Hydrocephalus physical examination: Difference between revisions
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'''Associate Editor-In-Chief:''' [[User:zorkun|Cafer Zorkun]] M.D., PhD.{{KD}} | '''Associate Editor-In-Chief:''' [[User:zorkun|Cafer Zorkun]] M.D., PhD.{{KD}} | ||
==Overview== | ==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. | 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. | ||
==Appearance of the Patient== | ==Appearance of the Patient== | ||
The patient may appear [[anxious]] | The patient may appear [[anxious]] | ||
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[[Obesity]] may be present. | [[Obesity]] may be present. | ||
The patient may complain of pain and may be in distress | The patient may complain of pain and may be in distress | ||
==Vitals== | ==Vitals== | ||
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====Rhythm==== | ====Rhythm==== | ||
*The pulse is regular | *The pulse is regular | ||
===Blood Pressure=== | ===Blood Pressure=== | ||
*[[Hypertension]] may be present | *[[Hypertension]] may be present | ||
===Respiratory Rate=== | ===Respiratory Rate=== | ||
[[Apnea]] may be present in infants. | [[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. | ||
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* 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]] which is inferior ocular deviation due to hydrocephalic pressure on the mesencephalic tegmentum and paralysis of upward gaze. | * [[Sunsetting sign]] which is inferior ocular deviation due to hydrocephalic pressure on the mesencephalic tegmentum and paralysis of upward gaze. | ||
* Features of [[chorioretinitis]] may be present in cases of [[TORCH infection]] | * Features of [[chorioretinitis]] may be present in cases of [[TORCH infection]] | ||
==Neurologic== | ==Neurologic== | ||
*[[Abducens nerve palsy]] and | *[[Abducens nerve palsy]] and | ||
*Vertical [[gaze palsy]] | *Vertical [[gaze palsy]] | ||
*[[Parinaud syndrome]] due to compression of the [[quadrigeminal plate]], where the neural centers coordinating the conjugated vertical eye movement are located | *[[Parinaud syndrome]] due to compression of the [[quadrigeminal plate]], where the neural centers coordinating the conjugated vertical eye movement are located | ||
*[[Pyramidal tract signs]] are seen in most cases | *[[Pyramidal tract signs]] are seen in most cases | ||
== References == | == References == | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Grammar]] | |||
Revision as of 14:40, 23 July 2012
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Hydrocephalus Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Hydrocephalus physical examination On the Web |
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American Roentgen Ray Society Images of Hydrocephalus physical examination |
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Risk calculators and risk factors for Hydrocephalus physical examination |
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
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.
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 distress
Vitals
Pulse
Rate
- Bradycardia may be present
Rhythm
- The pulse is regular
Blood Pressure
- Hypertension may be present
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
- Papilledema
- Sunsetting sign which is inferior ocular deviation due to hydrocephalic pressure on the mesencephalic tegmentum and paralysis of upward gaze.
- Features of chorioretinitis may be present in cases of TORCH infection
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
- Pyramidal tract signs are seen in most cases