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Tests and diagnosis
By Mayo Clinic staffA diagnosis of hydrocephalus is usually based on:
- Your answers to the doctor's questions about signs and symptoms
- A general physical
- A neurological exam
- Brain imaging tests
Neurological exam
The type of neurological exam will depend on a person's age. The neurologist may ask questions and conduct relatively simple tests in the office to judge:
- Reflexes
- Muscle strength
- Muscle tone
- Sense of touch
- Vision and eye movement
- Hearing
- Coordination
- Balance
- Mental status
- Mood
Brain imaging
Brain imaging tests can show enlargement of the ventricles caused by excess cerebrospinal fluid. They may also be used to identify underlying causes of hydrocephalus or other conditions contributing to the symptoms. Imaging tests may include:
- Ultrasound. Ultrasound imaging, which uses high-frequency sound waves to produce images, is often used for an initial assessment for infants because it's a relatively simple, low-risk procedure. The ultrasound device is placed over the soft spot (fontanel) on the top of a baby's head. Ultrasound may also detect hydrocephalus prior to birth when the procedure is used during routine prenatal examinations.
- Magnetic resonance imaging (MRI) uses radio waves and a magnetic field to produce detailed 3-D or cross-sectional images of the brain. This test is painless, but it is noisy and requires lying still. Some MRI scans can take up to an hour and require mild sedation for children. However, some hospitals may use a quick version of MRI that takes about five minutes and doesn't require sedation.
- Computerized tomography (CT) is a specialized X-ray technology that can produce cross-sectional views of the brain. Scanning is painless and takes about 20 minutes. This test also requires lying still, so a child usually receives a mild sedative. CT scans for hydrocephalus are usually used only for emergency exams.
References
- Hydrocephalus. American Association of Neurological Surgeons. http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Hydrocephalus.aspx. Accessed June 11, 2011.
- Hydrocephalus fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/hydrocephalus/detail_hydrocephalus.htm. Accessed June 10, 2011.
- Fishman MA. Hydrocephalus. http://www.uptodate.com/home/index.html. Accessed May 10, 2011.
- Diagnosis of hydrocephalus. Hydrocephalus Association. https://www.hydroassoc.org/hydrocephalus-education-and-support/learning-about-hydrcephalus/diagnosis-of-hydrocephalus. Accessed June 11, 2011.
- Graff-Radford NR. Normal pressure hydrocephalus. http://www.uptodate.com/home/index.html. Accessed June 10, 2011.
- Life-threatening complications of hydrocephalus. Hydrocephalus Association. https://www.hydroassoc.org/hydrocephalus-education-and-support/learning-about-hydrcephalus/life-threatening-complications-of-hydrocephalus. Accessed June 11, 2011.
- Hamilton MG. Treatment of hydrocephalus in adults. Seminars in Pediatric Neurology. 2009;16:34.
- Meningococcal vaccine: Who and when to vaccinate. Centers for Disease Control and Prevention. http://www.cdc.gov/vaccines/vpd-vac/mening/who-vaccinate.htm. Accessed June 28, 2011.
- Wetjen NM (expert opinion). Mayo Clinic, Rochester, Minn. July 6, 2011.
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