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.

Immediate, emergency care is needed for any infant who has a truly bulging fontanelle, especially if it occurs along with fever or excess drowsiness.

The health care provider will perform a physical examination and ask questions about the child's medical history, such as:

• 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 present (such as fever, irritability, lethargy)?

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Diagnostic tests that may be done are:

• CT scan of the head
• MRI scan of the head
• Spinal tap (lumbar puncture)

Review Date: 01/24/2011
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).