Diagnosis of hydrocephalus by cranial transillumination.

A full-term neonate was examined to have significant macrocephaly (>>97th percentile), widened cranial sutures and a large bulging anterior fontanelle (AF). A light-emitting diode source applied on the AF revealed asymmetrical cranial transillumination, predominantly on the right (figure 1A). He was alert with spontaneous movements of all limbs but had generalised upper motor neuron (UMN) signs of hypertonia and hyper-reflexia. These signs indicated raised intracranial pressure from a possible right hemispheric cystic lesion. Figure 1 (A) Cranial transillumination of the skull through the anterior fontanelle showing asymmetrical transillumination, affecting …