Increasing head circumference

Growth rate of head circumference faster than normal (crossing centiles on a growth chart) especially in relation to height and weight
Early review (within two weeks) if well child with isolated one off increased measurement to measure head circumference again and plot on growth chart

Growth rate of head circumference faster than normal (crossing two or more centiles)
Abnormal neurological examination
Increasing head circumference with 1 or more other symptoms attributable to a brain tumour

Failure to measure and monitor head circumference in a baby with persistent vomiting

Determine duration and rate of increase in head circumference
Plot height, weight and head circumference on a growth chart and compare to previous
Ask specifically about associated symptoms and risk factors:
- Personal or family history of a brain tumour
- Leukaemia
- Sarcoma and early onset breast or bowel cancer prior therapeutic CNS irritation
- Neurofibromatosis types 1 and 2
- Tuberous Sclerosis
- Li Fraumeni Syndrome
- Family history of colorectal polyposis
- Gorlins Syndrome
- Other familial genetic syndromes
Feel anterior fontanelle
Neurological examination (include assessment of vision (including acuity), gait and coordination)
Full visual assessment – in particular looking for roving eye movements