What are the signs and symptoms of hydrocephalus?

Updated: Jun 04, 2018
  • Author: Stephen L Nelson, Jr, MD, PhD, FAACPDM, FAAN, FAAP; Chief Editor: Jasvinder Chawla, MD, MBA  more...
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Clinical features of hydrocephalus are influenced by the patient's age, the cause of the hydrocephalus, the location of the obstruction, its duration, and its rapidity of onset.

Symptoms in infants include poor feeding, irritability, reduced activity, and vomiting.

Symptoms in children and adults include the following:

  • Slowing of mental capacity, cognitive deterioration

  • Headaches (initially in the morning)

  • Neck pain, suggesting tonsillar herniation

  • Vomiting, more significant in the morning

  • Blurred vision: A consequence of papilledema and, later, of optic atrophy

  • Double vision: Related to unilateral or bilateral sixth nerve palsy

  • Difficulty in walking secondary to spasticity: Preferentially affects the lower limbs because the periventricular pyramidal tract is stretched by the hydrocephalus

  • Drowsiness

Children may also exhibit stunted growth and sexual maturation from third ventricle dilatation. Adults may also have nausea that is not exacerbated by head movements; incontinence (urinary first, fecal later if condition remains untreated) indicates significant destruction of the frontal lobes and advanced disease.

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