Clinical issue: A correct interpretation of radiological data in cases of suspected hydrocephalus is not possible when ignoring patient age and clinical symptoms.
Standard treatment: An in-depth knowledge of clinical findings is accordingly essential.
Innovations: New pathophysiological findings and a detailed assignment of previously unrecognized or ignored clinical symptoms to various entities of the spectrum of hydrocephalus disorders allow a coherent diagnosis drawn from clinical and radiological data. For this purpose it is necessary to know the specific symptoms of hydrocephalus in relation to age. Especially in chronic hydrocephalus, this is of utmost importance to avoid misdiagnosis.
Diagnostic work-up: The radiological method of choice depends on the age and the specific issue to be addressed.
Achievements: The typical clinical symptoms of different hydrocephalus entities presented here must be considered as confirmed knowledge.
Practical recommendations: Only the synopsis of clinical and radiological findings currently allows correct interpretation of imaging. There is a threat of misdiagnosis if interpretation is restricted purely to radiological findings as the sole predictive value of modern imaging is still too limited despite all innovations.