Investigations
A minimal series of investigations in hydrocephalus includes:
- skull X ray:
- assess skull size, suture diastasis; may be obvious in infants
- look for evidence of chronic raised pressure - erosion of the posterior clinoids
- look for associated defects - e.g. basilar invagination
- CT scan including contrast - reveals pattern of ventricular enlargement and, frequently, the site and cause of obstruction:
- generalised dilatation - suggests communicating hydrocephalus
- lateral and 3rd ventricles dilated:
- 4th ventricle normal - suggests aqueduct stenosis
- 4th ventricle absent or deviated - suggests a posterior fossa mass
- ultrasonography through the anterior fontanelle in infants - demonstrates ventricular enlargement but is less informative than CT
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