Hydrocephalus physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];
Associate Editor-In-Chief: Cafer Zorkun M.D., PhD.Kalsang Dolma, M.B.B.S.[2]
Overview
Appearance of the Patient
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 ditress.
Vitals
Pulse
Rate
- Bradycardia may be present
Rhythm
- The pulse is regular
Blood Pressure
- Hypertension may be present
Respiratory Rate
Tachypnea may be present.
Head
- Large head: Head circumference is measured and recorded.
- 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
- Papilledema
- Sunsetting sign
Neurologic
- Abducens nerve palsy and
- Vertical gaze palsy
- Parinaud syndrome due to compression of the quadrigeminal plate, where the neural centers coordinating the conjugated vertical eye movement are located