García-Alix A, Sáenz-de Pipaón M, Martínez M, Salas-Hernández S, Quero J
Servicio de Neonatología, Departamento de Pediatría, Hospital Universitario La Paz, Madrid, Spain.
Rev Neurol. 2004;39(6):548-54.
We review the ability of head circumference (HC) at birth and head growth during the neonatal period to predict neurodevelopmental outcome, putting emphasis on new knowledge in this area.
During infancy HC correlates closely with intracranial volume and constitutes an accurate predictor of cerebral volume. Both an abnormal head size at birth and an abnormal head growth during the neonatal period, can express brain damage or the presence of entities that involve varied degrees of neurological dysfunction in childhood. In general, the influence of head size or growth abnormalities on neurodevelopment is more related to the underlying etiology and/or the presence of structural diseases of the brain than with the HC alteration itself. HC evaluation is of particular interest in sick neonates, specially very low birth weight infants, regardless of whether they are normal or small for gestational age, and both during admission an during the first months of life. In these patients, HC catch-up within the first months of life represents a favorable neurodevelopmental prognostic factor.
HC measuring and head growth evaluation constitute the most simple, inexpensive and quick available tools to assess the development of the central nervous system and identify neonates at risk of neurodevelopmental disorders.
我们回顾了出生时头围（HC）及新生儿期头部生长情况预测神经发育结局的能力，重点关注该领域的新知识。
在婴儿期，头围与颅内容积密切相关，是脑容积的准确预测指标。出生时头围异常及新生儿期头部生长异常均可表明脑损伤或存在在儿童期涉及不同程度神经功能障碍的病症。一般而言，头围大小或生长异常对神经发育的影响更多地与潜在病因和/或脑结构疾病的存在有关，而非与头围改变本身相关。对头围的评估在患病新生儿中尤为重要，特别是极低出生体重儿，无论其是适于胎龄儿还是小于胎龄儿，在入院时及出生后的头几个月均是如此。在这些患儿中，出生后头几个月头围的追赶生长是一个良好的神经发育预后因素。
头围测量和头部生长评估是评估中枢神经系统发育及识别有神经发育障碍风险新生儿的最简单、廉价且快速可用的工具。
