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Normally, a child's pediatrician will suspect hydrocephalus when the child shows signs of neurological distress, such as persistent sleepiness, vomiting or seizures, combined with an unusually large or rapid increase in head size. The diagnosis can be confirmed in several ways, including ultrasound, CT (computed tomography) scans, MRI (magnetic resonance imaging) or intracranial pressure monitoring, which allows direct measurement of pressure through an opening in the skull. When placing the ICP monitoring device, neurosurgeons can also drain off excess fluid to see if symptoms improve.
Hydrocephalus also occurs along with other complex genetic disorders, and may be diagnosed before birth based on routine ultrasound tests. In those cases, parents may want to seek the advice of a neurosurgeon from the antenatal evaluation unit at Children's Hospital Boston. Neurological surgery is rarely performed before birth, but often an evaluation will allow surgeons to be fully prepared to operate, if necessary, shortly after birth.
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