• Positional plagiocephaly
    www.rch.org.au/clinicalguide/guideline_index/Positional_plagiocephaly/
    use 4-6 months corrected age), and ongoing growth until the anterior fontanelle closes Self-correction … of cervical rotation  Palpate Size of anterior fontanelle The anterior fontanelle can vary in size from small … to large 1% have a closed fontanelle at 3 months of age, 38% at 12 months of age, 96% at 24 months of age …
  • Recognition of the seriously unwell neonate and young infant
    www.rch.org.au/clinicalguide/guideline_index/Recognition_of_the_seriously_unwell_neonate_and_young_infant/
    membranes, reduced skin turgor, sunken fontanelle Reduced urine output Poor weight gain Glucose Apnoea … or hypothermia Bulging fontanelle Neck stiffness Vesicular rash, encephalopathy (HSV) Causes that need …, tachypnoea, increased work of breathing Irritable, neck stiffness or bulging fontanelle Bone or joint Reduced …
  • Vomiting
    www.rch.org.au/clinicalguide/guideline_index/Vomiting/
    (eg Cushing's triad) may suggest intracranial pathology Bulging fontanelle may be a sign of raised ICP … bulging fontanelle in infant Neck stiffness, photophobia and fever in older child Signs of peritonitis …
  • Radiology - Acute indications
    www.rch.org.au/clinicalguide/guideline_index/Radiology_Guidelines_Acute_indications/
    : Large head  Rapidly enlarging head with open fontanelle. Neurological concerns in neonates/ infants … Clinical usefulness will vary depending on size of fontanelle and indications and should be discussed …
  • Lumbar puncture
    www.rch.org.au/clinicalguide/guideline_index/Lumbar_puncture/
    Note: a bulging fontanelle in the absence of other signs of raised ICP is  not  a contraindication ….3-A106. 10.1136/archdischild-2012-301885.250 Beri S et al 2011. Bulging fontanelle in febrile infants …
  • Dehydration
    www.rch.org.au/clinicalguide/guideline_index/Dehydration/
    & fontanelle Not sunken Sunken Deeply sunken Mucous membranes Moist Dry Dry Skin turgor Instant recoil Mildly …
  • Acute meningococcal disease
    www.rch.org.au/clinicalguide/guideline_index/Acute_meningococcal_disease/
    stiffness , headache , photophobia , bulging fontanelle Non-blanching rash: petechiae/purpura Note …
  • Febrile seizure
    www.rch.org.au/clinicalguide/guideline_index/Febrile_seizure/
    fontanelle, neck stiffness, photophobia) prolonged postictal altered consciousness (>1 Hour) Neurocutaneous …
  • Gastrooesophageal reflux disease in infants
    www.rch.org.au/clinicalguide/guideline_index/Gastrooesophageal_reflux_disease_in_infants/
    Hepatosplenomegaly Bulging fontanelle and/or increasing head circumference Management Investigations Investigations …
  • Brief Resolved Unexplained Event BRUE
    www.rch.org.au/clinicalguide/guideline_index/Brief_Resolved_Unexplained_Event_BRUE/
    , subconjunctival haemorrhage, full fontanelle, head circumference crossing centiles, epistaxis, oral injury …