clinical features of adult hydrocephalus

Last reviewed 04/2022

The presentation of hydrocephalus in adults is variable and dependent on the type and the underlying aetiology.

Features of an acute onset include:

  • features of raised intracranial pressure - headache, vomiting, papilloedema and impaired conscious level
  • impaired upward gaze (1)

Features of a gradual onset are similar to those seen in normal pressure hydrocephalus. These develop progressively and include:

  • mental impairment
  • gait apraxia; plantar reflexes often extensor; tendon jerks exaggerated or diminished
  • urinary incontinence due to sphincter dysfunction
  • hypopituitarism due to enlargement of the third ventricle into the posterior fossa (2)

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