materials. The initial prototype of ADMEM has been tested in vivo with rat pups, using the open field test to assess for stress and anxiety at two post-installation time-points: one day after ADMEM installation (acute time-point) and four days after ADMEM installation (sub-acute time-point). There was no significant difference in normal developmental weight gain between Control and ADMEM rat groups. Although no significant difference was found in the level of anxiety between groups at the acute time-point, the ADMEM group spent significantly less time in the center of the open field test, suggesting higher anxiety. The test also showed no difference in the measured traveled distances between Control and ADMEM groups on either time-points.

Increased Risk of Very Low Birth Weight, Rapid Postnatal Growth, and Autism in Underweight and Obese Mothers

To determine whether prepregnancy weight was associated with children's birth weight, early physical growth, and autism diagnosis. Early Childhood Longitudinal Study-Birth Cohort data. United States. Representative sample of U.S. children followed from birth through kindergarten (n = 4800). Also, a subpopulation of the very low birth weight children was examined (n = 500). Maternal variables included age and prepregnancy body mass index. Changes in children's height, weight, and head circumference between 9 months and 2 years were used as growth metrics. Children's sex, age, birth weight, and reported autism were also considered. Logistic and multinomial logistic models assessed the impact of prepregnancy weight on birth weight and children's subsequent rate of physical growth and autism. Children born to underweight or obese mothers had increased odds of very low birth weight. Very low birth weight was related to rapid height and weight growth and more than twice the likelihood to subsequently be diagnosed with autism. For the subgroup of very low birth weight children, rapid head growth was related to a fivefold increase in the odds of autism. After accounting for the impact birth weight and growth rates, we found prepregnancy weight indirectly impacted autism risk. Being underweight or obese during prepregnancy indirectly increased risk for autism from increased odds of low birth weight and accelerated postnatal growth.

Rapid head growth in a baby with ADPKD: Answers

I. Obstructive hydrocephalus—possibly due to blood from a sub-arachnoid hemorrhage secondary to an intra-cranial aneurysm II. Tuberous sclerosis, which may be associated with ADPKD III. Space-occupying lesions such as teratomas, astrocytic tumors, or primitive neuroectodermal tumors IV. Dural arterio-venous malformation V. Arachnoid cyst VI. Benign macrocrania of infancy 2. The magnetic resonance imaging (MRI) brain scan (Fig. 1) shows collections of fluid with visible septations over the frontal lobes. There is no midline shift. The fluid displays the same density as cerebrospinal fluid and the radiological appearances are consistent with a diagnosis of bilateral frontal arachnoid cysts. 3. The management involves a conservative approach with:

Rapid head growth in a baby with autosomal dominant polycystic kidney disease (ADPKD): Questions

Rapid head growth in a baby with autosomal dominant polycystic kidney disease (ADPKD): Questions

Effect of temperature on the growth of broccoli (brassica oleracea l. var. italica plenck) cv. fiesta

Summary Three-year studies on the influence of temperature on vegetative growth and growth of broccoli heads (Brassica oleracea var. italica cv. Fiesta) were carried out at the Experimental Station “Marcelin” of Poznań University of Life Sciences in Poland. The relationship between temperature sum day-degree, number and area of leaves as well as head diameter was estimated. Likewise relationship between number and area of leaves and head diameter was established. The correlations were described using linear, curvilinear and segment linear regression. The relationship between temperature sum day-degree and number of leaves was linear, whereas the correlation between temperature and area of leaves and head diameter was curves function. On the basis of segment linear regression it was found that in the period when slow growth of heads was observed (the size of up to about 1.5 cm), the area of leaves increased the fastest. It occurred between the 24th and 27th day after planting. The fastest growth of broccoli heads was noted, when the plant had about 18 leaves and area 4900 cm2. In the period of rapid head growth, the increase of sum temperature of 100 day-degree resulted in head diameter increase by 3.5 cm.

Brain enlargement is associated with regression in preschool-age boys with autism spectrum disorders

Autism is a heterogeneous disorder with multiple behavioral and biological phenotypes. Accelerated brain growth during early childhood is a well-established biological feature of autism. Onset pattern, i.e., early onset or regressive, is an intensely studied behavioral phenotype of autism. There is currently little known, however, about whether, or how, onset status maps onto the abnormal brain growth. We examined the relationship between total brain volume and onset status in a large sample of 2- to 4-y-old boys and girls with autism spectrum disorder (ASD) [n = 53, no regression (nREG); n = 61, regression (REG)] and a comparison group of age-matched typically developing controls (n = 66). We also examined retrospective head circumference measurements from birth through 18 mo of age. We found that abnormal brain enlargement was most commonly found in boys with regressive autism. Brain size in boys without regression did not differ from controls. Retrospective head circumference measurements indicate that head circumference in boys with regressive autism is normal at birth but diverges from the other groups around 4-6 mo of age. There were no differences in brain size in girls with autism (n = 22, ASD; n = 24, controls). These results suggest that there may be distinct neural phenotypes associated with different onsets of autism. For boys with regressive autism, divergence in brain size occurs well before loss of skills is commonly reported. Thus, rapid head growth may be a risk factor for regressive autism.

Subdural hematoma in infants: can it occur spontaneously? Data from a prospective series and critical review of the literature by Vinchon et al

Dear Editor, Now that Vinchon [1] has validated Piatt's [2] observation that the diagnosis of abuse is unsafe in infants with preexisting enlarged cerebrospinal fluid spaces, the entire abuse literature needs revision to remove all such cases from the abuse category to the non-abuse or at least the undetermined categories. Rather than comparing “spontaneous” to “abuse” cases, Vinchon apparently has sufficient clinical material to compare those cases with either rapid head growth (crossing two percentile lines) or increased space between the brain and skull (McNeely [3] used 5 mm) on presentation to those without. This may be the more informative comparison. References

External hydrocephalus in discordant birth weight twins: a case report

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.

Early head growth: relation with IQ at 8 years and determinants in term infants of low and appropriate birthweight

To investigate the relation between head growth at different periods and IQ at 8 years, and to identify factors associated with more rapid head growth. Two parallel cohorts of term low birthweight (LBW) and appropriate birthweight (ABW) infants were enrolled at birth in northeast Brazil. Anthropometric measurements were made at birth, 2 months, 6 months, 12 months, 24 months, and 8 years. Cognition was assessed at 8 years (n=164) with the Wechsler Intelligence Scale for Children. Multivariable analysis with a two-stage residual model was used to relate head growth between successive time points with IQ. Mean birthweight was 2.35kg (SD 0.15) in the LBW group (33 males, 50 females), and 3.21kg (SD 0.15) in the ABW group (28 males, 53 females). Mean gestational age was 38.8 weeks (SD 1.4) and 40.0 weeks (SD 1.3) respectively. In the LBW group, head growth from birth to 2 months and from 2 to 6 months, conditional on previous size, were significant independent predictors of IQ at 8 years. Conditional head growth from 6 months to 8 years and head size at birth were unrelated to IQ. In the ABW group there was no significant relation between conditional head growth and IQ for any period. Determinants of more rapid head growth from birth to 6 months in LBW infants were maternal height and rate of infant weight gain. Head growth from birth to 6 months in term LBW infants is more important than prenatal or later postnatal head growth in predicting IQ at 8 years.

Two brothers with a microduplication including the MECP2 gene: rapid head growth in infancy and resolution of susceptibility to infection

Microduplications in chromosome Xq28, which include the methyl-CPG binding protein (MECP2) gene, cause severe X-linked mental retardation. Serious recurrent infections are a feature of this condition. Affected males are micro or normocephalic. We report two normocephalic brothers with an approximately 0.5 Mb duplication which includes MECP2 who had rapid head growth in infancy. The younger boy had chronic constipation until the age of 3 years. For both boys, the susceptibility to infection subsided in the second year of life. Whether or not rapid head growth in infancy and/or constipation are frequent features of the phenotype remains to be seen as more patients are described. Susceptibility to infection can remit after early childhood and could theoretically be related to overexpression of the interleukin 1 receptor-associated kinase IRAK1 gene.

Association of Rapid Head Growth in Children Following Tracheostomy Tube Placement

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.

Growth of infants born to HIV-infected women when fed a biologically acidified starter formula with and without probiotics

Objectives: To compare the growth of HIV-exposed uninfected infants fed a biologically acidified milk formula with or without probiotics (Bifidobacterium lactis) during the first six months of life, with control infants fed a standard starter formula.Design: Multi-centre, double-blinded randomised controlled trial.Setting: Infants born to HIV-infected women delivering at one of three academic hospitals in Johannesburg, South Africa.Subjects: Consenting HIV-positive women, who had previously decided not to breast-feed, were randomised to receive one of three milk formulas for their newborn infants.Outcome measures: Comparisons of growth parameters through the first four months of life were made between infants fed the acidified formula without probiotics and those fed the control formula (“acidification effect”), and between infants fed the acidified formulas with and without added probiotics (“probiotic effect”).Results: Of 131 randomised infants, 33 (25%) did not complete the study and 13 (10%) were HIV infected, leaving 85 infants available for analysis. Infants receiving the acidified formula with probiotics had more rapid head growth (p=0.04) and showed a trend towards more rapid weight gain (p=0.06) over the first four months of life than the infants receiving the acidified formula without probiotics. No other significant differences between the feeding groups were demonstrated.Conclusions: Infants in all study groups grew well, with increased head growth and a trend towards increased weight gain for those receiving probiotics. There were no differences in morbidity between the three study groups and no evidence of adverse effects of the study formulas.

Rate of Head Growth Decelerates and Symptoms Worsen in the Second Year of Life in Autism

Longitudinal studies of head circumference growth in infants later diagnosed with autism are needed to understand the accelerated head growth in this disorder. We analyzed longitudinal head circumference data from birth to 3 years in 28 children later diagnosed with autism spectrum disorder on the basis of individual growth curve analyses using hierarchical linear models. Head circumference Z scores relative to norms significantly increased in the autism sample from birth to 12 months, but this pattern did not persist beyond 12 months. Rather, the rate of change in head circumference from 12 to 36 months was not different from the normative sample. These results suggest that a period of exceptionally rapid head growth occurs during the first year of life in autism; after 12 months of age, the rate of head circumference growth decelerates relative to the rate during the first year of life. Studies of behavioral development in infants later diagnosed with autism suggest that the period of acceleration of head growth precedes and overlaps with the onset of behavioral symptoms, and the period of deceleration coincides with a period of worsening of symptoms in the second year of life.

Endoscopic washout: a new technique for treating chronic subdural hematomas in infants.

Chronic hematomas are a common problem during infancy and usually occur as the consequence of trauma. They tend to enlarge and are often managed successfully with repeated subdural taps. In patients with collections that fail to respond to percutaneous drainage, the choice of operative management, including burr hole evacuation, shunting, or craniotomy, remains controversial. A new technique, called endoscopic washout, was successfully used in 7 children under the age of 2 years who presented with irritability, vomiting, seizures, and rapid head growth. Preoperative computerized tomography (CT) scans demonstrated enlarging, bilateral, chronic subdural collections; these failed to respond to repeated percutaneous taps over 10 days. With the patient positioned supine, bilateral linear incisions were made anterior to the coronal suture in the midpupillary lines and burr holes were placed. After the dura and outer membrane were opened and coagulated with bipolar cautery, a 4-mm steerable fiberscope was introduced into the subdural space to visualize the collections, evacuate any residual clot, and continuously irrigate the space with lactated Ringer's solution warmed to physiologic temperature. No bridging vessels or synechiae were violated; nitrous oxide and hyperventilation were discontinued before removing the fiberscope. The subdural space was irrigated again prior to closure. At follow-up (range 18 months to 8 years), CT scans showed reexpansion of the brain and no reaccumulation of the hematomas. We conclude that the endoscopic washout is a safe, uncomplicated treatment for chronic subdural hematomas in infants; is more effective than treatment with conventional burr holes alone, and eliminates the need for shunting or craniotomy.

Clinical course, early diagnosis, treatment, and prevention of disease in glutaryl-CoA dehydrogenase deficiency.

Glutaryl-CoA dehydrogenase deficiency (GDD) is a recessively inherited neurometabolic disorder associated with encephalopathic crises and severe extrapyramidal symptoms. Treatment regimens including glucose and electrolyte infusions during acute illnesses, oral carnitine supplementation and/or a low-protein or lysine-restricted diet have been recommended, but their efficacy has been documented only on an anecdotal basis. We conducted a retrospective analysis of 57 patients with proven GDD-relating appearance and severity of neurological disease to age and clinical status at diagnosis, glutaric acid levels in body fluids, and different treatment regimens. Thirty-six patients were diagnosed after the onset of neurological disease (symptomatic group), twenty-one before (presymptomatic group). Carnitine levels were found to be reduced in all patients at diagnosis. In the symptomatic group, macrocephaly had been present around birth and was followed by rapid postnatal head growth in 70% of the children. The patients often showed symptoms such as hypotonia, irritability, and jitteriness followed by an acute encephalopathic crisis occurring on average at 12 months of age. Common neuroimaging findings included frontotemporal atrophy, subependymal pseudocysts, delayed myelination, basal ganglia atrophy, chronic subdural effusions and hematomas. In four patients the latter two findings were initially misinterpreted as resulting from child abuse. Other important misdiagnoses in older siblings who were affected and went undiagnosed include postencephalitic cerebral palsy, dystonic cerebral palsy and sudden infant death syndrome. Metabolic treatment did not convincingly improve the neurological disease, although it may have prevented further deterioration. Symptomatic treatment with baclofen or benzodiazepines was effective in reducing muscle spasms. Children in the presymptomatic group were diagnosed because of familiarity for the disease (n = 13), macrocephaly and/or additional minor neurological signs in infancy (n = 6), or acute encephalopathy, which was fully reversible after prompt treatment (n = 2). After diagnosis, all children were treated with oral carnitine, fluid infusion during intercurrent illnesses and, in addition, a diet was started in 13 of the 21 children. All 21 children except one (born prematurely at 31 weeks) have continued to develop normally up to now. Mean age at report is 6.3 years with a range from 6 months to 14.8 years. In older patients, the neuroradiological changes, present in infancy as in the symptomatic patients, became less prominent and in one girl disappeared. In presymptomatic children with GDD, the onset of neurological disease can be prevented by vigorous treatment of catabolic crises during illnesses together with carnitine supplementation. The importance of dietary therapy remains unclear and needs further evaluation. The potential treatability of GDD calls for increased attention to early presenting signs in order to recognize the disorder and to initiate treatment before the onset of irreversible neurological disease.

The size of the intra- and extraventricular cerebrospinal fluid compartments in children with idiopathic benign widening of the frontal subarachnoid space.

The aim of this study was to quantify the intra- and extraventricular cerebrospinal fluid (CSF) spaces in children with benign enlargement of the frontal subarachnoid space (BE). The infra- and supratentorial CSF compartments were measured in 61 CT examinations of children with BE, 3-27 months old, and compared with those of 96 CT examinations considered normal. Measurements of the ventricular system, and the pontine and chiasmatic cisterns were related to cranial size. In all children with BE the lateral and third ventricles were dilated and the chiasmatic cistern was widened. The subarachnoid space was wider than the upper limits in the control group, in the frontal region (4 mm), and the anterior interhemispheric (4 mm) and Sylvian (3 mm) fissures. The infratentorial CSF compartments, the occipital subarachnoid space, the posterior part of the interhemispheric fissure and, in most cases, the cortical sulci were normal in size in children with BE. The majority were macrocephalic or had rapid head growth but there were also normocephalic children with normal head growth. The size of the posterior fossa was within the normal range in all children with BE. Idiopathic BE is not uncommon in children up to about 3 years old who are healthy or have minimal neurological disturbance and is characterised by a specific pattern of widening of the supratentorial CSF compartments.

Pre-anthesis partitioning of dry matter in sunflower (Helianthus annuus L.) crops

Abstract A simple framework for describing the partitioning of biomass among the organs (root, stem, laminae, head) of sunflower plants between emergence and anthesis as been developed using data from experiments in which adequate water and nitrogen supplies were assured. It was hypothesized that organ partitioning coefficients (the slope of the organ weight: total weight relationship) remained constant during phenologically defined phases of crop development. A non-linear optimization routine was used to define organ partitioning coefficients and the values of total plant weight at which changes in partitioning took place. It proved possible to relate these values to defined stages of plant development, namely bud visible and commencement of rapid head growth. The dynamics of partitioning to the stem could be described by two coefficients applying to the emergence-bud visible and bud visible-anthesis phases, respectively. Complementary changes in the coefficients for leaf laminae and fine roots took place at the bud visible stage. Once rapid growth of the inflorescence had become established, further changes in partitioning to roots and laminae, but not to stem, took place. Values of the coefficients for each organ changed only slightly between experiments (three) and cultivars (five), in spite of substantial variations, between data sets, of total plant weight at anthesis and, to a lesser extent, in the timing of the anthesis and bud visible stages. A satisfactory description of organ biomass dynamics was obtained when this descriptive framework was tested against data obtained in an independent experiment.

Late Hydrocephalus after Arrest and Resolution of Neonatal Posthemorrhagic Hydrocephalus

This report describes the occurrence of rapid progression of hydrocephalus after discharge from the nursery in four of 48 infants who had had previous arrest of progression of post-hemorrhagic hydrocephalus, and at least partial resolution of ventriculomegaly. This later-onset hydrocephalus occurred at a mean age of seven months; the most consistent presenting clinical feature was rapid head growth. Three of the four infants required a ventriculo-peritoneal shunt and the fourth was treated with acetazolamide, with apparent resolution of the hydrocephalus. Newborn infants with post-hemorrhagic hydrocephalus should be followed carefully throughout the first year for prompt detection of later hydrocephalus.

GROWTH, DEVELOPMENT AND YIELD OF WHITE CABBAGE IN RELATION TO TIME OF PLANTING

Experiments were carried out during two seasons to study growth, development and yield of the rather early maturing white cabbage cultivar Castello, and the late maturing cv. Bartolo, in relation to time of planting during the season. Results indicated that for both cultivars, planting late in the season resulted in a substantially reduced yield at the end of the season. When harvested at an average weight of 1.1 kg per head, effects for cv. Castello on necessary period of growth were small. The onset of rapid head growth was earlier with cv. Castello and this cultivar partitioned a greater part of total weight to the head as compared to cv. Bartolo. With planting late in the season quality of the head of cv. Bartolo was unacceptable

1290 EXTERNAL HYDROCEPHALUS IN WEAVER SYNDROME

The Weaver syndrome is a rare disorder of overgrowth, characterized by accelerated somatic growth and osseous maturation, increased head size and unusual facies. Excessive macrocephaly is a striking finding that differentiates Weaver from other overgrowth syndromes. We report a male infant who had the characteristic features of Weaver syndrome including rapid growth. His facial features included round face, frontal bossing, wide bifrontal diameter, hypertelorism, down-slanted palpebral fissures, epicanthi, flat nasal bridge, long prominent philtrum, retromicrognathia and large ears. At birth his length (Lt) was 63.5cm and weight (Wt) 5.8kg. At age 2 months Lt was 72.5cm and wt 8.3kg. Carpal bone age was advanced to 6-9 months. At age 3 months his head circumferance (HC) was 50.4cm. A CT scan showed large bilateral extracerebral fluid collections. A repeat CT at 4 1/2 months showed a decrease in this collection and a picture more consistent with external hydrocephalus. A subdural tap confirmed that the fluid was normal CSF under no increasure pressure. No intervention was done. We have seen a similar CT abnormality in at least one patient with Soto syndrome and in several patients with benign familial macrocephaly. Based on the observation in patients with benign familial macrocephaly, we suggest that the CT appearance may be a relatively benign finding, common to syndromes with rapid head growth in early life.