Fontanelles - bulging

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Bulging fontanelles

Skull of a newborn

Soft spot - bulging; Bulging fontanelles

If the fontanelle returns to normal appearance when the child is calm and head-up, it is not a truly bulging fontanelle.

An infant with a truly bulging fontanelle, especially if accompanied by fever or lethargy, should be examined promptly by an emergency room physician or pediatrician. THIS IS A MEDICAL EMERGENCY.

The medical history will be obtained and a physical examination performed.

Medical history questions documenting bulging fontanelle in detail may include:

• Does the "soft spot" return to normal appearance when the infant is calm or head-up?
• Does it bulge all the time or does it come and go?
• When did you first notice this?
• Which fontanelles bulge (top of the head, back of the head, or other)?
• Are all the fontanelles bulging?
• What other symptoms are also present (such as fever, irritability, lethargy)?

Diagnostic tests that may be performed are:

• CT scan of the head
• Possible lumbar puncture

After seeing your health care provider:

You may want to add a diagnosis related to bulging fontanelles to your personal medical record.

Review Date: 10/27/2005
Reviewed By: Daniel Rauch, MD, FAAP, Director, Pediatric Hospitalist Program, Associate Professor of Pediatrics, NYU School of Medicine, New York, NY. Review provided by VeriMed Healthcare Network.