Hydrocephalus physical examination: Difference between revisions

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__NOTOC__
{{Hydrocephalus}}
{{Hydrocephalus}}
{{CMG}};
{{CMG}}; {{AE}} {{SAH}}
__NOTOC__
==Overview==
'''Associate Editor-In-Chief:''' [[User:zorkun|Cafer Zorkun]] M.D., PhD.{{KD}}
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]]


==Overview==
== Physical Examination ==
        Normal  0          false  false  false    EN-IN  X-NONE  X-NONE                                                                                                                                                                                                                                                                                                                                                          Physical examination shows progressive enlargement of head in infants and in older children, increased intracranial pressure signs are seen.
*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 anxious.
* 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==
* The patient is often sitting upright and has [[difficulty breathing]].


===Pulse===
* The patient is often [[confused]].
===Rate===
* [[Obesity]] may be present.
*[[Bradycardia]] may be present
====Rhythm====
*The pulse is regular


===Blood Pressure===
* The patient may complain of pain and may be in distress
*[[Hypertension]] may be present


===Respiratory Rate===
== Vital Signs ==
[[Apnea]] may be present in infants.


==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]]
* [[Sunsetting sign]]: This is inferior ocular deviation seen in hydrocephalus
* Features of [[chorioretinitis]] may be present in cases of TORCH infection
==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}}


*[[Abducens nerve palsy]] and
[[Category:Neurological disorders]]
*Vertical [[gaze palsy]]
[[Category:Disease]]
*[[Parinaud syndrome]] due to compression of the [[quadrigeminal plate]], where the neural centers coordinating the conjugated vertical eye movement are located
[[Category:Neurology]]
*[[Pyramidal tract signs ]]are seen in most cases
[[Category:Pediatrics]]


== References ==
{{WikiDoc Help Menu}}
{{reflist|2}}
{{WikiDoc Sources}}

Latest revision as of 01:41, 23 August 2018

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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

  • The physical examination of hydrocephalus is given below:[1][2][3]

Appearance of the Patient

  • The patient may complain of pain and may be in distress

Vital Signs

Pulse

  • The rate and rhythm is given below:
  • Rate
  • Rhythm
    • The pulse is regular.
  • Blood Pressure:
  • Respiratory Rate is given below:

Head

Infants

Older children

Eyes

Neurologic

References

  1. 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.
  2. 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.
  3. 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.


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