Introduction

This study would help us understand the concept about the case. Our knowledge will be expanded
when we will be able to discover the cause and effect of this microcephaly.

Microcephaly is a rare condition in which the head is abnormally small.

Microcephaly is usually present at birth, but it can also develop during the first few years of life.
Thus, it is possible for the head to be normal in size at birth, but to stop growing at a normal rate,
causing it to be too small.

Brain damage during birth can also lead to microcephaly, as can disease or any trauma. Trauma is
most likely to lead to microcephaly during the last three months of pregnancy or when the child is
a young infant.

Microcephaly is a condition that can be present at birth in which the baby's head is much smaller
than normal for an infant of that age and gender. "Micro" means small and "cephaly" refers to the
head. Most children with microcephaly also have a small brain and mental retardation. However,
some children with small heads have normal intelligence. Unfortunately, in other children, the
growth of the brain may have been affected by any one of a number of factors.

OBJECTIVES:
1. To be able to learn and understand the concept of microcephaly.

2. To be able to formulate an effective nursing care plan for an infant having microcephaly.

3. To be able to give recommendations to the parents regarding the next pregnancy to

prevent the incidence of having a child with microcephaly.

Anatomy and Physiology

Microcephaly is a medical condition in which the circumference of the head is smaller than
normal because the brain has not developed properly or has stopped growing. Microcephaly can
be present at birth or it may develop in the first few years of life. It is most often caused by
genetic abnormalities that interfere with the growth of the cerebral cortex during the early
months of fetal development. It is associated with Down’s syndrome, chromosomal syndromes,
and neurometabolic syndromes. Babies may also be born with microcephaly if, during
pregnancy, their mother abused drugs or alcohol, became infected with a cytomegalovirus,
rubella (German measles), or vermicelli (chicken pox) virus, was exposed to certain toxic
chemicals, or had untreated phenylketonuria (PKU). Babies born with microcephaly will have a
smaller than normal head that will fail to grow as they progress through infancy.

In many cases, microcephaly may not be evident by ultrasound until the third trimester, and,
therefore, may not be seen on ultrasounds performed earlier in pregnancy. The diagnosis of
microcephaly may be made at birth or later in infancy. The baby's head circumference is much
smaller than normal. During the physical examination, the physician obtains a complete prenatal
and birth history of the child. In older babies and children, the physician may also ask if there is
a family history of microcephaly or other medical problems. The physician will also ask about
developmental milestones since microcephaly can be associated with other problems, such as
mental retardation.

Infants with microcephaly are born with either a normal or reduced head size. Subsequently the
head fails to grow while the face continues to develop at a normal rate, producing a child with a
small head and a receding forehead, and a loose, often wrinkled scalp. As the child grows older,
the smallness of the skull becomes more obvious, although the entire body also is often
underweight and dwarfed. Development of motor functions and speech may be delayed.
Hyperactivity and mental retardation are common occurrences, although the degree of each
varies. Convulsions may also occur. Motor ability varies, ranging from clumsiness in some to
spastic quadriplegia in others.

Causes of Microcephaly

Microcephaly can occur alone or in association with other health problems, and may occur from
inheritance of an autosomal recessive, or rarely, an autosomal dominant gene. Acquired
microcephaly may occur after birth due to various brain injuries such as lack of oxygen or
infection.

Microcephaly may be inherited but the gene is considered to be extremely rare. In the general
population, microcephaly due to genetic factors occurs in 1 in 30,000 to 50,000 live births, and in
1 per 10,000 births due to other causes. In some populations, frequency may be as high as 1 in
2,000 births.

Microcephaly can also be caused if the mother has an infection while pregnant or if she is
exposed to harmful substances during early pregnancy, such as x-rays (a type of energy) or
chemicals. Another cause of microcephaly is if the bones of the skull come together too early.
For genetic (inherited) causes of microcephaly, see the next section.

Microcephaly is either caused by exposure to harmful substances during the fetal development,
or it may be associated with genetic problems or syndromes that may have a tendency to run in
families.
Microcephaly most often occurs because of failure of the brain to grow at a normal rate. Skull
growth is determined by brain expansion, which takes place during the normal growth of the
brain during pregnancy and infancy.It is most often caused by genetic abnormalities that interfere
with the growth of thecerebral cortex during the early months of fetal development. It is
associated withDown's syndrome, chromosomal syndromes, and neurometabolic syndromes.
Babies may also be born with microcephaly if, during pregnancy, their mother:

• abused drugs or alcohol,

• became infected with a cytomegalovirus,
• rubella (German measles), or varicella (chickenpox) virus,
• was exposed to certain toxic chemicals, or
• had untreated phenylketonuria (PKU).

Babies born with microcephaly will have a smaller than normal head that will fail to grow as
they progress through infancy.