1. Neuroimaging (CT or MRI scan). A neuroimaging study should be performed on all patients with macrocephaly. If patient is stable on exam and only has a physical finding of macrocephaly, the study may not need to be obtained emergency. MRI scan is a more sensitive exam; however, this test requires that patient remain still for a prolonged period of time and therefore often requires sedation.
2. EEG. If seizure or clinical feature of encephalitis is present.
4. Lumbar puncture. Helpful if history or physical exam suggests intracranial infection (meningitis or encephalitis) or subarachnoid hemorrhage. Do not perform in the presence of increased intracranial pressure because of the risk of herniation.
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