Macrocephaly as a Key Neurological Sign: A Case Report

Deilaigdo FT, Criuze PR, Heirriera LS and Paichaicaino JS

Published on: 2026-02-07

Abstract

Pediatric brain tumors may present with nonspecific and progressive neurological symptoms, particularly in children without routine well-child follow-up, leading to delayed diagnosis. We report the case of a 2-year-old male with no history of regular pediatric care who presented with 24 hours of projectile vomiting and a four-week history of asthenia, gait instability, and behavioral changes. Physical examination revealed macrocephaly, cranial suture diastasis, facial palsy, left-sided hemiparesis, bilateral Babinski sign, and a wide-based gait. Cranial computed tomography demonstrated a large intracranial cystic lesion with midline shift. The patient underwent complete surgical resection of the mass with placement of a ventriculoperitoneal shunt. Histopathological analysis confirmed a low-grade astrocytoma. Postoperative recovery was favorable, and the patient remains disease-free under outpatient follow-up without neurological sequelae. This case underscores the importance of early recognition of progressive neurological signs and abnormal head growth in young children, as well as the critical role of prompt neuroimaging and multidisciplinary management in improving outcomes, particularly in settings lacking routine pediatric surveillance.