Hydrocephalus: Difference between revisions
| Line 10: | Line 10: | ||
*[[Nausea and Vomiting]] | *[[Nausea and Vomiting]] | ||
*[[Altered Mental Status]] | *[[Altered Mental Status]] | ||
===Pediatric=== | |||
''In addition to above:'' | |||
*Large fontanelles | |||
*Dilated scalp veins | |||
*"Cracked pot" sound on percussion | |||
*Irritability | |||
*Increased lower extremity tone | |||
*Remember that Babinski sign is normal up to 3 years of age | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 06:37, 24 September 2016
Background
- Caused by excessive cerebrospinal fluid accumulation, often from an obstructive process such as CSF shunt malfunction or subarachnoid hemorrhage
- Patients can also suffer from nonobstructive hydrocephalus due to excessive production of CSF[1]
Clinical Features
- Headache
- Diplopia
- Ocular Palsy - 6th nerve palsy, strabismus
- Papilledema
- Nausea and Vomiting
- Altered Mental Status
Pediatric
In addition to above:
- Large fontanelles
- Dilated scalp veins
- "Cracked pot" sound on percussion
- Irritability
- Increased lower extremity tone
- Remember that Babinski sign is normal up to 3 years of age
Differential Diagnosis
- Psuedotumor cerebri
- Meningitis
- Temporal arteritis
- Cavernous sinus or cerebral sinus thrombosis
- Migraine, Tension, or Cluster headaches
- Pre-eclampsia
- Hypertensive urgency/emergency
- Carbon monoxide poisoning
- Febrile Headache (ex: pyelonephritis, nonspecific viral infection)
Evaluation
- Physical Exam to assess for papilledema or neuro defects
- CT Brain non contrast
- In acute cases will see dilated ventricles and tight sulci
- In chronic cases (loss of tissue with age, alcoholism, etc) will see dilated ventricles with large amount of CSF in sulci
Management
Disposition
See Also
External Links
References
- ↑ Shprecher D. et al. Normal pressure hydrocephalus: diagnosis and treatment. Curr Neurol Neurosci Rep. 2008;8(5):371-376.