The 3 W's of hydrocephalus are wet, wobbly, and wacky and are also known as Hakim's triad.
The wet, wobbly, and wacky which are the 3 W's of hydrocephalus describe the classic symptom group of bladder incontinence, walking trouble and memory or thinking changes that can occur in people with hydrocephalus.
The wet in hydrocephalus describes urinary incontinence or a strong sudden need to use the restroom.
The wobbly, in hydrocephalus describes the trouble walking, balance issues or even a slow, wide based "magnetic" step.
And the wacky, in hydrocephalus describes memory loss, confusion, or even slow thinking, which can look like dementia.
Certain types of hydrocephalus can also make you pee a lot and can cause urinary frequency, urgency and even loss of bladder control.
The urinary symptoms of hydrocephalus is a core sign of NPH or normal pressure hydrocephalus, which is a form of fluid buildup in your brain, which mostly affects older adults and can also appear in children.
The signs of NPH and hydrocephalus are bladder changes like needing to pee a lot, sudden strong urges to pee or even bladder leaks.
Walking trouble, like shuffling steps, poor balance or even a hard time walking and even mild memory loss, confusion, or trouble focusing.
Some people with hydrocephalus do also sleep a lot, although the sleep patterns in people with hydrocephalus also vary widely depending on the person's age as well as the type of hydrocephalus.
People with hydrocephalus can and sometimes do experience excessive daytime sleepiness or unusual lethargy, and other people with hydrocephalus experience insomnia or trouble sleeping.
Adults that have normal pressure hydrocephalus often report high levels of daytime sleepiness, which can also sometimes improve after shunt surgery.
And babies with hydrocephalus may also sleep a lot during their first year of life as their brains rest and heal.
And sudden or extreme sleepiness, lethargy, or difficulty waking up can also be a sign of increased intracranial pressure or a malfunctioning shunt, which also requires immediate medical attention.
Many people with hydrocephalus also experience, struggling with insomnia, frequent night waking or even restless sleep due to chronic headaches, pain or anxiety.
Hydrocephalus does sometimes make you tired as excess fluid and pressure inside your brain with hydrocephalus often causes severe fatigue, sluggishness or even extreme sleepiness, which can also be a warning sign that a medical shunt is either failing or is blocked.
Common signs of fatigue and pressure with hydrocephalus include feeling unusually exhausted or weak during the day, having trouble waking up from sleep or staying awake, having low energy levels and a general slowing of movement and even brain fog or trouble focusing.
Feeling some tiredness with hydrocephalus is normal although experiencing any extreme sleepiness or difficulty walking up with hydrocephalus can mean that dangerous pressure is building up in the brain, so you should get emergency medical attention right away if the tiredness also comes along with bad headaches, throwing up or feeling sick to your stomach, vision changes like blurry vision or double vision or any fever or redness around the shunt site.
The gait of hydrocephalus is an apraxic gait or magnetic gait where the feet of the person with hydrocephalus appear glued or even stuck to the floor.
The gait with hydrocephalus is often slow, unsteady and wide based with short, shuffling steps.
The key characteristics of the gait of hydrocephalus include:
Magnetic foot placement, where the feet seem stuck or even have a hard time clearing the ground.
Short and shuffling, in which stride length is reduced significantly.
Slow speed, where walking velocity drops notably.
And impaired balance, where the person has a broad based stance with frequent unsteadiness and a high risk of falls.
And trouble starting or turning, where the person with hydrocephalus has difficulty initiating the first step or making turns.
Having a gait disturbance is also often the first and most prominent sign of hydrocephalus or NPH and it often also appears alongside of the classic clinical triad, which includes.
Urinary incontinence and cognitive impairment such as mild memory loss or executive dysfunction.
The three common signs of hydrocephalus include severe headaches, nausea or vomiting, and vision problems such as blurred or double vision.
In older adults with normal pressure hydrocephalus, the classic signs are difficulty walking, memory or thinking changes, and loss of bladder control.
Signs of hydrocephalus in Infants include:
Rapid increase in head size.
Bulging or tense soft spot on the head.
Eyes fixed downward. (sunsetting eyes)
Extreme sleepiness or irritability.
Signs of hydrocephalus in Older Children and Adults include:
Frequent headaches.
Nausea and throwing up.
Trouble with balance and walking.
Memory loss or confusion.
Someone with normal pressure hydrocephalus (NPH) walks with a slow, unsteady, and wide-based gait often called a "magnetic gait".
Their feet appear stuck or glued to the floor, forcing them to take short, shuffling steps with a high risk of falling.
Characteristics of an NPH Gait in hydrocephalus include:
Magnetic feet: Feet seem heavy and attached to the ground, making it hard to lift them up.
Shuffling steps: Steps are very short, low to the ground, and lack normal bounce or fluid motion.
Wide stance: Feet are placed farther apart than normal to help keep balance.
Turning trouble: Difficulty making sharp turns or freezing in place when trying to move forward.
Imbalance: General unsteadiness that mimics being drunk or severely off-balance, often leading to frequent falls.