Paris Hilton faced cruel trolls this week who mocked her son’s ‘deformed’ head and compared him to Family Guy’s Stewie.
Other apparently concerned fans urged the socialite to take nine-month-old Phoenix to a neurologist for a brain scan.
But babies with big heads are not uncommon. About one in fifty babies are born with macrocephaly, a scary-sounding word that just means big head.
The vast majority of cases of macrocephaly are harmless, but some may result from a more dangerous underlying cause, such as hydrocephalus or excess fluid around the brain, which affects about one in a thousand children.
Paris Hilton defended herself and her son against internet bullying by some who say baby Phoenix’s head is abnormally large and could indicate a health problem
She said Phoenix saw a doctor who would measure the child’s head as part of at least seven regular well visits during a child’s first year of life. During these doctor visits, a potential problem may be noticed
During their first year, babies typically go to the pediatrician for check-up visits seven times.
Each time, the doctor measures the baby’s head to look for possible neurological problems, meaning any warning signs will likely be spotted by the experts by the time a baby like Phoenix reaches nine months old.
About two percent of babies have macrocephaly, defined as a head circumference greater than two standard deviations above the mean for gestational age and gender.
In simpler terms, this means that the baby’s head is larger than 97 percent of other babies’ heads. About half of all cases can be attributed to large heads in the baby’s family.
The pediatrician measures the baby’s head circumference at every check-up until he or she is three years old.
If repeated measurements confirm macrocephaly, the doctor will turn his attention to the parents and measure their heads to determine whether the child’s large skull is a genetic product.
If parents or other family members have large heads, it is more likely that the baby’s head will be larger as well.
But if genetics is ruled out, the doctor will typically order an ultrasound of the baby to see if there is a buildup of cerebrospinal fluid (CSF) around the brain, and possibly more tests like MRIs and CT scans afterward.
Fluid retention in the brain, or hydrocephalus, is a potentially fatal underlying cause of macrocephaly that may require surgery.
Every human’s brain and spinal cord in the central nervous system are surrounded by cerebrospinal fluid that acts as a shock-absorbing cushion to protect them from injury or sudden shock.
CSF is a fluid that flows in and around cavities in the brain known as ventricles and removes waste products to keep the central nervous system functioning.
When cerebrospinal fluid cannot flow normally through the brain, possibly due to a tumor blocking its path, and builds up in those cavities, causing pressure on surrounding parts of the brain
Sometimes the normal flow of CSF is obstructed, perhaps due to a tumor or cyst, causing fluid to build up in the ventricles. This puts pressure on the ventricles to expand, which then puts pressure on other parts of the brain.
If the pressure is not relieved, usually by inserting a shunt to divert excess fluid away from the brain, hydrocephalus can result in permanent brain damage, developmental delays, learning disabilities over time, and an increased risk of seizures.
Ms Hilton said Phoenix is ’perfectly healthy’, adding ‘of course he’s been to a doctor, he’s just got a big brain.’
However, having a big brain doesn’t necessarily translate into hyper-intelligence.
Macrocephaly can also indicate a potentially serious, similar-sounding problem: megalencephaly, which refers to an abnormally large brain.
Symptoms of megalencephaly include delayed development of motor skills and speech, intellectual disability, paralysis, seizures, coordination problems and defects in muscle tone.
A brain tumor can also cause a baby’s head to grow rapidly and beyond what pediatricians consider normal for various age criteria. But brain tumors in babies are rare, occurring in only five in 100,000 children.
In addition to a strong familial bond, macrocephaly has been linked to cases of autism spectrum disorder.
The strength of that connection varies depending on the study, and some estimate it about 20 percent of people with autism also have a large head, while the estimated proportion of people is much higher 35 percent.
A doctor cannot reliably diagnose a child with autism before the age of two, meaning a possible clinical diagnosis for Hilton’s son Phoenix won’t come for another 15 months.
Ms. Hilton added that “he’ll be crawling soon,” which would put him neatly within the target age range for babies’ developmental milestones.