What are symptoms of hydrocephalus in 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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Symptoms in adults include the following:

  • Cognitive deterioration: This can be confused with other types of dementia in the elderly.

  • Headaches: These are more prominent in the morning because cerebrospinal fluid (CSF) is resorbed less efficiently in the recumbent position. This can be relieved by sitting up. As the condition progresses, headaches become severe and continuous. Headache is rarely if ever present in normal pressure hydrocephalus (NPH).

  • Neck pain: If present, neck pain may indicate protrusion of cerebellar tonsils into the foramen magnum.

  • Nausea that is not exacerbated by head movements

  • Vomiting: Sometimes explosive, vomiting is more significant in the morning.

  • Blurred vision (and episodes of "graying out"): These may suggest serious optic nerve compromise, which should be treated as an emergency.

  • Double vision (horizontal diplopia) from sixth nerve palsy

  • Difficulty in walking

  • Drowsiness

  • Incontinence (urinary first, fecal later if condition remains untreated): This indicates significant destruction of frontal lobes and advanced disease.

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