Hydrocephalus physical examination: Difference between revisions
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{{Hydrocephalus}} | {{Hydrocephalus}} | ||
{{CMG}}; | {{CMG}}; {{AE}} {{SAH}} | ||
==Overview== | |||
Physical examination shows progressive enlargement of head in infants. Depending upon the rate of development duration of hydrocephalus, signs of [[increased intracranial pressure]] may be seen, [[headache]], [[fever]], [[nausea]], [[vomiting]] | |||
== | == Physical Examination == | ||
*The physical examination of hydrocephalus is given below:<ref name="pmid15046669">{{cite journal |vauthors=Binder DK, Lyon R, Manley GT |title=Transcranial motor evoked potential recording in a case of Kernohan's notch syndrome: case report |journal=Neurosurgery |volume=54 |issue=4 |pages=999–1002; discussion 1002–3 |date=April 2004 |pmid=15046669 |doi= |url=}}</ref><ref name="pmid12163808">{{cite journal |vauthors=Bulger EM, Nathens AB, Rivara FP, Moore M, MacKenzie EJ, Jurkovich GJ |title=Management of severe head injury: institutional variations in care and effect on outcome |journal=Crit. Care Med. |volume=30 |issue=8 |pages=1870–6 |date=August 2002 |pmid=12163808 |doi= |url=}}</ref><ref name="pmid18365169">{{cite journal |vauthors=Mauritz W, Steltzer H, Bauer P, Dolanski-Aghamanoukjan L, Metnitz P |title=Monitoring of intracranial pressure in patients with severe traumatic brain injury: an Austrian prospective multicenter study |journal=Intensive Care Med |volume=34 |issue=7 |pages=1208–15 |date=July 2008 |pmid=18365169 |doi=10.1007/s00134-008-1079-7 |url=}}</ref> | |||
==Appearance of the Patient== | ==Appearance of the Patient== | ||
The patient may appear | * The patient may appear [[anxious]]. | ||
[[ | |||
* The patient is often sitting upright and has [[difficulty breathing]]. | |||
* The patient is often [[confused]]. | |||
* [[Obesity]] may be present. | |||
*[[ | |||
* The patient may complain of pain and may be in distress | |||
* | |||
=== | == Vital Signs == | ||
==Pulse== | |||
*The rate and rhythm is given below: | |||
*Rate | |||
**[[Bradycardia]] may be present. | |||
*Rhythm | |||
**The pulse is regular. | |||
*Blood Pressure: | |||
**[[Hypertension]] may be present. | |||
*Respiratory Rate is given below: | |||
**Increase in [[respiratory rate]]. | |||
**[[Apnea]] may be present in infants. | |||
==Head== | ==Head== | ||
'''Infants''' | '''Infants''' | ||
* Large head: [[Head circumference]] is measured and recorded. | * Large head: [[Head circumference]] is measured and recorded. | ||
* [[Anterior fontanel]] is wide and bulging | * [[Anterior fontanel]] is wide and bulging | ||
* Scalp veins are visible and prominent | * [[Scalp veins]] are visible and prominent | ||
'''Older children''' | '''Older children''' | ||
* Cranial bruit may be audible in cases of [[arteriovenous malformation]] | * Cranial bruit may be audible in cases of [[arteriovenous malformation]] | ||
* [[Macewen's sign]]: Tapping ([[percussion, medical|percussion]]) the skull near the junction of the [[frontal bone|frontal]], [[temporal bone|temporal]] and [[parietal bone|parietal]] bones will produce a stronger [[resonant]] sound when either hydrocephalus or a brain abscess are present. | * [[Macewen's sign]]: Tapping ([[percussion, medical|percussion]]) the skull near the junction of the [[frontal bone|frontal]], [[temporal bone|temporal]] and [[parietal bone|parietal]] bones will produce a stronger [[resonant]] sound when either hydrocephalus or a [[brain abscess]] are present. | ||
==Eyes== | ==Eyes== | ||
* [[Papilledema]] | * [[Papilledema]] | ||
==Neurologic== | ==Neurologic== | ||
*[[Abducens nerve palsy]]. | |||
*Vertical [[gaze palsy]]. | |||
*[[Parinaud syndrome]] due to compression of the [[quadrigeminal plate]], where the neural centers coordinating the conjugated vertical eye movement are intact. | |||
*[[Pyramidal tract signs]] are seen in most cases. | |||
== References == | |||
{{reflist|2}} | |||
[[Category:Neurological disorders]] | |||
[[Category:Disease]] | |||
[[Category:Neurology]] | |||
[[Category:Pediatrics]] | |||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Ahsan Hussain, M.D.[2]
Overview
Physical examination shows progressive enlargement of head in infants. Depending upon the rate of development duration of hydrocephalus, signs of increased intracranial pressure may be seen, headache, fever, nausea, vomiting
Physical Examination
Appearance of the Patient
- The patient may appear anxious.
- The patient is often sitting upright and has difficulty breathing.
- The patient may complain of pain and may be in distress
Vital Signs
Pulse
- The rate and rhythm is given below:
- Rate
- Bradycardia may be present.
- Rhythm
- The pulse is regular.
- Blood Pressure:
- Hypertension may be present.
- Respiratory Rate is given below:
- Increase in respiratory rate.
- Apnea may be present in infants.
Head
Infants
- Large head: Head circumference is measured and recorded.
- Anterior fontanel is wide and bulging
- Scalp veins are visible and prominent
Older children
- Cranial bruit may be audible in cases of arteriovenous malformation
- Macewen's sign: Tapping (percussion) the skull near the junction of the frontal, temporal and parietal bones will produce a stronger resonant sound when either hydrocephalus or a brain abscess are present.
Eyes
Neurologic
- Abducens nerve palsy.
- Vertical gaze palsy.
- Parinaud syndrome due to compression of the quadrigeminal plate, where the neural centers coordinating the conjugated vertical eye movement are intact.
- Pyramidal tract signs are seen in most cases.
References
- ↑ Binder DK, Lyon R, Manley GT (April 2004). "Transcranial motor evoked potential recording in a case of Kernohan's notch syndrome: case report". Neurosurgery. 54 (4): 999–1002, discussion 1002–3. PMID 15046669.
- ↑ Bulger EM, Nathens AB, Rivara FP, Moore M, MacKenzie EJ, Jurkovich GJ (August 2002). "Management of severe head injury: institutional variations in care and effect on outcome". Crit. Care Med. 30 (8): 1870–6. PMID 12163808.
- ↑ Mauritz W, Steltzer H, Bauer P, Dolanski-Aghamanoukjan L, Metnitz P (July 2008). "Monitoring of intracranial pressure in patients with severe traumatic brain injury: an Austrian prospective multicenter study". Intensive Care Med. 34 (7): 1208–15. doi:10.1007/s00134-008-1079-7. PMID 18365169.