First sign of hydrocephalus in children is :
C i.e. Sutural diastasis In infants, the diagnosis of hydrocephalus is confirmed by USG (as the fontanel are open)Q and in most cases, it tells about the level of obstruction & cause (like Dandywalker & arachnoid cyst.) Also Remember Aqueductal StenosisQ is m.c. of obstructive / non-communicating hydrocephalus. Subarachnoid hemorrhageQ (which is usually a result of intraventricular hemorrhage in premature infant) is m.c. of nonobstructive / communicating hydrocephalus. In an infant accelerated rate of enlargement of head is the most prominent sign. Clinical presention is: open anterior fontanelQ, setting sun eye signQ, UMN signs & cracked pot / macewen signQ on percussion. Skull X Ray shows copper beaten sign, indicative of chronic raised intra cranial pressure (ICP)Q. In adults, erosion of dorsum sellaeQ occurs earliest in hydrocephalus.
Post clinoid erosion
Large ffiead
Sutural diastasis
Thinned out vault