Hydrocephalus in children: Clinical features and diagnosis
- Abilash Haridas, MD
Abilash Haridas, MD
- Pediatric & Cerebrovascular Neurosurgery, Children’s Hospital of Michigan
- Assistant Professor of Neurosurgery, Wayne State University
- Tadanori Tomita, MD
Tadanori Tomita, MD
- Yeager Professor and Division Head of Pediatric Neurosurgery,
- Director, Falk Brain Tumor Center
- Ann & Robert H. Lurie Children’s Hospital of Chicago;
- Professor and Vice-Chair, Department of Neurosurgery,
- Northwestern University Feinberg School of Medicine
Hydrocephalus is a disorder in which an excessive amount of cerebrospinal fluid (CSF) accumulates within the cerebral ventricles and/or subarachnoid spaces, resulting in ventricular dilation and increased intracranial pressure (ICP) [1,2]. Hydrocephalus can be congenital or acquired; both categories include a diverse group of conditions (table 1).
The clinical features and diagnosis of hydrocephalus in children will be reviewed here. The pathophysiology, etiology, management, and prognosis of hydrocephalus are discussed separately. (See "Hydrocephalus in children: Physiology, pathogenesis, and etiology" and "Hydrocephalus in children: Management and prognosis".)
This topic will focus on the clinical features and diagnosis of obstructive and communicating hydrocephalus in childhood, which are almost always associated with increased ICP. Normal pressure hydrocephalus, a condition seen predominantly in adults in which the cerebral ventricles are pathologically enlarged, but the ICP is not elevated, is discussed separately. (See "Normal pressure hydrocephalus".)
The prevention and initial management of hydrocephalus associated with intraventricular hemorrhage in preterm neonates is also discussed in greater detail separately. (See "Management and complications of intraventricular hemorrhage in the newborn".)
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- CLINICAL FEATURES
- Common signs and symptoms
- Clinical suspicion
- Physical examination
- Lumbar puncture
- Measurement of ICP
- Obstructive versus communicating hydrocephalus
- MIMICS OF HYDROCEPHALUS
- Reduced brain volume
- Benign extra-axial fluid of infancy
- Normal pressure hydrocephalus
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS