Question

What are the symptoms of cerebral edema in infants?

Answer

The main signs of cerebral edema are a rapidly increasing head circumference in the first few weeks or months after birth. A normal infant’s head circumference increases by 1.2-1.3cm per month until the sixth month, but infants with cerebral edema grow at twice or three times the normal rate. The head appears round and prominent, with an abnormal enlargement of the sagittal suture, enlarged fontanelle, separated sutures, thinning and sometimes transparency of the skull. The temporal-frontal veins are engorged, the infraorbital groove is lost, and the sclera are often exposed (setting sun sign). Affected infants are lethargic and unable to lift their heads. In severe cases, brain function may be impaired, including convulsions, visual and olfactory disturbances, nystagmus, strabismus, limb paralysis, and intellectual disability. Due to compensatory enlargement of the infant’s head, symptoms such as headache, vomiting, and papilledema of the optic nerve are not always evident.