Why does my son have a large head?

Q: My three years old son’s head circumference is 55 cm. He is also having delayed milestones. He looks normal in all aspects. At present, he is able to walk with support. He is undergoing physiotherapy as per recommendation of the doctor. How do we make his head size normal?

A:Your son has a large head- known as Macrocephaly. It would be important to check the parents’ head size too, to see if one of them has a large head (Familial Macrocephaly). But the fact that the child has delayed milestones indicates the need for determining the cause of macrocephaly. In any case, I would like the child to be examined by your doctor to see for any birth marks on his body, abnormal shape of head and face. An MRI of the brain is a must to see for collection of fluid in the brain (hydrocephalus etc.) or any structural defects of the brain. Subsequent to the diagnosis, further management can be instituted.