Signs, Symptoms & Clinical Features
Bulging fontanelle
A bulging fontanelle is a tense or outwardly swollen soft spot on a baby's head, which can indicate raised intracranial pressure.
In short: Bulging fontanelle
- It is an outward swelling of the baby's soft spot.
- It can indicate raised intracranial pressure.
- It is checked during examination.
- A persistently bulging fontanelle warrants prompt evaluation.
What it is
A bulging fontanelle is a soft spot on a baby's head that appears swollen or tense, pushing outward rather than being soft and flat. It can be a sign of raised pressure inside the skull.
Understanding Bulging fontanelle
The fontanelles are the soft, membrane-covered gaps between a baby's skull bones. Normally the anterior fontanelle is soft and flat (it may pulse gently or bulge slightly when a baby cries or strains). A persistently tense or bulging fontanelle when the baby is calm and upright can indicate increased intracranial pressure, as from hydrocephalus. Because it offers a window onto pressure inside the skull, the fontanelle is checked during examinations, and a persistently bulging fontanelle is a warning sign that warrants prompt evaluation. It is assessed alongside head circumference and other signs.
Why it matters
Understanding the bulging fontanelle helps families recognize a key warning sign of raised pressure in babies, and know that a persistently bulging soft spot (when the baby is calm) should be reported promptly.
Common questions
What does a bulging fontanelle indicate?
It can indicate raised intracranial pressure.
Is some bulging normal?
Slight bulging when crying or straining can be normal; persistent bulging when calm is concerning.
What should be done?
A persistently bulging fontanelle warrants prompt evaluation.
Bottom line
A bulging fontanelle is a swollen soft spot that can indicate raised intracranial pressure and warrants prompt evaluation.
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