Symptoms and signs of progressive hydrocephalus.

Abstract

SUMMARY The clinical features of 107 cases of children with hydrocephalus and measured raised intraventricular pressure were analysed retrospectively. Fifty one children had recently been diagnosed as having hydrocephalus, and the remainder had had shunts injected to direct the cerebrospinal fluid. The most common symptoms in the group were vomiting, behavioural changes, drowsiness, and headaches. The most common clinical signs were inappropriately increasing occipitofrontal head circumferences, tense anterior fontanelles, splayed sutures, and distension of the scalp veins. Half the infantile cases of hydrocephalus were without symptoms, and a quarter of the cases with cerebrospinal fluid shunts and measured raised intraventricular pressure were without signs. There were no fewer than 33 different clinical signs including several unusual ones, such as macular rash and sweating. We believe that the presentation of hydrocephalus with raised intraventricular pressure is sufficiently variable, unusual, or even absent to justify the direct measurement of intracranial pressure.

Aqueductal Stenosis Presenting as Isolated Tremor: Case Report and Review of the Literature

“…Although this patient also presented with many other symptoms, such as headache and cognitive decline, he is similar to this patient in that they both possessed action tremor from hydrocephalus due to aqueductal stenosis, and both patients had rapid improvement after ETV. Our patient did not possess any of the major clinical signs or symptoms of hydrocephalus, with the exception of macrocephaly [13]. This makes his case unique amongst previous reports linking tremor and hydrocephalus.…”

Unusual clinical manifestations of disturbed CSF dynamics in hydrocephalic children

“…Note the complete obstruction of the superior sagittal sinus. Most symptoms and signs of venous congestion presented by this girl disappeared after shunting symptoms and signs may be absent despite raised ICP [2,4,9].…”

“…Common clinical signs are increased occipitofrontal head circumference, tense anterior fontanel, splayed sutures, distended scalp veins and sunsetting of the eyes. However, the clinical symptoms and signs may also be nonspecific and unreliable or even entirely absent despite the presence of disturbed cerebrospinal fluid (CSF) dynamics with increased ICP [3,6,9]. Even when hydrocephalus is demonstrated radiologically, it is often difficult to distinguish between "arrested hydrocephalus" and slowly progressive hydrocephalus requiring treatment [2].…”

In vivo1H MR spectroscopic imaging and difusion weighted mri in experimental hydrocephalus

“…In four tion. In the caudateputamen complex of control rats, the ADC was 0.76 +-0.04, compared with 0.78 t-0.04 in hydrocephalics at 1 an increased ADC adjacent to the corpus callosum. Thus, both extracellular white matter edema due to hydrocephalus and diffuse intracellular gray matter edema as a consequence of severe cerebral ischemia were detected.…”