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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

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
Bulging fontanelle in febrile infants: is lumbar puncture mandatory?
Shacham S, Kozer E, Bahat H, Mordish Y, Goldman M
Arch Dis Child 2009 Sep;94(9):690-2. Epub 2009 Jun 15 doi: 10.1136/adc.2009.158956. PMID: 19531528
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
Fever and bulging fontanelle mimicking meningitis in an infant diagnosed with benign intracranial hypertension.
Goldberg EM
Pediatr Emerg Care 2013 Apr;29(4):513-4. doi: 10.1097/PEC.0b013e31828a3a28. PMID: 23558272
Bulging fontanelle in febrile infants: is lumbar puncture mandatory?
Shacham S, Kozer E, Bahat H, Mordish Y, Goldman M
Arch Dis Child 2009 Sep;94(9):690-2. Epub 2009 Jun 15 doi: 10.1136/adc.2009.158956. PMID: 19531528

Therapy

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
Neonatal vitamin A supplementation for the prevention of mortality and morbidity in term neonates in low and middle income countries.
Haider BA, Sharma R, Bhutta ZA
Cochrane Database Syst Rev 2017 Feb 24;2(2):CD006980. doi: 10.1002/14651858.CD006980.pub3. PMID: 28234402Free 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
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
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
Shaken baby syndrome: a review of 20 cases.
Ludwig S, Warman M
Ann Emerg Med 1984 Feb;13(2):104-7. doi: 10.1016/s0196-0644(84)80571-5. PMID: 6691610

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
Shunt surgery for early-onset severe hydrocephalus in methylmalonic acidemia: report on two cases and review of the literature.
Ma M, Wu M, Li Y, Wu D, Zhang B
Childs Nerv Syst 2018 Jul;34(7):1417-1421. Epub 2018 Feb 27 doi: 10.1007/s00381-018-3753-6. PMID: 29488077
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

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
Neonatal vitamin A supplementation for the prevention of mortality and morbidity in term neonates in low and middle income countries.
Haider BA, Sharma R, Bhutta ZA
Cochrane Database Syst Rev 2017 Feb 24;2(2):CD006980. doi: 10.1002/14651858.CD006980.pub3. PMID: 28234402Free 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
Neonatal vitamin A supplementation for prevention of mortality and morbidity in infancy: systematic review of randomised controlled trials.
Gogia S, Sachdev HS
BMJ 2009 Mar 27;338:b919. doi: 10.1136/bmj.b919. PMID: 19329516Free PMC Article

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