Acquired microcephaly: causes, patterns, motor and IQ effects, and associated growth changes.
OBJECTIVE
The goals were to identify and to classify causes and growth patterns of acquired (or progressive) microcephaly and to look for hypothesized correlations between causes, growth patterns, and developmental quotient/IQ.


METHODS
Fifty-one children (24 boys), 0.7 to 11.3 years of age, with early occipitofrontal circumference measurements above and later ones below the second percentile (SD: -2.03) were studied through retrospective note and growth chart review, with formal assessments of developmental quotient or IQ (n = 34).


RESULTS
Causes were classifiable into 5 groups as follows: idiopathic, familial, syndromic, symptomatic, and mixed. Four patterns of head growth were identified, as follows: type A, initial decrease from the normal range to below the second percentile, followed by growth below and parallel to the second percentile; type B, continued decrease away from the second percentile; type C, decrease below the normal range, with partial later recovery; type D, insufficient data. For 12 children, there were accompanying decreases in weight percentiles and for 5 of these in height percentiles as well. Infants with lower head circumference z scores at the end of the study also had lower z scores for final weight and final length. There was no correlation between causal group and growth pattern. Developmental quotient/IQ values were mostly <100 and did not correlate with head circumference z score, cause, or pattern.


CONCLUSIONS
The classification of causal groups and growth patterns should aid clinical management. Neither cause nor pattern predicted outcomes. The associations with poor weight gain and body growth deserve further study.
Baxter
Peter Stuart
PS
Department of Pediatric Neurology, Sheffield Children's National Health Service Foundation Trust, Sheffield, England. peter.baxter@sch.nhs.uk
Rigby
Alan Steven
AS
Rotsaert
Marianne Hélène Elise Pascale Dominique
MH
Wright
Ingram
I
D001827:Body Height; D001835:Body Weight; D001921:Brain / Q000473:pathology; D002508:Cephalometry; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000175:diagnosis; D003937:Diagnosis, Differential; D004739:England; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000209:etiology* / Q000235:genetics; D007360:Intelligence; D008279:Magnetic Resonance Imaging; D008297:Male; D008831:Microcephaly / Q000150:complications / Q000175:diagnosis / Q000209:etiology* / Q000235:genetics; D009483:Neuropsychological Tests; D011596:Psychomotor Disorders / Q000175:diagnosis*; D012189:Retrospective Studies; D012307:Risk Factors; D013223:Statistics as Topic; D013577:Syndrome