Case history
Case history
A 6-year-old boy presents with 3 to 4 weeks of morning headaches and intermittent vomiting without fever. The headaches improve throughout the day. Over the past 2 days, the headaches are lasting longer and the vomiting is more frequent, but after vomiting the headaches are much improved. The headaches are not localised to one side. On the day of presentation, the parents note that he is walking unsteadily.
Other presentations
Obstructive hydrocephalus may also result in sixth cranial nerve palsies (e.g., diplopia, impaired horizontal gaze). Infants can present with an increasing head circumference and bulging fontanelle. Other cerebellar effects include nystagmus and head tilt. Patients with metastatic disease in the spinal cord may present with back pain, weakness, and/or bowel or bladder dysfunction.
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