pediatrics
Hydrocephalus
Diagnosis of Hydrocephalus
Prenatal ultrasonography For neonates, cranial ultrasonography For older infants and children, CT or MRI Diagnosis of hydrocephalus is often made by routine prenatal ultrasonography. After birth, diagnosis is suspected if routine examination reveals an increased head circumference; infants may have a bulging fontanelle or widely separated cranial sutures. Similar findings can result from intracranial space-occupying lesions (eg, subdural hematomas, porencephalic cysts, tumors). Macrocephaly may result from an underlying brain problem (eg, Alexander disease or Canavan disease), or it may be a benign, sometimes inherited, feature characterized by an increased amount of CSF surrounding a normal brain. Children suspected of having hydrocephalus require cranial imaging by CT, MRI, or ultrasonography (if the anterior fontanelle is open). Cranial CT or ultrasonography is used to monitor progression of hydrocephalus once an anatomic diagnosis has been made. If seizures occur, electroencephalography may be helpful. 