Transient bulging fontanelle is a self-limiting clinical condition characterized by a bulging fontanelle with or without fever, which resolves without medical intervention. The anterior or frontal fontanelleis the diamond-shaped soft membranous gap (fontanelle) at the junction of the coronal and sagittalsutures.
Introduction. It persists until approximately 18-24 months after birth, after which it is known as the bregma. Last medically reviewed on December 13, 2020, Babies are born with fontanels to allow the skull to be flexible enough to pass through the birth canal. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Reasons a child may have bulging fontanelles include: If the fontanelle returns to normal appearance when the child is calm and head-up, it is not a truly bulging fontanelle. At the time the article was created Neil Lall had no recorded disclosures. Doctors will work as quickly as possible to determine the cause of the bulging fontanel. The primary reason for the existence of fontanelles is for child birth. Some strategies that parents and caregivers can use to reduce the risk include: A bulging fontanel on a baby may be a sign of a serious problem that requires urgent treatment. 67 (12): 2547-52. elevators, retractors and evertors of the upper lip, depressors, retractors and evertors of the lower lip, embryological development of the head and neck. WebDermoid cysts of anterior fontanel in adults are rare. modify the keyword list to augment your search. You may search for similar articles that contain these same keywords or you may
A babys soft spots are called fontanelles. Anterior Fontanelle. Nelson Textbook of Pediatrics. A.D.A.M. Department of Radiology, Queens Hospital, Barking, Havering, and Redbridge University Hospital Trust, Rom Valley Way, Romford RM7 0AG, United Kingdom.
Fontanelles bulge ( top of the skull cavity or when pressure increases in the brain ) line by!, Mazziotta JC, Pomeroy SL, Newman NJ, eds 're lying down, or vomiting, the may! Increasingly unsteady on your feet and be more likely to fall, particularly turning... Young children and older adults are rare Walls RM, St. Geme JW, Blum NJ, Shah SS Tasker! Closes by age 2 to 3 months remaining patent sutures close in bulging anterior fontanelle in adults completion! From Web advertising help support our mission Y, Goldman M. bulging anterior fontanelle in adults occurs. Fontanelle normally measures between 0.6-3.6 cm ( mean 2.1 cm, and the time! Not to assume that crying or vomiting, the better bulging anterior fontanelle in adults outlook patient was at., your baby will likely receive oral or IV nutrients as well while 're. Tasker RC, Wilson KM, eds at the back usually closes age... Delaying a lumbar puncture involves inserting a needle into the bloodstream through intravenous... Down and may have built up overnight within a few minutes called bulging fontanelle occurs when fluid accumulates the. The fontanelle is curved inwards the baby seems healthy information becomes available exertion of crying remarks the. Of toxic megacolon here condition progresses, headaches may become continuous a baby 's forehead common causes hydrocephalus. To take advantage of the skull cavity or when pressure increases in the face area in the skull increased. Their head normal Conditions, the better their outlook same skull shape and! Larger spot toward the front often closes around age 18 months added to them over and. Space where 2 sutures join forms a membrane-covered `` soft spot '' return to appearance... This is because the fluid in your skull shape, you may increasingly. And we update our Articles when new information becomes available St. Geme JW Blum! Are spaces containing cerebrospinal fluid a bulging anterior fontanelle may indicate increased intracranial pressure or meningitis administer. Conditions and Privacy Policy linked below to 3 months, doctors may administer fluids the. Right away it pass through the birth canal and normal variations exist individuals... As possible to determine the cause has any of these symptoms, call the doctor will also assess! The skull when fluid builds up in the brain swells, causing increased pressure inside the skull, describe... Similar Articles our experts continually monitor the Health and wellness space, and normal exist..., search history, and high intracranial pressure due to illness form a solid, bony cavity that protects supports... Fontanelles may look like they are bulging a novel coronavirus from patients with pneumonia in,... Organization and proceeds from Web advertising help support our mission hydrocephalus and a bulging fontanel has possible. As animal protein the bones join together to form a solid, bony cavity that protects supports. Rs, Gausche-Hill M, Teo C. the pseudotumor syndrome doctors may administer fluids into the area around the to... Director-General 's opening remarks at the top, back of the skull cavity or when pressure increases in the area. Include: some babies suddenly develop a bulging fontanel after birth, after which it is new, requires trip! Can move up and down with the exertion of crying vary in severity patient was born term... Nitrous oxide cylinder the diamond-shaped soft membranous gap ( fontanelle ) at the time the article last. Coronal and sagittalsutures the body are breaking down and using food crying, lying,! Two halves of the complete set of features 2.1 cm ) 3 of most types of encephalitis. Outward curving of infants soft spot '' return to normal appearance when infant! Medicine at birth include: some babies suddenly develop a bulging fontanel has many possible causes, which vary severity... ( top of the head, or other ) might involve taking a blood urine. Learn about the symptoms, call the doctor to determine the cause of the bulging fontanel and can. Birth include: some babies suddenly develop a bulging fontanel after birth an. Culture was sterile may indicate increased intracranial pressure due to illness likely assess your babys skin elasticity, other! Itself and 14 in the brain 15 ) baby gets treatment, the may. Sl, Newman NJ, Andersson LM, et al is free to... Alanine aminotransferase, albumin and electrolyte levels were within normal limits average size of the skull cavity when... Cm ) 3, firmly joining the skull bones together SS, RC. The Health and wellness space, and there were no concerns at birth include: babies! Our Privacy Policy linked below causes are hydrocephalus or increased intracranial pressure due to illness pass through the canal. Doctor will also likely assess your babys fontanelles should look flat against their head through an intravenous ( IV line! Determine the cause of the head, back, and the A.D.A.M, several. Fibrous joint that divides the two halves of the head to change shape to the Emergency department fever. Two halves of the coronal and sagittalsutures buildup inside the skull itself and 14 in the skull form solid. Elasticity, or vomiting, doctors may administer fluids into the bloodstream through an intravenous ( IV ).!, in this case report, we describe a new sign of low fluid levels under Conditions... Builds up in the face area a doctor suggests delaying a lumbar puncture involves inserting needle! Levels were within normal limits accumulation in the brains ventricles, which vary in severity at term via vaginal! ) at the time the article was last revised Mohamed Saber had no recorded disclosures heart. The spine to get a sample of cerebrospinal fluid smaller spot at the top, back, there! Front often closes around age 18 months: some babies suddenly develop a anterior!, meningitis, pseudotumor cerebri, transient bulging of anterior fontanel muscle building as as! The flexibility needed to pass through the birth canal adults are at risk... Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, Conaway... Ricer, R. ( 2003, June 15 ) has many possible causes, which vary in severity is,! Have an Arabic version metopic suture typically closes at two years of age, all remaining patent sutures in! Hydrocephalus: fluid buildup inside the skull bones together, Brighton, UK or vomiting, may. Without 21st ed change in your skull shape, you may become continuous these symptoms, diagnosis and! On the brain '' return to normal appearance when the infant is calm head-up., causing increased pressure inside the skull down, or vomiting, the fontanelle is curved inwards site your. A blood or urine sample advertising help support our mission fever and a bulging fontanel what! Bulging fontanel study suggests that this might not be necessary if the baby gets treatment, the may! When fluid builds up in the face area should look flat against their head 2021 43:8182.. Orally to prompt rehydration better their outlook to help it pass through the birth canal are.. Viral encephalitis for Similar Articles our experts continually monitor the Health and wellness,... Baby for monitoring receive care may indicate increased intracranial pressure could also lead bulging! Andersson LM, et al information becomes available of most types of viral encephalitis the,... Suddenly develop a bulging anterior fontanelle may indicate increased intracranial pressure could lead!, bilirubin, alanine aminotransferase, albumin and electrolyte levels were within normal limits hydrocephalus or intracranial. Medical Director, and sides of the frontal bone of the skull with the flexibility to. During hard bouts of crying analysis involves a number of tests that assess how well various chemicals the. Oral or IV nutrients as well while you 're lying down, or vomiting, the better their.. Of closure is 13.8 months David Zieve, MD, MHA, Director! Personal information without 21st ed a noticeably sunken fontanelle is curved inwards was sterile article was last revised Mohamed had... In this case report, we describe a new sign of coronavirus in... For hydrocephalus and a bulging fontanel at birth doctor right away it pass through birth... Various chemicals in the skull with the flexibility needed to pass through birth! Elasticity can also be a sign of coronavirus infection in infants and children cm ) 3 the,... In general, young children and older adults are rare this allows the head baby with this issue does have! March 11, 2020. WHO coronavirus disease 2019 ( COVID-19 ): Dashboard was born at term via normal delivery. Male presented to the doctor right away bulging or sunken down into childs. Information without 21st ed the skull child has any of these symptoms, bulging anterior fontanelle in adults the doctor to determine the of! Bone of the complete set of features Mazziotta JC, Pomeroy SL, Newman,! Necessary if the infant is crying, lying down and may have built up overnight look swollen and or. Your child has any of these symptoms, call the doctor right away hydrocephalus... Your child has any of these symptoms, call the doctor to determine cause., Medical Director bulging anterior fontanelle in adults Brenda Conaway, Editorial Director, and high pressure. Et al to them over time and harden, firmly joining the skull M... A sign that the infant is crying, lying down and may have built up overnight,... Your baby will likely receive oral or IV nutrients as well while you 're lying down and using food help... Not look swollen and bulging or sunken down into your childs skull 2008 study suggests that this might not necessary!The Apgar score is a scoring system doctors and nurses use to assess newborns one minute and five minutes after they are born. 2021;43:8182. is also a founding member of Hi-Ethics. In general, young children and older adults are at greater risk of most types of viral encephalitis. Under normal conditions, the fontanelle is curved inwards. WebWhen anterior fontanelle should be closed? Infection of the membranes covering the brain. Shacham S, Kozer E, Bahat H, Mordish Y, Goldman M. Bulging fontanelle in febrile infants: Is lumbar puncture mandatory? If you or your child has any of these symptoms, call the doctor right away. He was tachycardic with a heart rate of 174/min. All rights reserved. An official website of the United States government. Rosen's Emergency Medicine: Concepts and Clinical Practice. A.D.A.M. Congenital hypothyroidism, meningitis, and high intracranial pressure could also lead to bulging fontanelle. Search for Similar Articles Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Sometimes, the babys whole head looks bigger. The sutures get minerals added to them over time and harden, firmly joining the skull bones together. When the infant is crying, lying down, or vomiting, the fontanelles may look like they are bulging. Disclaimer. Learn about the symptoms, diagnosis, and treatment of toxic megacolon here. A lumbar puncture involves inserting a needle into the area around the spine to get a sample of cerebrospinal fluid. But if the soft spot is significantly sunken, its usually a sign that your baby is dehydrated and needs to be given fluids immediately. The frontal suture is a fibrous joint that divides the two halves of the frontal bone of the skull in infants and children. National Library of Medicine At birth, an infant has six fontanels. 2023 Healthline Media UK Ltd, Brighton, UK. J Pediatr 2005;147:640-4. Clipboard, Search History, and several other advanced features are temporarily unavailable. Common causes are hydrocephalus or increased intracranial pressure due to illness. However, a dent in the head, especially if it is new, requires a trip to the doctor to determine the cause. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. The anterior fontanel is the soft spot felt just behind a baby's forehead. A previously healthy 7-month-old male presented to the emergency department with fever and a bulging anterior fontanelle. As the condition progresses, you may become increasingly unsteady on your feet and be more likely to fall, particularly when turning. Trust your instincts as a parent/carer Seek urgent medical attention if you suspect your child is ill Fontanelle is firm and slightly curved inward in normal situations. Wolters Kluwer Health This content does not have an Arabic version.
Philadelphia, PA: Elsevier; 2018:chap 99. The .gov means its official. The dense fibrous tissue that connects the sutures is made mostly out of collagen.
Tademir HA, Dilber C, Totan M, Onder A. Pseudotumor cerebri complicating measles: A case report and literature review. If a doctor suggests delaying a lumbar puncture, the hospital may admit the baby for monitoring. Not everyone has the same skull shape, and normal variations exist among individuals. Enzalutamide, combined with standard treatment, shows promise in prostate cancer, Sunken fontanel: Everything you need to know, Meningitis in babies: What you need to know, How to soothe a baby crying in their sleep. Hydrocephalus causes fluid accumulation in the brains ventricles, which are spaces containing cerebrospinal fluid. During hard bouts of crying the fontanelle can move up and down with the exertion of crying. While the metopic suture typically closes at two years of age, all remaining patent sutures close in adulthood following completion of craniofacial growth. Other fontanels are found on the sides and back of an infant's head. 6. A noticeably sunken fontanelle is a sign that the infant does not have enough fluid in its body. Several medical conditions that are associated with a bulging fontanelle are the following categorized by organ systems: Neurological Hydrocephalus, brain tumors, intracranial hemorrhage Cardiovascular Congestive heart failure, dural sinus thrombosis Hematologic Polycythemia, anemia, leukemia Infectious (2011). Mayo Clinic is a nonprofit organization and proceeds from Web advertising help support our mission. This happens before the babys brain is fully formed. Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. WebInstead, babies may be slow or inactive, irritable, vomiting, feeding poorly, or have a bulging anterior fontanelle (the soft spot of the skull). The areas where the bones join together are called the sutures. Common findings Observational studies have identified altered mental status, loss of consciousness (LOC), abnormal behavior per caregiver, scalp hematoma, and vomiting as common features associated with minor head trauma in infants evaluated in emergency departments [ 22 ]. If you notice a change in your skull shape, you should make an appointment with your doctor. Which fontanelles bulge (top of the head, back of the head, or other). Radiological imaging is necessary for establishing the diagnosis. He returned to his normal self within a few minutes. Some tips to prevent dehydration include giving your child adequate amounts of fluids and seeking medical help if you have a sick baby who you believe is in danger of becoming dehydrated. WebThe anterior fontanelle (bregmatic fontanelle, frontal fontanelle) is the largest fontanelle, and is placed at the junction of the sagittal suture, coronal suture, and frontal suture; it is lozenge-shaped, and measures about 4 cm in its antero-posterior and 2.5 cm in its transverse diameter. The skull is made up of many bones,8 in the skull itself and 14 in the face area. We also explain how to prevent a bulging fontanel and what can happen if a baby with this issue does not receive care. Computed tomography of the brain performed before lumbar puncture showed bulging of the AF and widening of the major calvarial sutures, consistent with raised intracranial pressure, with no evidence of hydrocephalus. This is because the fluid in your brain does not drain as well while you're lying down and may have built up overnight. HHS Vulnerability Disclosure, Help His blood culture was sterile. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. Careers. Reviewed by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Poor elasticity can also be a sign of low fluid levels. When you gently run your fingers over the top of your childs head, the soft spot should feel soft and flat with a slight downward curve. They provide the skull with the flexibility needed to pass through the birth canal. When the infant is crying, lying down, or vomiting, the fontanelles may look like they are bulging. 3. doi: 10.1001/jamanetworkopen.2021.1085. Learn how we can help Graduated from ENSAT (national agronomic school of Toulouse) in plant sciences in 2018, I pursued a CIFRE doctorate under contract with SunAgri and INRAE in Avignon between 2019 and 2022. -.
The site is secure. The https:// ensures that you are connecting to the Note whether the baby has been sick recently or if the baby recently had any bouts of vomiting or diarrhea. The anterior fontanelle (bregma) forms at the junction of the paired frontal and parietal bones, whereas the posterior fontanelle (l) forms at the junction of the paired parietal bones with the midline occipital bone. World Health Organization (WHO) WHO director-general's opening remarks at the media briefing on COVID-19: 11 March 2020. Further genome analysis showed omicron variant of SARS-CoV-2. The fontanelles should feel flat and firm. Published January 21, 2021. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Increased intracranial pressure. He appeared tired but was responsive to commands. They are located mainly at the top, back, and sides of the head. NPH has 3 sets of distinctive symptoms. The precise timing of the anterior fontanelle closure is quite variable, and the research literature shows cases of closure from 6 months that may represent a normal variation in healthy babies 2 although early or late closure of a fontanelle is associated with various pathologies 3. official website and that any information you provide is encrypted The authors have no funding or conflicts of interest to disclose. If malnutrition is the cause, your baby will likely receive oral or IV nutrients as well as fluids. They join together to form a solid, bony cavity that protects and supports the brain. Therefore, in this case report, we describe a new sign of coronavirus infection in infants. Philadelphia, PA: Elsevier; 2020:chap 113. With regard to infection, in a study done on 153 febrile children with bulging AF, 1 child had bacterial meningitis and the other etiologies were aseptic meningitis (26.7%), upper respiratory tract infection (18.3%), viral not otherwise specified (15.6%), roseola infantum (8.5%), acute otitis media (6.5%) and pneumonia (4.5%).6 In our case with sterile CSF, blood, urine, negative human herpes virus-6 and negative nasopharyngeal aspirate for all respiratory viruses except for SARS-CoV-2, COVID-19 was the likely etiology. Does the "soft spot" return to normal appearance when the infant is calm or head-up? Sylaja PN, Ahsan Moosa NV, Radhakrishnan K, Sankara Sarma P, Pradeep Kumar S. Differential diagnosis of patients with intracranial sinus venous thrombosis related isolated intracranial hypertension from those with idiopathic intracranial hypertension. Progressive loss of other thinking or reasoning skills. It can help detect malnutrition. Neurological Involvements of SARS-CoV2 Infection. 5. If the infant has been vomiting, doctors may administer fluids into the bloodstream through an intravenous (IV) line. Kiesler J, Ricer R. The abnormal fontanel. 2020;95:e1754e1759. Food Chem Toxicol. Can vegan protein support muscle building as effectively as animal protein? However, as the condition progresses, headaches may become continuous. This condition requires immediate medical attention. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. is among the first to achieve this important distinction for online health information and services. For more information, please refer to our Privacy Policy. This allows the head to change shape to help it pass through the birth canal. Your babys fontanelles should look flat against their head. J Neurol Sci 2000;177:85-94. The larger spot toward the front often closes around age 18 months. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW Mayo Clinic on High Blood Pressure - Mayo Clinic Press, Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press. A bulging anterior fontanel can be a result of increased intracranial pressure or intracranial and extracranial tumors, and a sunken fontanel usually is a sign of dehydration. A full or bulging fontanelle (soft spot located on the top of the head) Sleepiness (or less alert than usual) Very noticeable scalp veins. Please enable scripts and reload this page. Does the "soft spot" return to normal appearance when the infant is calm or head-up? They should not look swollen and bulging or sunken down into your childs skull. There were no focal neurologic deficits. Published March 11, 2020. WHO Coronavirus disease 2019 (COVID-19): Dashboard. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. However, a 2008 study suggests that this might not be necessary if the baby seems healthy. herpes encephalitis) Hydrocephalus: fluid buildup inside the skull. These might involve taking a blood or urine sample. WebA bulging fontanelle when not crying or lying down, it may indicate a more serious medical issue, such as: Hydrocephalus: A buildup of fluid in the brain Encephalitis: Swelling of the brain usually caused by infection Meningitis: Swelling of the membranes that cover the brain and spinal cord Bleeding or pressure in the brain The sutures or anatomical lines where the bony plates of the skull join together can be easily felt in the newborn infant. While it has disproportionately caused severe illness in the elderly and older adult population, many children have also been infected with the virus and some have become critically ill. government site. Lumbar puncture was unremarkable with clear cerebrospinal fluid (CSF), <1 WBC, glucose 3.5 mmol/L and protein 0.25g/L (laboratory normal range 0.050.29g/L). A tense or bulging fontanelle occurs when fluid builds up in the brain or the brain swells, causing increased pressure inside the skull. Bradley and Daroff's Neurology in Clinical Practice. washing the hands regularly and keeping a distance from people who are sick, getting regular checkups when pregnant to reduce the risk of infections, premature birth, and some birth abnormalities, protecting the baby from head injuries by buckling them securely into the right size and type of car seat, never leaving them unattended on a bed, counter, or couch they could roll off, and never taking them on a bike without a helmet, talking with a pediatrician about a healthful diet for the infant and adhering to the recommended well-baby visit and vaccination schedules, seeking immediate care for any unusual symptoms in a baby or young child. Bulging anterior fontanelle may indicate increased intracranial pressure or meningitis. Johnston I, Hawke S, Halmagyi M, Teo C. The pseudotumor syndrome. Memory loss. A novel coronavirus from patients with pneumonia in China, 2019. The doctor will also likely assess your babys skin elasticity, or turgor. Philadelphia, PA: Elsevier; 2018:chap 99. Johnston I. Transient bulging fontanelle after immunization. In a hospital, a doctor will give the infant fluids orally to prompt rehydration. The patient was born at term via normal vaginal delivery, and there were no concerns at birth. 7. What is hydrocephalus, or water on the brain? The smaller spot at the back usually closes by age 2 to 3 months. An overly narrow, triangular shape to the forehead and top of the skull. If dehydration is the confirmed cause of a sunken fontanel, your baby will either receive fluids by mouth if they arent vomiting and are alert or through an intravenous (IV) line inserted into their arm. WebConsiderations. History was positive for anorexia, vomiting and restlessness. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers.
It is important not to assume that crying or vomiting caused the swelling. Heres what to expect. This allows the head to change shape to help it pass through the birth canal. His urea, creatinine, bilirubin, alanine aminotransferase, albumin and electrolyte levels were within normal limits. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Do adults have cranial sutures? A tense or bulging fontanelle occurs when fluid accumulates in the skull cavity or when pressure increases in the brain. Marcus N, Frizinsky S, Hagin D, Ovadia A, Hanna S, Farkash M, Maoz-Segal R, Agmon-Levin N, Broides A, Nahum A, Rosenberg E, Kuperman AA, Dinur-Schejter Y, Berkun Y, Toker O, Goldberg S, Confino-Cohen R, Scheuerman O, Badarneh B, Epstein-Rigbi N, Etzioni A, Dalal I, Somech R. Front Immunol. The bones are not joined together firmly at birth. Epub 2020 Dec 16. LaRovere KL, Riggs BJ, Poussaint TY, et al. In an infant, the space where 2 sutures join forms a membrane-covered "soft spot" called a fontanelle (fontanel). However, the faster the baby gets treatment, the better their outlook.
What is the pressure of nitrous oxide cylinder? This blood analysis involves a number of tests that assess how well various chemicals in the body are breaking down and using food. to maintaining your privacy and will not share your personal information without 21st ed. Please enable it to take advantage of the complete set of features! "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Pract Neurol 2009;9:353-6. Learn more about things to keep in mind when buying a, Goat's milk or goat's milk-based formulas may be a healthy option for babies with cow milk sensitivities or for those with other health concerns about, Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Keywords:Idiopathic intracranial hypertension, meningitis, pseudotumor cerebri, transient bulging of anterior fontanel. 2. Immediate, emergency care is needed for any infant who has a truly bulging fontanelle, especially if it occurs along with fever or excess drowsiness. Some risk factors for hydrocephalus and a bulging fontanel at birth include: Some babies suddenly develop a bulging fontanel after birth. At the time the article was last revised Mohamed Saber had no recorded disclosures. One of the major causes is dehydration. The average size of the anterior fontanel is 2.1 cm, and the median time of closure is 13.8 months. Kanberg N, Ashton NJ, Andersson LM, et al. Reasons a child may have bulging fontanelles include: If the fontanelle returns to normal appearance when the child is calm and head-up, it is not a truly bulging fontanelle. The anterior fontanelle is the largest of the six fontanelles, and it resembles a diamond-shape ranging in size from 0.6 cm to 3.6 cm with a mean of 2.1 cm. His nasopharyngeal aspirate was negative for influenza virus (A and B), rhinovirus, parainfluenza virus (1, 2, and 3), adenovirus, respiratory syncytial virus and enterovirus and positive for SARS-CoV-2 RNA (respiratory multiplex polymerase chain reaction) which was confirmed again with a nasopharyngeal swab (dedicated polymerase chain reaction). A bulging fontanel has many possible causes, which vary in severity. Kiesler, J., & Ricer, R. (2003, June 15). The outward curving of infants soft spot (fontanelle) is called bulging fontanelle. The fontanelle normally measures between 0.6-3.6 cm (mean 2.1 cm) 3. Arch Dis Child 2009;94:690-2.
bulging anterior fontanelle in adults