An unusual finding on the anterior fontanelle exam

Authors

  • Catarina Marques Pinho General and Family Practice, Unidade de Saúde Familiar Pevidém, Agrupamento de Centros de Saúde Alto Ave – Guimarães
  • Joana Vidal Teixeira General and Family Practice, Unidade de Saúde Familiar Pevidém, Agrupamento de Centros de Saúde Alto Ave – Guimarães
  • Antony Nogueira General and Family Practice, Unidade de Saúde Familiar Pevidém, Agrupamento de Centros de Saúde Alto Ave – Guimarães
  • Ana Ribeiro da Silva General and Family Practice, Unidade de Saúde Familiar Pevidém, Agrupamento de Centros de Saúde Alto Ave – Guimarães
  • Alexandra Martins General and Family Practice, Unidade de Saúde Familiar Pevidém, Agrupamento de Centros de Saúde Alto Ave – Guimarães

DOI:

https://doi.org/10.25753/BirthGrowthMJ.v27.i4.10212

Keywords:

Cranial fontanelles, Epidermal cyst, Magnetic resonance imaging, Ultrasonography

Abstract

Introduction: Palpation of the anterior fontanelle allows to investigate intracranial pressure and volume. Swelling of anterior fontanelle in a quiet baby examined in a supine position indicates high intracranial pressure, which may have distinctive causes, namely neoplasms.
Case report: A female infant, two months old, attended an emergency consultation at the Family Health Unit due to swelling in the anterior fontanelle. A soft nodular swelling with approximately one centimeter in diameter was observed at the fontanelle. Transfontanellar ultrasound revealed a potential epidermal cyst. The infant was referred to the Pediatric Surgery Department. Ultrasound was repeated two months later and revealed lesion growth. The infant was referred to the Neurosurgery Department, and a brain magnetic resonance imaging was performed. Absence of communication with endocranial structures was confirmed. Surveillance was maintained until fontanelle closure, aiming at later excision. Histological examination confirmed the diagnosis of dermoid cyst.
Discussion: Regular clinical follow-up supported by imaging studies revealed the benign nature of the lesion, allowing to postpone surgery.

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References

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Published

2019-01-02

How to Cite

1.
Pinho CM, Teixeira JV, Nogueira A, da Silva AR, Martins A. An unusual finding on the anterior fontanelle exam. REVNEC [Internet]. 2019Jan.2 [cited 2024Mar.29];27(4):243-5. Available from: https://revistas.rcaap.pt/nascercrescer/article/view/10212

Issue

Section

Case Reports

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