Signs, Symptoms & Clinical Features
Tense fontanelle
A tense fontanelle is a firm, full soft spot that can be a sign of increased pressure inside a baby's skull.
In short: Tense fontanelle
- It is a firm or full soft spot, lacking the usual softness.
- It can indicate raised intracranial pressure.
- It is assessed when the baby is calm and upright.
- It is one of several signs of pressure in infants.
What it is
A tense fontanelle is a soft spot that feels firm or full rather than soft, reflecting increased fullness or pressure beneath it. It is a related finding to a bulging fontanelle and can indicate raised intracranial pressure.
Understanding Tense fontanelle
When intracranial pressure rises in a baby, the fontanelle can become tense and full. Because crying, straining, or lying down can normally make the fontanelle fuller, it is best assessed when the baby is calm and upright. A persistently tense fontanelle, especially with other signs such as rapid head growth or irritability, suggests raised pressure and warrants evaluation. The fontanelle's character (soft, tense, or bulging) is part of the routine examination of a baby with or at risk for hydrocephalus.
Why it matters
Understanding the tense fontanelle helps families see that the firmness of the soft spot, assessed when the baby is calm, provides information about pressure inside the skull, and that a persistently tense fontanelle is worth reporting.
Common questions
What does a tense fontanelle indicate?
It can indicate raised intracranial pressure.
When is it best assessed?
When the baby is calm and upright.
Is it the same as a bulging fontanelle?
They are related findings, both reflecting fullness or pressure.
Bottom line
A tense fontanelle is a firm, full soft spot that can indicate raised pressure, best assessed when the baby is calm and upright.
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