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Bulging fontanelle

MedGen UID:
115977
•Concept ID:
C0235014
•
Sign or Symptom
Synonyms: Bulging Fontanel; Fontanelle Bulging; Tense fontanelle
SNOMED CT: Bulging fontanelle (103019006)
 
HPO: HP:6000647

Definition

An outward curving of a fontanelle, which occurs when fluid builds up in the brain or the brain swells, causing increased pressure inside the skull. [from HPO]

Professional guidelines

PubMed

Congenital hydrocephalus in the northeast of Brazil: epidemiological aspects, prenatal diagnosis, and treatment.
Melo JR, de Melo EN, de Vasconcellos AG, Pacheco P
Childs Nerv Syst 2013 Oct;29(10):1899-903. Epub 2013 Apr 23 doi: 10.1007/s00381-013-2111-y. PMID: 23609898
Surgical treatment of brain tumors in infants younger than six months of age and review of the literature.
Lang SS, Beslow LA, Gabel B, Judkins AR, Fisher MJ, Sutton LN, Storm PB, Heuer GG
World Neurosurg 2012 Jul;78(1-2):137-44. Epub 2011 Nov 7 doi: 10.1016/j.wneu.2011.09.012. PMID: 22120270Free PMC Article
The 'bulging fontanelle' to be included in primary care algorithms.
de Goede C
Br J Gen Pract 2005 Oct;55(519):802-3. PMID: 16212857Free PMC Article

Recent clinical studies

Etiology

Oral vitamin A supplements to prevent acute upper respiratory tract infections in children up to seven years of age.
Cheng X, Li D, Yang C, Chen B, Xu P, Zhang L
Cochrane Database Syst Rev 2024 May 13;5(5):CD015306. doi: 10.1002/14651858.CD015306.pub2. PMID: 38738639Free PMC Article
Outcomes of children presenting to the emergency department with fever and bulging fontanelle.
Shahada J, Tavor O, Segev O, Rimon A, Scolnik D, Glatstein M
Am J Emerg Med 2022 Jul;57:153-155. Epub 2022 Apr 14 doi: 10.1016/j.ajem.2022.04.011. PMID: 35588655
Bulging fontanelle in febrile infants as a predictor of bacterial meningitis.
Takagi D, Oren-Ziv A, Shles A, Schujovitzky D, Yechiam H, Rosenbloom E
Eur J Pediatr 2021 Apr;180(4):1243-1248. Epub 2020 Nov 9 doi: 10.1007/s00431-020-03865-4. PMID: 33169238
Vitamin A supplementation for postpartum women.
Oliveira JM, Allert R, East CE
Cochrane Database Syst Rev 2016 Mar 25;3(3):CD005944. doi: 10.1002/14651858.CD005944.pub3. PMID: 27012320Free PMC Article
Transient bulging fontanelle after vaccination: case report and review of the vaccine adverse event reporting system.
Freedman SB, Reed J, Burwen DR, Wise RP, Weiss A, Ball R
J Pediatr 2005 Nov;147(5):640-4. doi: 10.1016/j.jpeds.2005.06.009. PMID: 16291356

Diagnosis

Outcomes of children presenting to the emergency department with fever and bulging fontanelle.
Shahada J, Tavor O, Segev O, Rimon A, Scolnik D, Glatstein M
Am J Emerg Med 2022 Jul;57:153-155. Epub 2022 Apr 14 doi: 10.1016/j.ajem.2022.04.011. PMID: 35588655
Neonatal hydrocephalus: an atypical presentation of malignant infantile osteopetrosis.
Lee A, Cortez S, Yang P, Aum D, Singh P, Gooch C, Smyth M
Childs Nerv Syst 2021 Dec;37(12):3695-3703. Epub 2021 Sep 14 doi: 10.1007/s00381-021-05345-y. PMID: 34519872
Bulging fontanelle in febrile infants as a predictor of bacterial meningitis.
Takagi D, Oren-Ziv A, Shles A, Schujovitzky D, Yechiam H, Rosenbloom E
Eur J Pediatr 2021 Apr;180(4):1243-1248. Epub 2020 Nov 9 doi: 10.1007/s00431-020-03865-4. PMID: 33169238
Infantile Idiopathic Intracranial Hypertension: A Case Study and Review of the Literature.
Boles S, Martinez-Rios C, Tibussek D, Pohl D
J Child Neurol 2019 Nov;34(13):806-814. Epub 2019 Jul 16 doi: 10.1177/0883073819860393. PMID: 31309848
Central nervous system involvement in hemophagocytic lymphohistiocytosis: a single-center experience.
Jovanovic A, Kuzmanovic M, Kravljanac R, Micic D, Jovic M, Gazikalovic S, Pasic S
Pediatr Neurol 2014 Mar;50(3):233-7. Epub 2013 Nov 1 doi: 10.1016/j.pediatrneurol.2013.10.014. PMID: 24332871

Therapy

Oral vitamin A supplements to prevent acute upper respiratory tract infections in children up to seven years of age.
Cheng X, Li D, Yang C, Chen B, Xu P, Zhang L
Cochrane Database Syst Rev 2024 May 13;5(5):CD015306. doi: 10.1002/14651858.CD015306.pub2. PMID: 38738639Free PMC Article
Predictors of death in infants with probable serious bacterial infection.
Singh P, Arora A, Strand TA, Sommerfelt H, Lodha R, Kabra SK, Aneja S, Natchu UCM, Chandra J, Rath B, Sharma VK, Kumari M, Saini S, Bhatnagar S, Wadhwa N
Pediatr Res 2018 Apr;83(4):784-790. Epub 2017 Dec 20 doi: 10.1038/pr.2017.299. PMID: 29166376
Vitamin A supplementation for postpartum women.
Oliveira JM, Allert R, East CE
Cochrane Database Syst Rev 2016 Mar 25;3(3):CD005944. doi: 10.1002/14651858.CD005944.pub3. PMID: 27012320Free PMC Article
Vitamin A supplementation for the prevention of morbidity and mortality in infants six months of age or less.
Gogia S, Sachdev HS
Cochrane Database Syst Rev 2011 Oct 5;(10):CD007480. doi: 10.1002/14651858.CD007480.pub2. PMID: 21975770
Transient bulging fontanelle after vaccination: case report and review of the vaccine adverse event reporting system.
Freedman SB, Reed J, Burwen DR, Wise RP, Weiss A, Ball R
J Pediatr 2005 Nov;147(5):640-4. doi: 10.1016/j.jpeds.2005.06.009. PMID: 16291356

Prognosis

Neonatal hydrocephalus: an atypical presentation of malignant infantile osteopetrosis.
Lee A, Cortez S, Yang P, Aum D, Singh P, Gooch C, Smyth M
Childs Nerv Syst 2021 Dec;37(12):3695-3703. Epub 2021 Sep 14 doi: 10.1007/s00381-021-05345-y. PMID: 34519872
Bulging fontanelle in febrile infants as a predictor of bacterial meningitis.
Takagi D, Oren-Ziv A, Shles A, Schujovitzky D, Yechiam H, Rosenbloom E
Eur J Pediatr 2021 Apr;180(4):1243-1248. Epub 2020 Nov 9 doi: 10.1007/s00431-020-03865-4. PMID: 33169238
Predictors of death in infants with probable serious bacterial infection.
Singh P, Arora A, Strand TA, Sommerfelt H, Lodha R, Kabra SK, Aneja S, Natchu UCM, Chandra J, Rath B, Sharma VK, Kumari M, Saini S, Bhatnagar S, Wadhwa N
Pediatr Res 2018 Apr;83(4):784-790. Epub 2017 Dec 20 doi: 10.1038/pr.2017.299. PMID: 29166376
Vitamin A supplementation for postpartum women.
Oliveira JM, Allert R, East CE
Cochrane Database Syst Rev 2016 Mar 25;3(3):CD005944. doi: 10.1002/14651858.CD005944.pub3. PMID: 27012320Free PMC Article
Vitamin A supplementation for the prevention of morbidity and mortality in infants six months of age or less.
Gogia S, Sachdev HS
Cochrane Database Syst Rev 2011 Oct 5;(10):CD007480. doi: 10.1002/14651858.CD007480.pub2. PMID: 21975770

Clinical prediction guides

Outcomes of children presenting to the emergency department with fever and bulging fontanelle.
Shahada J, Tavor O, Segev O, Rimon A, Scolnik D, Glatstein M
Am J Emerg Med 2022 Jul;57:153-155. Epub 2022 Apr 14 doi: 10.1016/j.ajem.2022.04.011. PMID: 35588655
Bulging fontanelle in febrile infants as a predictor of bacterial meningitis.
Takagi D, Oren-Ziv A, Shles A, Schujovitzky D, Yechiam H, Rosenbloom E
Eur J Pediatr 2021 Apr;180(4):1243-1248. Epub 2020 Nov 9 doi: 10.1007/s00431-020-03865-4. PMID: 33169238
Bacterial meningitis in Sudanese children; critical evaluation of the clinical decision using clinical prediction rules.
Abdelrahim NA, Fadl-Elmula IM, Ali HM
BMC Pediatr 2019 Sep 6;19(1):319. doi: 10.1186/s12887-019-1684-3. PMID: 31492124Free PMC Article
Predictors of death in infants with probable serious bacterial infection.
Singh P, Arora A, Strand TA, Sommerfelt H, Lodha R, Kabra SK, Aneja S, Natchu UCM, Chandra J, Rath B, Sharma VK, Kumari M, Saini S, Bhatnagar S, Wadhwa N
Pediatr Res 2018 Apr;83(4):784-790. Epub 2017 Dec 20 doi: 10.1038/pr.2017.299. PMID: 29166376
Childhood pyogenic meningitis: clinical and investigative indicators of etiology and outcome.
Johnson AW, Adedoyin OT, Abdul-Karim AA, Olanrewaju AW
J Natl Med Assoc 2007 Aug;99(8):937-47. PMID: 17722674Free PMC Article

Recent systematic reviews

Effects of primary or secondary prevention with vitamin A supplementation on clinically important outcomes: a systematic review of randomised clinical trials with meta-analysis and trial sequential analysis.
Bjelakovic G, Nikolova D, Bjelakovic M, Pavlov CS, Sethi NJ, Korang SK, Gluud C
BMJ Open 2024 May 30;14(5):e078053. doi: 10.1136/bmjopen-2023-078053. PMID: 38816049Free PMC Article
Oral vitamin A supplements to prevent acute upper respiratory tract infections in children up to seven years of age.
Cheng X, Li D, Yang C, Chen B, Xu P, Zhang L
Cochrane Database Syst Rev 2024 May 13;5(5):CD015306. doi: 10.1002/14651858.CD015306.pub2. PMID: 38738639Free PMC Article
Effect of Synthetic Vitamin A and Probiotics Supplementation for Prevention of Morbidity and Mortality during the Neonatal Period. A Systematic Review and Meta-Analysis of Studies from Low- and Middle-Income Countries.
Imdad A, Rehman F, Davis E, Attia S, Ranjit D, Surin GS, Lawler S, Smith A, Bhutta ZA
Nutrients 2020 Mar 17;12(3) doi: 10.3390/nu12030791. PMID: 32192165Free PMC Article
Vitamin A supplementation for postpartum women.
Oliveira JM, Allert R, East CE
Cochrane Database Syst Rev 2016 Mar 25;3(3):CD005944. doi: 10.1002/14651858.CD005944.pub3. PMID: 27012320Free PMC Article
Vitamin A supplementation for the prevention of morbidity and mortality in infants six months of age or less.
Gogia S, Sachdev HS
Cochrane Database Syst Rev 2011 Oct 5;(10):CD007480. doi: 10.1002/14651858.CD007480.pub2. PMID: 21975770

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