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When a physician taps fingertips on the skull, there may be abnormal sounds associated with thinning and separation of skull bones. Scalp veins may appear dilated.
The circumference of the entire head may be large, or only part of the head may be enlarged, most commonly the frontal area. Head circumference measurements, repeated over time, may show progressive enlargement.
The eyes may be depressed, with a "setting-sun" sign where the sclera (white portion of the eye) is visible above the iris (colored portion of the eyes). A neurologic examination may show specific deficits, and reflexes may be abnormal for the age of the child.
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