Diagnosis of a Large Ependymal Cyst in a Patient with Severe Macrocephaly and No Neurological Risk Factors

Macrocephaly is defined as an unusually large head circumference, measuring more than two standard deviations (SDs) above the mean.While benign familial macrocephaly is the most common diagnosis, various neuropathological disordersincluding megalencephaly, subdural fluid collection, hydrocephalus, intracranial masses, and conditions involving abnormal skull growth-are also occasionally found in patients exhibiting neurological symptoms [1-3].However, there are only a few documented instances where individuals with macrocephaly have been diagnosed with neuropathological conditions without any accompanying neurological risk factors.A 2-year-old patient visited the outpatient clinic due to macrocephaly, with a head circumference of 51.5 cm (99.2 percentile, 2.409 SD), detected during a routine clinical checkup.He was born at full term, weighing 3,100 g, with no dysmorphic features and a head circumference of 32.5 cm (6.1 percentile, -1.546 SD).There was no family history of macrocephaly, and no abnormal neonatal history, including perinatal asphyxia or neonatal seizures, was reported.Additionally, the child achieved normal developmental milestones and exhibited no focal neurological deficits during the neurological examination.Other nonspecific symptoms such as lethargy, irritability, or vomiting were absent, and the fontanelle was closed, although the caregiver could not recall the exact timing.Further review of the regular checkup re-