What does a bulging fontanelle mean?
A tense or bulging fontanelle occurs when fluid builds up in the brain or the brain swells, causing increased pressure inside the skull. When the infant is crying, lying down, or vomiting, the fontanelles may look like they are bulging.
What causes large anterior fontanelle?
The most common causes of a large anterior fontanel or delayed fontanel closure are achondroplasia, hypothyroidism, Down syndrome, increased intracranial pressure, and rickets.
What is the ICD 10 code for bulging fontanelle?
Bulging anterior fontanelle should be coded to R68. 1 Nonspecific symptoms peculiar to infancy when it meets the criteria in ACS 0001 Principal diagnosis or ACS 0002 Additional diagnoses.
What are the 4 fontanelles?
The fontanelles include:
- Anterior fontanelle (also called soft spot). This is the junction where the 2 frontal and 2 parietal bones meet. The anterior fontanelle remains soft until about 18 months to 2 years of age.
- Posterior fontanelle. This is the junction of the 2 parietal bones and the occipital bone.
Can a large anterior fontanelle be normal?
It is normal for infants to have these soft spots, which can be seen and felt on the top and back of the head. Fontanelles that are abnormally large may indicate a medical condition. A wide fontanelle occurs when the fontanelle is larger in size than expected for the age of the baby.
What happens if the anterior fontanelle closes early?
A condition in which the sutures close too early, called craniosynostosis, has been associated with early fontanelle closure. Craniosynostosis results in an abnormal head shape and problems with normal brain and skull growth. Premature closure of the sutures may also cause the pressure inside of the head to increase.
At what age do fontanelles close?
The posterior fontanelle usually closes by age 1 or 2 months. It may already be closed at birth. The anterior fontanelle usually closes sometime between 9 months and 18 months. The sutures and fontanelles are needed for the infant’s brain growth and development.
What is the ICD 10 code for bulging fontanelles?
ICD-10 code bulging fontanelels 2017 ICD-10-CM Diagnosis Code Q03.1 Atresia of foramina of Magendie and Luschka
When to consider an abnormal fontanel in an infant?
An abnormal fontanel in an infant can indicate a serious medical condition. Therefore, it is important to understand the wide variation of normal, how to examine the fontanels, and which diagnoses to consider when an abnormality is found.
What is the average size of the anterior fontanel?
The anterior fontanel is the largest and most important for clinical evaluation. The average size of the anterior fontanel is 2.1 cm, and the median time of closure is 13.8 months. The most common causes of a large anterior fontanel or delayed fontanel closure are achondroplasia, hypothyroidism, Down syndrome, increased intracranial pressure,
What are the clinical features of bulging fontanelles?
Clinical features include occipital bossing, progressive head enlargement, bulging of anterior fontanelle, papilledema, ataxia, gait disturbances, nystagmus, and intellectual compromise. (from menkes, textbook of child neurology, 5th ed, pp294-5)