Clinical Presentation of Hydrocephalus

Headaches and vomiting occurring mainly nocturnally and early in the morning are due to a native hydrocephalus, or in case of shunt-insufficiency combined with clouding of consciousness due to an episodic increase in an already increased basal pressure. The demonstrated curve of such a patient shows the increased basal pressure in mm mercury. The symptoms and signs (cephalea, restlessness, clouding of consciousness) are promptly reversible (consciousness, arrow at the end of the curve) if CSF is removed by puncture of the shunt, and the increased intracranial pressure is lowered. Equivalents of increased intracranial pressure in infants and toddlers are restlessness, irritability and crying, and, in case of long-standing hydrocephalus, less obvious signs $$hydr_16??(see alternate figure).