Hydrocephalus

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Skull of a newborn

Water on the brain

Early symptoms in infants:

• Enlarged head (increased head circumference)
• Bulging fontanelles (soft spots of the head) with or without enlargement of the head size
• Separated sutures
• Vomiting

Symptoms of continued hydrocephalus:

• Irritability, poor temper control
• Muscle spasticity (spasm)

Symptoms that occur later in the disease:

• Decreased mental function
• Delayed development
• Slow or restricted movement
• Difficulty feeding
• Lethargy , excessive sleepiness
• Urinary incontinence (loss of control over bladder)
• Brief, shrill, high-pitched cry
• Slow growth (child 0-5 years)

Symptoms in older babies and children:

• Headache
• Vomiting
• Vision changes
• Crossed eyes
• Uncontrolled eye movements
• Loss of coordination
• Poor gait (walking pattern)
• Mental aberrations (such as confusion or psychosis)
• Changes in facial appearance and eye spacing

When a health care provider taps fingertips on the skull, there may be abnormal sounds that indicated thinning and separation of skull bones. Scalp veins may appear stretched or enlarged (dilated).

Part or the entire head may be larger than normal. Enlarge is most commonly seen in the front part of the head. Head circumference measurements, repeated over time, may show that the head is getting bigger.

The eyes may look "sunken in." The white part of the eye (the sclera) may appear above the colored part of the eye (the iris), given the eyes a "setting-sun" appearance. Reflexes may be abnormal.

The following tests may be performed:

• Transillumination of the head (shining a light against the head)
• Head CT scan (one of the best tests for identifying hydrocephalus)
• Spinal tap and examination of the CSF (rarely done)
• Skull x-rays
• Brain scan using radioisotopes
• Arteriography
• Echoencephalogram , an ultrasound of the brain

Review Date: 08/18/2006
Reviewed By: Benjamin W. Van Voorhees, MD, MPH, Assistant Professor of Medicine and Pediatrics, The University of Chicago, Chicago, IL. Review provided by VeriMed Healthcare Network.