Paris Hilton battled cruel trolls this week who made fun of her baby son’s “deformed” head and compared him to Stewie from Family Guy.
Other seemingly concerned fans urged the celebrity to take nine-month-old Phoenix to a neurologist for a brain scan.
But babies with big heads are not uncommon. About one in 50 babies are born with macrocephaly, a scary-sounding word that simply means “big head.”
The vast majority of cases of macrocephaly are harmless, but some could be the result of a more dangerous underlying cause, such as hydrocephalus or excess fluid in the brain, which affects about one in 1,000 children.
Paris Hilton has defended herself and her young son against internet bullying by some who say baby Phoenix’s head is unusually large and could indicate a health problem
She said Phoenix visited a doctor who measured the infant’s head as part of at least seven regular visits to the well during a child’s first year of life. These doctor visits could identify a potential problem
In the first year of life, babies usually go to the pediatrician seven times.
Each time, the doctor takes measurements of the baby’s head to identify potential neurological problems. This means that experts would likely spot any potential warning signs by the time a baby like Phoenix is nine months old.
About two percent of babies have macrocephaly, meaning they have a head circumference that is more than two standard deviations above the average for gestational age and gender.
In simple terms, this means that the baby’s head is larger than 97 percent of other infants’ heads. About half of all cases are due to large heads in the baby’s family.
Up to the age of three, the pediatrician measures the baby’s head circumference at every check-up.
If repeated measurements confirm macrocephaly, the doctor will turn his attention to the parents and measure their heads to determine whether the infant’s large skull is a genetic product.
If parents or other family members have large heads, the baby’s head is more likely to grow larger too.
However, if genetic reasons are ruled out, the doctor will usually order an ultrasound scan of the baby to determine whether there is a buildup of cerebrospinal fluid (cerebrospinal fluid) around the brain, and may then do further tests such as MRIs and CT scans.
Fluid buildup in the brain, also called hydrocephalus, is a potentially fatal root cause of macrocephaly that may require surgery to correct.
Within the central nervous system, every person’s brain and spinal cord are surrounded by cerebrospinal fluid, which acts as a shock-absorbing cushion and protects them from injury or sudden impact.
CSF is a fluid that flows in and around cavities in the brain called ventricles and removes waste products to maintain central nervous system function.
When cerebrospinal fluid cannot flow normally through the brain, perhaps due to a tumor blocking its path, it accumulates in these cavities and puts pressure on surrounding areas of the brain
Sometimes the normal flow of CSF is obstructed, possibly due to a tumor or cyst causing fluid to build up in the ventricles. This puts pressure on the ventricles to expand, which in turn puts pressure on other parts of the brain.
If the pressure is not relieved, typically by inserting a shunt to drain excess fluid away from the brain, hydrocephalus can lead to permanent brain damage, developmental delays, later learning difficulties, and an increased risk of epileptic seizures.
According to Ms Hilton, Phoenix is ”completely healthy”, adding: “Of course he’s been to the doctor, he’s just got a big brain.”
However, a large brain does not necessarily mean hyperintelligence.
Macrocephaly could 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 language, mental retardation, paralysis, seizures, coordination problems, and impaired muscle tone.
A brain tumor can also cause a baby’s head to grow rapidly and beyond what pediatricians consider normal for different ages. However, brain tumors in babies are rare and only occur in five out of 100,000 children.
In addition to a strong familial connection, macrocephaly is also associated with cases of autism spectrum disorder.
The strength of this connection varies depending on the study, although some estimate this about 20 percent of people with autism also have large heads, while this estimated proportion of people is much higher 35 percent.
A doctor cannot reliably diagnose a child with autism until he or she is two years old, meaning a possible clinical diagnosis for Ms. Hilton’s son Phoenix would not come for at least 15 months.
Ms Hilton added that “he will be crawling soon”, which would put him right in the target age window for babies’ developmental milestones.