Which physical findings indicate hydrocephalus in children and adults?

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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Children and adults may demonstrate the following findings on physical examination:

  • Papilledema (optic nerve swelling), although this does not develop acutely

  • Failure of upward gaze: Due to pressure on the tectal plate through the suprapineal recess; the limitation of upward gaze is of supranuclear origin

  • Unsteady gait

  • Large head

  • Unilateral or bilateral sixth nerve palsy (secondary to increased ICP)

Children may also exhibit the Macewen sign, in which a "cracked pot" sound is noted on percussion of the head.

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