HYDROCEPHALUS

 Hydrocephalus represents a diverse group of conditions that result from impaired circulation and or
absorption of CSF or, in rare circumstances, from increased production of CSF by a choroid plexus
papilloma.
 In the pediatric population, hydrocephalus is characterized by an initial increase in intraventricular
pressure, resulting in pathologic dilation of the cerebral ventricles with an accumulation of
cerebrospinal fluid (CSF). Although the pressure may be slight or severe, the balance between CSF
production, flow, and absorption is lost in hydrocephalus. This condition is a significant cause of
morbidity and mortality within the pediatric population.
 In plain skull films, it may show separation of sutures.
 CT, MRI and Utrasonography are the most important studies to identify the abnormality that causes
hydrocephalus.

CLINICAL MANIFESTATIONS RULE IN RULE OUT

Long tract signs (brisk tendon  (stiffening of extremities,
reflex, spasticity, clonus, Babinski clonus)
sign)
Seizure (advance sign of 
hydrocephalus)
Decrease consciousness  (stupor, progressive
decrease in sensorium)
Age at onset (infants and adults) 
Increased ICP 
Macrocephaly 
“Setting-sun” eye sign 
Irritability 
Lethargy  (body malaise, weakness)
Vomiting 
Headache 
Chiari malformation 
Dandy-Walker malformation 

References:

Nelson’s Textbook of Pediatrics 21st Ed.

Pedia Platinum 1st Ed.
Pediatric Hydrocephalus: Current State of Diagnosis and Treatment | American
Academy of Pediatrics