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When a physician taps fingertips on the skull, there may be abnormal sounds associated with thinning and separation of skull bones. Scalp veins may appear dilated.
The circumference of the entire head may be large, or only part of the head may be enlarged, most commonly the frontal area. Head circumference measurements, repeated over time, may show progressive enlargement.
The eyes may be depressed, with a "setting-sun" sign where the sclera (white portion of the eye) is visible above the iris (colored portion of the eyes). A neurologic examination may show specific deficits, and reflexes may be abnormal for the age of the child.
The following tests may be performed:
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Transillumination of the head (shining a light against the head) may show abnormal fluid accumulation in various areas of the head.
- A head CT scan is one of the best tests for identifying hydrocephalus.
- A spinal tap and examination of the CSF may be performed (rarely).
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Skull x-rays show thinning and/or separation of skull bones and enlargement of the skull.
- A brain scan using radioisotopes may show abnormalities of the fluid pathway.
- An arteriography may show causes of hydrocephalus related to the brain's blood vessels.
- An echoencephalogram, a form of ultrasound of the brain, may show dilated ventricles caused by hydrocephalus or intraventricular bleeding.
This disease may also alter the results of a RHISA scan.
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