Question

The doctor has diagnosed the newborn with hydrocephalus. What are the early symptoms of neonatal hydrocephalus?

Answer

The early symptoms of neonatal hydrocephalus primarily manifest as headaches. This is due to increased intracranial pressure causing traction and inflammatory changes in the meninges, blood vessels, and brain nerves, stimulating the nerves. Initially, the headaches are intermittent and may later develop into a persistent nature, mainly concentrated in the forehead and bilateral temporal areas, with varying intensity. They often worsen during coughing, sneezing, straining during bowel movements, bending over, or standing up. In severe cases of hydrocephalus, headaches may feel like being torn apart. Infants may not be able to express their headaches and instead may show signs of restlessness, high-pitched crying, or even hitting their heads. Sometimes, when the vestibular nerve in the ear canal is compressed, it can also cause tinnitus and dizziness. Since the fontanelle in infants is not yet closed and the skull sutures are open, they can partially relieve intracranial hypertension, so headaches are usually less severe than in adults.