Is this an emergency urgent or routine clinical condition

Determine if this is an emergency. Remember the ABCs (airway breathing, and circulation).

B. Is there a family history of macrocephaly? Macrocephaly can be familial, unassociated with an underlying abnormality, or associated with an array of other problems, as in neurocutaneous disorders.

C. Does patient have an associated developmental delay? Many conditions (eg, hydrocephalus, neurocutaneous disorders, metabolic disorders) can present with macrocephaly and developmental delay.

D. Pertinent Historical Information. Information about child's prenatal and neonatal course may identify risks for neurologic disorders or sequelae.

1. Did mother receive prenatal care?

2. Was prenatal ultrasonography performed?

3. Was there any history of maternal medication use or substance abuse during pregnancy?

4. Were there any maternal medical complications during pregnancy?

5. Was pregnancy completed to term?

6. Were there any complications during delivery?

7. Were developmental milestones achieved at appropriate ages?

8. Is there any significant medical or surgical history?

9. Any history of head trauma?

10. Any family history of neurologic disorders?

11. Is patient appropriately developed and nourished? Growth and development problems may reflect an underlying medical or neurologic disorder.

12. Is patient cooperative, interactive, or in distress?

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