First sign of hydrocephalus in children is :
Post clinoid erosion
Large ffiead
Sutural diastasis
Thinned out vault
C i.e. Sutural diastasis In infants, the diagnosis of hydrocephalus is confirmed by USG (as the fontanel are open)Q and in most cases, it tells about the level of obstruction & cause (like Dandywalker & arachnoid cyst.) Also Remember Aqueductal StenosisQ is m.c. of obstructive / non-communicating hydrocephalus. Subarachnoid hemorrhageQ (which is usually a result of intraventricular hemorrhage in premature infant) is m.c. of nonobstructive / communicating hydrocephalus. In an infant accelerated rate of enlargement of head is the most prominent sign. Clinical presention is: open anterior fontanelQ, setting sun eye signQ, UMN signs & cracked pot / macewen signQ on percussion. Skull X Ray shows copper beaten sign, indicative of chronic raised intra cranial pressure (ICP)Q. In adults, erosion of dorsum sellaeQ occurs earliest in hydrocephalus.