Sami, a 9 month old has been referred to the community

Question

Sami, a 9 month old has been referred to the community pediatric clinic by his health visitor because his head circumference is on the 99.6th centile.HE was born at 38 weeks gestation by spontaneous vaginal delivery, following an uneventful pregnancy to a Samoan woman. His birth weight was 4.3kgand his head circumference at birth was 38cm .This is the mothers 3rd baby but the other two children have a different father. Sami doesn’t sleep very well ,waking up to three times sit unsupported for the last 2 months ,he crawls he can use either hand to pick up grains of rise. His mother has no concerns about his vision or hearing and he passes his newborn hearing screen

What features in the history helps to distinguish between the causes of a big head

What other feature should be sought on examination

What is the most likely explanation of the large head circumference

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