Jeong Goun, Kim Minkyun, Han Byoung Hee
Department of Pediatrics, Cheil General Hospital & Women's Healthcare Center, Seoul, Korea.
Department of Radiology, Cheil General Hospital & Women's Healthcare Center, Seoul, Korea.
Korean J Pediatr. 2014 Feb;57(2):75-8. doi: 10.3345/kjp.2014.57.2.75. Epub 2014 Feb 24.
This study aimed to investigate the clinical features of macrocephaly at birth in Korea using ultrasonography.
We retrospectively investigated the medical records of full-term birth neonates in Cheil General Hospital & Women's Healthcare Center from January 2000 to June 2012. The following parameters were recorded and analyzed: gestational age, sex, birth weight, height, occipitofrontal circumference (OFC), physical examination, perinatal problems, and ultrasonography results. Macrocephaly was diagnosed when the OFC was greater than two standard deviations, based on the 2007 Korean National Growth Charts.
There were 75 neonates with macrocephaly at birth (52 boys and 23 girls), with a mean OFC of 38.1±0.49 cm. A comparison of the birth weight and height with the OFC value showed that height was correlated with OFC (r=0.35) but birth weight was not correlated with OFC (r=0.06). There were no remarkable findings in 56 cases (75%). Germinal matrix hemorrhage was identified in 10 cases (13%). An enlarged cerebrospinal fluid space was found in 5 cases (6.7%). There were 3 cases of mega-cisterna magna (4%), 1 case of ventriculomegaly, and 1 case of an enlarged interhemispheric space (6 mm) among these patients. In addition, a choroid plexus cyst was seen in 1 case. Mineralizing vasculopathy in both basal ganglia with no evidence of congenital infection was found in 2 cases and an asymptomatic subarachnoid hemorrhage was found in 1 case.
Our results indicate that macrocephaly at birth has benign ultrasonography findings and shows a pattern of male dominance.
本研究旨在利用超声检查调查韩国出生时巨头畸形的临床特征。
我们回顾性调查了2000年1月至2012年6月在首尔圣母医院及妇女保健中心足月出生新生儿的病历。记录并分析了以下参数：胎龄、性别、出生体重、身高、枕额周长（OFC）、体格检查、围产期问题及超声检查结果。根据2007年韩国国家生长图表，当枕额周长大于两个标准差时诊断为巨头畸形。
有75例出生时巨头畸形的新生儿（52例男孩和23例女孩），平均枕额周长为38.1±0.49厘米。出生体重和身高与枕额周长值的比较显示，身高与枕额周长相关（r = 0.35），但出生体重与枕额周长不相关（r = 0.06）。56例（75%）无明显异常发现。10例（13%）发现生发基质出血。5例（6.7%）发现脑脊液间隙增宽。这些患者中有3例（4%）为巨大枕大池，1例脑室扩大，1例半球间间隙增宽（6毫米）。此外，1例可见脉络丛囊肿。2例在双侧基底节发现矿化性血管病变且无先天性感染证据，1例发现无症状蛛网膜下腔出血。
我们的结果表明，出生时巨头畸形超声检查结果呈良性，且表现为男性占优势的模式。
