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Journalism of Courage
After learning about why we have a headache despite no pain receptors in the brain, and whether our ears continue to grow, we decided to seek a simple explanation — until when does the head and, by default, the skull continue to grow? The human skull, which is the bony structure encasing and protecting the brain, is the most vital organ in the human body.
“The skull can be divided into two main parts – the cranium and the facial bones. The cranium protects the brain, while the facial bones support the face and form the entrance to the respiratory and digestive systems. The skull also has various openings for blood vessels, nerves, and other structures to pass through,” explained Dr Pradnya Gadgil, senior consultant – Paediatric Neurology, NH SRCC Children’s Hospital, Mumbai. However, these modifications are quite subtle, said Dr Pradyumna Oak, Director, Neurology, Nanavati Max Super Speciality Hospital, Mumbai.
According to experts, as with most bones in our body, the skull grows during childhood and adolescence, and it typically completes its growth by the end of puberty, around the age of 18-20.
“Skull is mostly fully formed by the age of around 25. However, some bones continue to grow and fuse until the age of 40. The skull bones can also be affected by certain conditions such as craniosynostosis, where the bones fuse prematurely, resulting in an abnormally shaped skull and developmental issues,” said Dr Gadgil.
For example, the thickness of the skull can increase slightly, and the joints between skull bones can further harden. “The facial skeleton can also experience minor changes due to factors like gravity, muscle tone loss, and changes in fat distribution. However, these changes are usually measured in millimetres and may not be observable,” said Dr Oak.
Any substantial growth or change in the shape or size of the skull in adulthood is unusual and could be indicative of a medical condition, he stressed. It’s recommended to consult a neurologist if one notices such changes.
Concurring, Dr Sudhir Kumar, a neurologist, said that as skull growth corresponds to the growth in the size of the brain, the measurement of head circumference (HC) is an indirect measure of brain size.
“HC is routinely measured while following up with children in the OPD, along with their weight and height. If the HC is normal for age (and increasing in size as expected), it means that the brain is also growing normally. If the HC is lesser than expected at any age (especially in children), it means that the brain is smaller, a condition called microcephaly,” he noted, adding that microcephaly can be caused by infections of the brain, developmental anomalies, malnutrition, or reduction in the blood supply of the brain.
In some conditions, HC may be larger than expected, a condition called as macrocephaly. “Macrocephaly can be due to a greater amount of cerebrospinal fluid (CSF) in the brain, a condition called as hydrocephalus. Larger HC can also be due to greater brain volume, a condition called megalencephaly, which can be caused by brain tumours, brain haemorrhage, or leukodystrophy,” Dr Kumar stated.
According to Dr Kumar, further evaluation requires a brain scan such as CT or MRI, and other investigations to establish the cause. “Treatment depends on the underlying cause,” he said.
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