When is Hydrocephalus Diagnosed?

Signs and Symptoms

Hydrocephalus is typically diagnosed during infancy. Signs and symptoms are usually apparent early, making it easier to diagnose the condition. Common signs and symptoms indicative of hydrocephalus include:

1. irritability, agitation and increased crying
2. head circumference larger than normal for age
3. bulging fontanelle
4. sunsetting of the eyes
5. sleepiness
6. seizures
7. poor development of motor skills

In adults, hydrocephalus symptoms may develop slowly, even over a period of multiple years. If hydrocephalus has developed due to infection or an obstructive lesion, symptoms can include headaches, nausea, vomiting, trouble with balance and reduction of visual acuity.

Diagnosis

Hydrocephalus is usually diagnosed during infancy, as this is the time when the signs and symptoms are most noticeable and when the condition can be treated most effectively. A medical team consisting of a pediatrician, neurologist, and a neurosurgeon will typically collaborate to diagnose hydrocephalus. The diagnosis process includes:

1. Physical examination
2. Neurological examination
3. Brain imaging tests such as CT scan, MRI and ultrasound
4. Spinal tap or lumbar puncture
5. Other tests to check for any underlying causes

These tests are used to measure the amount of fluid in the brain, identify any buildup of fluid, and locate the source of the fluid. Depending on the patient’s overall health and other factors, the medical team will then decide on the best course of treatment.

Imaging

Hydrocephalus is often diagnosed through a medical imaging test. Magnetic resonance imaging (MRI) is the most commonly used imaging modality for evaluation of hydrocephalus. It provides a detailed image of the brain and is capable of detecting any structural abnormalities and blockages in the brain. Computed tomography (CT) scan is also used for diagnosis of hydrocephalus. CT scans are useful for detecting bone fractures and can help to determine if the patient has any other associated medical conditions. Ultrasound is another imaging modality used in diagnosis of hydrocephalus in newborns. It is useful for detecting increased intracranial pressure and any abnormal enlargement of the ventricles.

Treatment

Hydrocephalus is typically diagnosed when a doctor notices an increase in head size, as well as other symptoms like irritability, poor feeding, sleepiness, vomiting, and a bulging fontanelle. Treatment options depend on the type and severity of hydrocephalus. Treatments may include medications, shunt placement, or other interventions. Medications may be used to control seizures or reduce any increased pressure in the brain. A shunt is a tube surgically implanted in the ventricles of the brain to remove the excess cerebrospinal fluid and redirect it elsewhere in the body. In severe cases a surgeon may need to enlarge the skull and remove a portion of the bone to make more room for the brain. More complex cases may include reconstructive surgery, endoscopy, and endovascular treatments. Regardless of the type of treatment, any hydrocephalus requiring medical attention requires close monitoring after the initial treatment.