{"id":3908,"date":"2022-11-24T17:25:15","date_gmt":"2022-11-24T17:25:15","guid":{"rendered":"https:\/\/neuropediatoolbox.org\/?p=3908"},"modified":"2023-12-28T18:59:44","modified_gmt":"2023-12-28T18:59:44","slug":"valoracion-del-crecimiento-cefalico","status":"publish","type":"post","link":"https:\/\/neuropediatoolkit.org\/en\/valoracion-del-crecimiento-cefalico\/","title":{"rendered":"Valoraci\u00f3n del crecimiento cef\u00e1lico."},"content":{"rendered":"\n<p>El crecimiento cef\u00e1lico es uno de los par\u00e1metros f\u00e1cilmente monitorizables en la edad pedi\u00e1trica que nos permite evaluar tanto el crecimiento, el desarrollo, como la presencia de problemas neurol\u00f3gicos subyacentes. <\/p>\n\n\n\n<div id=\"wp-block-themeisle-blocks-accordion-1dc64938\" class=\"wp-block-themeisle-blocks-accordion exclusive\">\n<details class=\"wp-block-themeisle-blocks-accordion-item\"><summary class=\"wp-block-themeisle-blocks-accordion-item__title\"><div>Problemas cuantitativos. Per\u00edmetro cef\u00e1lico. <\/div><\/summary><div class=\"wp-block-themeisle-blocks-accordion-item__content\">\n<p>La principal herramienta de medida es el per\u00edmetro cef\u00e1lico. <\/p>\n\n\n\n<p>El objetivo es detectar aquellas enfermedades que presentan <a href=\"https:\/\/www.pediatriaintegral.es\/publicacion-2020-10\/alteraciones-del-perimetro-cefalico-macrocefalia-y-microcefalia\/\">macrocefalia y microcefalia.<\/a><\/p>\n\n\n\n<p>Sin embargo su medici\u00f3n no est\u00e1 exenta de problemas: <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Al ser un per\u00edmetro, no tiene en cuenta las alteraciones de la forma (problemas cualitativos). Se trata de una medida externa a trav\u00e9s de la que pretendemos valorar una variable interna (volumen encef\u00e1lico). El mismo per\u00edmetro puede contener distintos vol\u00famenes en funci\u00f3n de la forma (una esfera tiene m\u00e1s volumen que una elipse).<\/li>\n\n\n\n<li>Es una de las medidas antropom\u00e9tricas con menos fiabilidad (presencia de pelo, movimientos del ni\u00f1o, distintas mediciones en funci\u00f3n de la posici\u00f3n del metro, etc.), por lo que es muy frecuente el error de medida. Es necesario repetir la medici\u00f3n m\u00faltiples veces en el tiempo para inferir una tendencia. <\/li>\n\n\n\n<li>El tama\u00f1o cef\u00e1lico est\u00e1 altamente condicionado por la gen\u00e9tica. \n\n\n<ul class=\"wp-block-list\">\n<li>Esto significa que es conveniente utilizar gr\u00e1ficas de una poblaci\u00f3n representativa para poder evitar sesgos por exceso o defecto de diagn\u00f3stico. La poblaci\u00f3n espa\u00f1ola tiene un promedio de tama\u00f1o cef\u00e1lico mayor que la muestra de referencia de las gr\u00e1ficas de la OMS, por lo que es conveniente comparar a los ni\u00f1os espa\u00f1oles con <a href=\"https:\/\/www.fundacionorbegozo.com\/el-instituto-de-investigacion-del-crecimiento-y-desarrollo\/graficas-y-tablas\/\">gr\u00e1ficas de Orbegozo<\/a>, y a ni\u00f1os provenientes de otros pa\u00edses con <a href=\"https:\/\/www.who.int\/tools\/child-growth-standards\/standards\">gr\u00e1ficas de la OMS<\/a>. <\/li>\n\n\n\n<li>Adem\u00e1s, en caso de desviaci\u00f3n significativa, ser\u00e1 necesario medir el per\u00edmetro cef\u00e1lico de ambos padres para poder excluir la posibilidad de una <a href=\"http:\/\/neuropediatoolkit.org\/metodo-de-weaver\/\">macrocefalia familiar.<\/a><\/li>\n\n\n\n<li>Existen algunas enfermedades gen\u00e9ticas para las que hay gr\u00e1ficas espec\u00edficas. \n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/www.achondroplasia-growthcharts.com\/\">Acondroplasia.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.cdc.gov\/ncbddd\/birthdefects\/downsyndrome\/growth-charts.html\">S\u00edndrome de Down.<\/a><\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>En caso de duda, tambi\u00e9n puede corregirse el per\u00edmetro cef\u00e1lico en funci\u00f3n de la talla, ya que deben ser proporcionados, de forma que no ser\u00e1 motivo de preocupaci\u00f3n un ni\u00f1o con microcefalia o macrocefalia arm\u00f3nica (misma z de peso, talla y PC), y si que lo ser\u00e1 un ni\u00f1o con microcefalia o macrocefalia relativa (aunque no supere las +\/-2DE para su poblaci\u00f3n de referencia). Hay que tener en cuenta que la proporci\u00f3n entre talla y PC cambia a lo largo de la vida. Puede calcularse la edad de talla, y posteriormente evaluar el percentil de PC en funci\u00f3n de su edad de talla y no su edad cronol\u00f3gica. <\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-full\"><img fetchpriority=\"high\" decoding=\"async\" width=\"744\" height=\"548\" src=\"http:\/\/neuropediaclinic.com\/wp-content\/uploads\/2022\/11\/image-14.png\" alt=\"\" class=\"wp-image-3972\" srcset=\"https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2022\/11\/image-14.png 744w, https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2022\/11\/image-14-300x221.png 300w, https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2022\/11\/image-14-16x12.png 16w\" sizes=\"(max-width: 744px) 100vw, 744px\" \/><\/figure>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full\"><img decoding=\"async\" width=\"558\" height=\"359\" src=\"http:\/\/neuropediaclinic.com\/wp-content\/uploads\/2022\/11\/imagen-69.png\" alt=\"\" class=\"wp-image-3940\" srcset=\"https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2022\/11\/imagen-69.png 558w, https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2022\/11\/imagen-69-300x193.png 300w, https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2022\/11\/imagen-69-18x12.png 18w\" sizes=\"(max-width: 558px) 100vw, 558px\" \/><\/figure>\n<\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full\"><img decoding=\"async\" width=\"448\" height=\"796\" src=\"http:\/\/neuropediaclinic.com\/wp-content\/uploads\/2022\/11\/imagen-68.png\" alt=\"\" class=\"wp-image-3913\" srcset=\"https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2022\/11\/imagen-68.png 448w, https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2022\/11\/imagen-68-169x300.png 169w, https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2022\/11\/imagen-68-7x12.png 7w\" sizes=\"(max-width: 448px) 100vw, 448px\" \/><figcaption class=\"wp-element-caption\"><div id=\"zotpress-374a1407bd09712a4641f93bc0010220\" 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ZP_ATTR\">%7B%22status%22%3A%22success%22%2C%22updateneeded%22%3Afalse%2C%22instance%22%3Afalse%2C%22meta%22%3A%7B%22request_last%22%3A0%2C%22request_next%22%3A0%2C%22used_cache%22%3Atrue%7D%2C%22data%22%3A%5B%7B%22key%22%3A%22DGHSIFHX%22%2C%22library%22%3A%7B%22id%22%3A332710%7D%2C%22meta%22%3A%7B%22creatorSummary%22%3A%22Bushby%20et%20al.%22%2C%22parsedDate%22%3A%221992-10%22%2C%22numChildren%22%3A1%7D%2C%22bib%22%3A%22%26lt%3Bdiv%20class%3D%26quot%3Bcsl-bib-body%26quot%3B%20style%3D%26quot%3Bline-height%3A%201.35%3B%20%26quot%3B%26gt%3B%5Cn%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-entry%26quot%3B%20style%3D%26quot%3Bclear%3A%20left%3B%20%26quot%3B%26gt%3B%5Cn%20%20%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-left-margin%26quot%3B%20style%3D%26quot%3Bfloat%3A%20left%3B%20padding-right%3A%200.5em%3B%20text-align%3A%20right%3B%20width%3A%201em%3B%26quot%3B%26gt%3B1.%26lt%3B%5C%2Fdiv%26gt%3B%26lt%3Bdiv%20class%3D%26quot%3Bcsl-right-inline%26quot%3B%20style%3D%26quot%3Bmargin%3A%200%20.4em%200%201.5em%3B%26quot%3B%26gt%3BBushby%20KM%2C%20Cole%20T%2C%20Matthews%20JN%2C%20Goodship%20JA.%20Centiles%20for%20adult%20head%20circumference.%20Arch%20Dis%20Child%20%5BInternet%5D.%201992%20Oct%20%5Bcited%202022%20Nov%2024%5D%3B67%2810%29%3A1286%26%23x2013%3B7.%20Available%20from%3A%20%26lt%3Ba%20class%3D%26%23039%3Bzp-ItemURL%26%23039%3B%20href%3D%26%23039%3Bhttps%3A%5C%2F%5C%2Fwww.ncbi.nlm.nih.gov%5C%2Fpmc%5C%2Farticles%5C%2FPMC1793909%5C%2F%26%23039%3B%26gt%3Bhttps%3A%5C%2F%5C%2Fwww.ncbi.nlm.nih.gov%5C%2Fpmc%5C%2Farticles%5C%2FPMC1793909%5C%2F%26lt%3B%5C%2Fa%26gt%3B%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%20%20%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%26lt%3B%5C%2Fdiv%26gt%3B%22%2C%22data%22%3A%7B%22itemType%22%3A%22journalArticle%22%2C%22title%22%3A%22Centiles%20for%20adult%20head%20circumference.%22%2C%22creators%22%3A%5B%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22K%20M%22%2C%22lastName%22%3A%22Bushby%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22T%22%2C%22lastName%22%3A%22Cole%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22J%20N%22%2C%22lastName%22%3A%22Matthews%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22J%20A%22%2C%22lastName%22%3A%22Goodship%22%7D%5D%2C%22abstractNote%22%3A%22Reference%20range%20for%20head%20circumference%20on%20the%20Tanner%20charts%20do%20not%20go%20beyond%20age%2016.%20In%20this%20study%20the%20head%20circumference%20and%20heights%20of%20354%20adults%20in%20two%20British%20centres%20were%20measured.%20The%20centile%20charts%20constructed%20from%20these%20measurements%20show%20that%20adult%20head%20circumference%20is%20related%20to%20height.%20The%20mean%20head%20circumference%20of%20a%20male%20of%20average%20height%20is%20above%20the%2097th%20centile%20for%20a%2016%20year%20old%20on%20the%20Tanner%20charts.%20The%20paediatric%20charts%20are%20therefore%20inappropriate%20for%20use%20in%20adult%20males.%22%2C%22date%22%3A%221992-10%22%2C%22section%22%3A%22%22%2C%22partNumber%22%3A%22%22%2C%22partTitle%22%3A%22%22%2C%22DOI%22%3A%22%22%2C%22citationKey%22%3A%22%22%2C%22url%22%3A%22https%3A%5C%2F%5C%2Fwww.ncbi.nlm.nih.gov%5C%2Fpmc%5C%2Farticles%5C%2FPMC1793909%5C%2F%22%2C%22PMID%22%3A%221444530%22%2C%22PMCID%22%3A%22PMC1793909%22%2C%22ISSN%22%3A%220003-9888%22%2C%22language%22%3A%22%22%2C%22collections%22%3A%5B%22XSZET5A5%22%5D%2C%22dateModified%22%3A%222025-09-27T22%3A59%3A17Z%22%7D%7D%5D%7D<\/span>\n\n\t\t\t\t<div id=\"zp-ID-3908-332710-DGHSIFHX\" data-zp-author-date='Bushby-et-al.-1992-10' data-zp-date-author='1992-10-Bushby-et-al.' data-zp-date='1992-10' data-zp-year='1992' data-zp-itemtype='journalArticle' class=\"zp-Entry zpSearchResultsItem\">\n<div class=\"csl-bib-body\" style=\"line-height: 1.35; \">\n  <div class=\"csl-entry\" style=\"clear: left; \">\n    <div class=\"csl-left-margin\" style=\"float: left; padding-right: 0.5em; text-align: right; width: 1em;\">1.<\/div><div class=\"csl-right-inline\" style=\"margin: 0 .4em 0 1.5em;\">Bushby KM, Cole T, Matthews JN, Goodship JA. Centiles for adult head circumference. Arch Dis Child [Internet]. 1992 Oct [cited 2022 Nov 24];67(10):1286\u20137. Available from: <a class='zp-ItemURL' href='https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC1793909\/'>https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC1793909\/<\/a><\/div>\n  <\/div>\n<\/div>\n\t\t\t\t<\/div><!-- .zp-Entry .zpSearchResultsItem -->\n\t\t\t<\/div><!-- .zp-zp-SEO-Content -->\n\t\t<\/div><!-- .zp-List -->\n\t<\/div><!--.zp-Zotpress-->\n\n<\/figcaption><\/figure>\n<\/div><\/div><\/details>\n\n\n\n<details class=\"wp-block-themeisle-blocks-accordion-item\"><summary class=\"wp-block-themeisle-blocks-accordion-item__title\"><div>Problemas cualitativos. Di\u00e1metros cef\u00e1licos. <\/div><\/summary><div class=\"wp-block-themeisle-blocks-accordion-item__content\">\n<p>Para la medida de los di\u00e1metros cef\u00e1licos se utiliza el <a href=\"http:\/\/neuropediatoolkit.org\/deformidades-craneales\/\">crani\u00f3metro<\/a>. <\/p>\n<\/div><\/details>\n<\/div>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>El crecimiento cef\u00e1lico es uno de los par\u00e1metros f\u00e1cilmente monitorizables en la edad pedi\u00e1trica que nos permite evaluar tanto el crecimiento, el desarrollo, como la presencia de problemas neurol\u00f3gicos subyacentes.<\/p>","protected":false},"author":1,"featured_media":3909,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_themeisle_gutenberg_block_has_review":false,"footnotes":""},"categories":[22],"tags":[],"class_list":["post-3908","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-exploracion-morfologica","entry"],"_links":{"self":[{"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/posts\/3908","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/comments?post=3908"}],"version-history":[{"count":3,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/posts\/3908\/revisions"}],"predecessor-version":[{"id":6871,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/posts\/3908\/revisions\/6871"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/media\/3909"}],"wp:attachment":[{"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/media?parent=3908"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/categories?post=3908"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/tags?post=3908"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}