Has anyone's toddler had to have a general anaesthetic to have a brain scan to investigate a big head?

[crb78]

My 17 month old has been flagged up for having a big head since his 10 month check. His head is now 51.5cm which is quite a lot above the 99.6th centile in his red book. His weight and height are more like the 25th centile.

We saw a geneticist at hospital today who took a family history, examined him and took lots of information about his behaviour. She couldn't find anything to worry about except his big head. I told her that his grandfather and great-grandfather also had very big heads.

She is still recommending that he needs to have a GA in order to scan his brain and just make sure nothing is wrong. I feel very worried about this procedure when there doesn't seem to be any reason to be concerned other than his big head. No other symptoms seem to exist to cause concern.

I wondered if anyone else had had similar experiences with their child's head and whether anyone could reassure me about the scan if we decide to go ahead with it? I just don't know what they could find that they could then do something about. Thank you for any advice.

[autumnchat]

DS1 had a big head as a baby, he was premature so was low on the centiles for height and weight but his head was off the top!
They just kept checking it for a couple of years but never suggested anything else. He too seemed to follow after his dad etc with regards the large head!
I remember at age 3 he was in age 18-24 month clothes but age 7-10 hats!
He is 17 now, almost 6 ft, and still struggles to get hats to fit but he looks in proportion.

[CaesiumTime]

There are a lot of different things that could cause macrocephaly.

Macrocephaly is associated with numerous genetic syndromes and not all present with obvious other symptoms at 17 months old.

However, obviously some children are statistical "outliers" and just have big heads.

The investigation can be helpful to make further accurate diagnosis - so even though the MRI may not lead to anything that can "be fixed", it could provide pieces of a picture that help them form a clinical diagnosis and inform necessary treatment/and or care in other areas. It could shed light on other vulnerabilities or necessary interventions. The macrocephaly could be a helpful indicator of other problems that are not obvious. The geneticist just wants to rule out any cause of macrocephaly other than just congenitally large head.

It is most likely nothing but the geneticist can't be sure.

We've had brain MRI's here multiple times for other reasons.

At 17 months a GA is routine for MRI scan. The biggest risk of the procedure is the GA and they simply don't put children at risk unless it is clinically indicated. If your child is otherwise healthy then they should recover quite fine from the GA.

Medical decisions are difficult to make, take your time, and think about it and make sure you are making the right decision for you and your child.

[CaesiumTime]

God, please, OP, don't feel alarmed by my post - I hope it doesn't sound too alarmist. I don't want to scare you that there is something wrong - just trying to help as a sounding board with more information.

Please don't worry too much, I know how stressful that medical worry about your children can be and I really don't want to add to your stress by being alarmist. Sorry if my post comes across that way.

[CaesiumTime]

And also, OP, I should say that my toddler had so many GA's that I can't even recall the number, some operations being as long as 8 hours. And he is a strapping huge lad now with no long term effects from the GA's even though each one was terrifying to me.

[MUjunkie]

My nephew had one because he's got a small head

[lougle]

DD1 had one to investigate her small head. It's a very light anaesthetic, really very quick and they're out before you know it.

[crb78]

Thank you to everyone. I am already feeling reassured.

It is very helpful to hear that other children have had the scan and it isn't as bad as it sounds.

CaesiumTime - it was very kind of you to write so much and I appreciate all your helpful comments. It wasn't alarmist, it was a helpful summary of possibilities. Thank you!

[DollopofTrollop]

They generally won't use a GA but sedation instead .... Something like Chloral hydrate will keep a child sedated enough for a MRI!

[QuackDuckQuack]

Have both parents had their heads measured? I think family history does make a big difference. My head is off the scales large and it turns out that large heads are part of family legend on both sides of my family. Obviously that doesn't answer questions about using a GA.

[CaesiumTime]

Dollop are you sure about that?

We've had MRI brain scans at 24 and 36 months, both were done under GA. The patient has to be completely still with no movement, sedatives don't accomplish that.

[Chippednailvarnishing]

My DD was very similar, except her development was affected by a type of hydrocephalus, caused by distorted growth. She had what the doctors called a void at the front of her head which was filled with fluid, she was on the 13th weight centile but her head was on 116th.
Lucky because she was younger than your DS we did a scan by "milk and wrap", she had milk and then swaddled her and she slept through the scan. But even if she needed a GA I would have done it, otherwise as someone said up thread you might have to have other investigations. It also means that if your DS continues to have issues there will be an accurate point of reference for measurements.

Good luck op.

[crb78]

Thank you everyone for your helpful replies and comments.

[hopsalong]

My son is 21 months and his head is 52 cm, but no one has ever flagged it up as an issue. His height and weight are also on high percentiles (97th or so), but the head size is definitely more extreme / noticeable! Having said that, I also have a massive head, as do many people in my family. To be honest, I can't imagine anything is wrong (I'd be much more worried about a very small head!) and if you don't notice any neurological problems or anything abnormal, I wouldn't both having the scan. Maybe when he's a bit older, but he seems very young to me to have a probably unnecessary general anaesthetic. What does your gut instinct say?

[elliejjtiny]

My 3 year old has had a big head from birth and has had several MRI scans under GA. The bit in the anaesthetic room was always the worst part as he shouted and thrashed around and I felt awful for putting him through it. Bring something to do while you wait for him as being occupied really helps.

[crb78]

Thank you hopsalong and elliejjtiny.

I'm going to ask advice from various doctors I know and see what their opinion is. I asked a GP friend this morning and he felt that the big head was worth investigating as it could be a sign of something that would cause big problems in the future.

My gut feeling is that there is nothing wrong with DS but if all medical advice is pointing the other way then I would feel irresponsible to ignore it. We still have another couple of appointments to discuss everything until it actually comes to the scan so I will ask lots of questions and try to weigh up the pros and cons of it all.

Thank you for all the helpful replies.

[Squaddielife]

My DS had to have an MRI scan age 5 but for something different. We soul searched for ages regarding whether to go ahead with it because of the GA involved. I'm glad we did it now as it's ruled out so much.
He wasn't given a venflon for the GA because I knew this would freak him out so instead he sat playing on his ipad whilst the anesthesiologist waved the gas apparatus under his nose, DS thought it was funny!
It's obviously distressing to see them 'go under' but the drs were absolutely fantastic. For me the worse part was when he was coming round. He tried to fight the GA so trashed about alot. I wasn't prepared for that and wish I had have been. After about 20mins it was like it'd never happened.

Best of luck hun, hope all goes well