Head Length

Definition Maximum dimension of the sagittal axis of the skull.

Landmarks Measure between the glabella (the most prominent point on the frontal bone above the root of the nose, between the eyebrows) and the opisthocranion (the most prominent portion of the occiput, close to the midline on the posterior rim of the foramen magnum) (Figs 7.1 and 7.4). These landmarks are also critical for measurement of head circumference.

Figure 7.4 Measuring head length with calipers.

Figure 7.4 Measuring head length with calipers.

Medical Calipers Head

Instruments Spreading calipers give the most precise measurement. A tape-measure can be used, stretched above or lateral to the head.

Position The patient should be standing or sitting. The examiner views the skull in profile.

Alternative The examiner may stand above the patient and look down on the skull.

Remarks Charts of head length are presented in Figs. 7.5 and 7.6. Alterations in skull shape will produce marked variation in this measurement, and in head width. Dolichocephaly increases, while brachycephaly reduces, head length. X-ray measurements are more precise but do not take the skin thickness into account.

Pitfalls A bulging forehead or cloverleaf deformity may make it difficult to define the landmarks. One should eliminate the effects of thick hair cover by applying the caliper tips firmly against the skull.

Figure 7.5 Head length, both sexes, at birth. From Merlob et al. (1984), by permission.

Figure 7.5 Head length, both sexes, at birth. From Merlob et al. (1984), by permission.

Gestational Head Circumference
27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 Gestational age (weeks)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Age from birth (years)

Figure 7.6 Head length, both sexes, birth to 16 years. From Feingold and Bossert (1974) and Farkas (1981), by permission.

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