Which clinical finding most strongly suggests hydrocephalus in an infant?

Which clinical finding most strongly suggests hydrocephalus in an infant?

• A. Depressed fontanelle
• B. Bulging fontanelle
• C. Vomiting
• D. Irritability

Answer: (B)

A bulging fontanelle indicates increased intracranial pressure in an infant, which is a hallmark of hydrocephalus. The anterior fontanelle remains open in infancy, so when CSF accumulates and pressure rises, it pushes outward against the skull, causing the fontanelle to bulge and the scalp to feel tense. This physical finding is more specific to elevated ICP in infants than other signs. Vomiting and irritability can occur with many common pediatric conditions and are non-specific. A depressed fontanelle, on the other hand, suggests dehydration or low pressure rather than the high pressure seen with hydrocephalus. Therefore, a bulging fontanelle is the strongest indicator of hydrocephalus in an infant.

A bulging fontanelle indicates increased intracranial pressure in an infant, which is a hallmark of hydrocephalus. The anterior fontanelle remains open in infancy, so when CSF accumulates and pressure rises, it pushes outward against the skull, causing the fontanelle to bulge and the scalp to feel tense. This physical finding is more specific to elevated ICP in infants than other signs.

Vomiting and irritability can occur with many common pediatric conditions and are non-specific. A depressed fontanelle, on the other hand, suggests dehydration or low pressure rather than the high pressure seen with hydrocephalus. Therefore, a bulging fontanelle is the strongest indicator of hydrocephalus in an infant.