The importance of activity …

We often come up with and need to come up with ‘projects’ that will help our son access new things, even everyday things, try them out, and hopefully find something he really enjoys doing. We have been through many things, most of which are eagerly accepted initially, but in many cases, interest is lost and we need to move on to find something else. In time we hope to return to some as he has shown a real talent for them.

The importance of activity is to hold his mind in focus, so that fear, uncertainty and perceived recollections of darker days, are kept at bay.  Using principles of Mindfulness, we try and engage totally in the activity, holding the moment and exploring what we see, hear and feel.

This particular project is based around photography. We look to set up the ‘shot’ together, talking about what we see in the frame, what colours do we see? what are we focusing the camera on? and what we can call the resulting image. We touch the textures of the leaves and petals, some we will smell to check the perfume – we like Lavender and Mint – our cat likes Nepeta! In this particular shot, we also dip a finger in the pond, is the water warm or cold? does it have ice on top? can we see any little creatures in it? The beauty of this project is that we can return to the pot each month and see the changing flowers and colours, giving something new to talk through. This picture was named ‘The February Garden’ allowing us a twelve-month project of ever changing flowers.The resulting pictures can form an entry in a photo album, creating a social story that we can refer to at a later date to rekindle positive memories and recollections of a positive activity.

We manage no more than an hour and then we need to change activity to keep interest and motivation high. Awareness of doing too much is critical, as frustration or confusion can kick in suddenly and the work to create a positive activity will be lost immediately and may not get returned to. We have had to leave many things undone or incomplete, but this is far better than the emotional and anxiety based consequences of sticking with it. Those mistakes we have made, and we still make.

The importance of activity must be accompanied by the importance of understanding and awareness. Correctly balanced, and everything is possible.

Wheel-walk #2 – Hollingworth Lake Country Park. Rochdale


Over the lake to 'The Wine Press'

Over the lake to ‘The Wine Press’

Name:       Hollingworth Lake Country Park

Address: Rakewood Road

Post Code: OL15 0AQ

Distance: 2.5 miles (4.0km) appx

Ground Type: Gravel and Tarmac



Area and History

Hollingworth Lake was once known as “The Weavers’ Seaport” a very popular spot to visit for the local Weavers until transport made it possible to access places like Blackpool and the lake saw a decline in visitor numbers.

Today, visitors can continue to enjoy many outdoor attractions, and the Visitor Centre. The Park covers 118 acres and the lake remains one of the most popular places for a day out in the area. The Park can boast boating, a nature reserve, trails, events, guided walks play areas and picnic areas as well as environmental exhibitions and community arts within the Visitor Centre.

The Lake is a base for a sailing and rowing club and the Water Activity Centre caters for those wanting instruction in windsurfing, dingy sailing and other water based sports as well as mountain biking and climbing.

The wider Country Park has plenty of walking routes, from easy strolls around the lake shore – and subject of this guide – to sturdier treks in the surrounding hills. This location is served by a number of cafes, pubs and restaurants as well as Bed and Breakfast locations and a Caravan and Camping site.

The lake was originally built as the main water source for the Rochdale Canal, but developed as a tourist location from the late 1860’s. The railway arrived in 1839 which brought day trippers and weekend visitors from Manchester, Bradford and Leeds.

In 1974 the area was developed into the Hollingworth Lake Country Park by Rochdale Council and it has been developing steadily ever since and is now a thriving centre for water sports and other activities. In 1875 the lake was used for training by Captain Matthew Webb before he became the first man to swim the English Channel and was used for the ‘World Professional Mile Championship’, a long distance swimming event, in the 1880’s. Rochdale’s Hollingworth Lake Rowing Club has used the lake continuously since 1872.

The scenic walk, 2.5 miles (4.0km) appx. Around the lake, passes a nature reserve with a bird hide in an area where the boats and water sports are prohibited. The lake provides habitat for a variety of wildlife and is used for fishing. The path around the lake is mainly a good, level gravel track from the Beach Hotel to the far side of the lake when you come will come across a café with all amenities including an easy access toilet, and at this point the gravel become tarmac around to Rakewood Road and then along Hollingworth Road. It is important to note that Rakewood Road is a vehicular route and for the most part, there is no footpath and you will be walking along the narrow road. When you reach the Wine Press and Hollingworth Road, there is a pedestrian footpath separate from the road.

Disabled car parking can be found at the Visitor Centre – and currently no charge for ‘blue badge’ holders, and also at the Watersports Centre on Hollingworth Road, adjacent to the Beach Hotel. There are also disabled toilet facilities in this car park.

Hollingworth Lake Country Park Visitor Centre

Hollingworth Lake Country Park Visitor Centre

This is a circular route, so eventually you will return to the point you set off. My personal preference is to park at the Visitor Centre, where you can get a drink, look at any events or exhibitions that may be displayed and there is also a small sensory garden to experience provided by the friends of Hollingworth Lake. A good place to relax after your walk. There is a short incline from the car park to the lake which may deter you from using this car park, in which case, make your start from the Watersports Centre but I have not had a problem getting up this incline with either Power Chair or Self Propelled Chair.

The walk

As you head out of the Visitor Centre car park, and reach the top of the slight incline, my preference world be to turn right and when you find a safe place to cross the road, you need to be on the lake side footpath heading towards ‘The Wine Press’

The Wine Press

The Wine Press

Rochdale Council have been very good at introducing drop kerbs, but even so, you will find that some still have a rise that we found a challenge in the power chair, but self-propelled chairs or pushchairs are fine as you can get a reasonable tilt on them to overcome the rise. As our power chair struggles with anything over a 10mm rise, we have taken to carry a portable collapsible ramp, for times like this. It packs away nicely and very lightweight and is able to be carried strapped on the back of the chair. [check my page ‘You might be interested in’ for some support suggestions]

When you reach the junction, with ‘The Wine Press’ on your right, follow the footpath left, moving down a small gradient onto what looks like the Lake ‘promenade’ fenced to the lakeside and stone wall to the road side of this footpath if you pause in your walk you will get fabulous views over the lake towards Rakewood Viaduct carrying M62 into Yorkshire from Lancashire and Manchester.

Lakeside Promenade

Lakeside Promenade

As you walk along, you will pass a pump station, and if you’re lucky you may see rowers out practicing, or yachtsmen/women as well as wind surfers. I would also recommend looking along the edges of the pathway for the plants that are ‘growing in the gaps’ amongst the colourful weeds you can catch sight of other plants that have taken hold over time. Keep walking along the pathway, which will split to offer an opportunity to reach a higher level parking spot and benches, but stay on the lower pathway as this skirts the lake and exits into the Hollingworth Road car park.

This area is where the main sailing activities are launch from and boasts picnic areas, cafés and toilets, including accessible facilities. It is here that I would suggest you park if you wanted to avoid the incline out of the visitor centre car park. If so, pick up our walk from this point and follow the details I have already started with when you reach that point in this walk, where we conclude.



At this point of our walk we pass through the car park and head towards the exit point over to your left as you leave the footpath. You will see an array of shops and cafés over the road here, but unless you want to visit these, turn left along the road keep to the narrow footpath until you reach the car park of the Beach Hotel, once again you need to cross this car park and head for the right hand side of the building which gives you access to the ‘restricted access’ part of this walk on a gravel bed. You will pass through a restricted access point which allows for wheelchair and pushchair with ease, it is vehicular access that is restricted.


Re-enter the Country Park walk

Re-enter the Country Park walk

You will now get a sense of being in a country park as the lake once again opens up in front of you. Follow the path around to your right. Its width is ideal to allow cyclists, runners, walkers, wheelchair and pushchair users easy access in either direction. My preference to walk this way, is that you pass the ‘hustle’ of the car parking areas first when you have more energy, and as you get to the end of the walk and perhaps tiring a little, the walk is more leisurely.

As you walk towards the end of the lake, you will see some fascinating ‘grand design’ architecture on your right, constructed by those eager for lakeside view residences and have completely restructured the original dwellings. When you do get to the edge of the lake, be sure to look out for some of the signs of the old ‘Rochdale’ with cobbled access points and dry stone walling. Benches are plentiful up to this point, so if you are with anyone walking, there are ample opportunities to sit and watch …….. and open your flask!

Benches and beautiful views

Benches and beautiful views

Restarting your walk, you will – if starting at the Visitor Centre car park – nearing the half way point and as you naturally face the opposite end of the lake here you will see in all its glory ‘The Wine Press’ and behind that ‘Blackstone Moors’ – depending upon time of year, these can be coated white as the snows usually hit this part of the Pennines, even if Rochdale in the valley remains unaffected. Keep walking around the track, it will take you around to the right, opening up another countryside view and then to the left as you walk along one of the walls to this reservoir, turning sharply left when you reach the end. By now you will have seen many ‘bridleways’ and ‘footpaths’ leading off this walk and they are well worth exploring if you are able – sadly these are not accessible to the wheelchair, but I will include images of these walks in a later post so everyone can have the benefit of seeing what I do and maybe give some recommendations about suitability of a ‘Tramper’ over this terrain.

Having turned left we again follow the footpath, at this point you may well be accompanied by horse riders who use the nearby stables and are regular users of some of these lanes. Keep following the path and you will reach another sharp left turn and building which was once used by the sailing club.

Horse Riding

Horse Riding

Now largely disused you will pass in front of this building and carry on along the lane. Shortly you will come across another café, with picnic area, toilets and easy access toilets (Remember to have packed your RADAR Key) – in truth, these are basic, but clean enough and fully functional and as we are out on a country park, you would not expect ‘Hotel’ levels of finish, and I have come across far worse.

Time for another short break if you feel like it, look across the lake at the places you have walked, our ‘Grand Design’ houses, Watersports Centre and car park, ‘The Wine Press’ and Blackstone Moors, and you will see recently introduced Wind Turbines dotted along the moors looking like sentinels watching over the town from on high. Again depending up the time you complete this walk, you may see competitive rowing, certainly practicing, sailing, wind surfing, fishing, many dogs having fun in and out of the water at the shoreline and possibly a range of birds, Heron, Cormorant, as well as the ducks, swans and seagulls as we are about to head towards the protected bird and wildlife park. A word of caution at this point and that is to be cautious of vehicles, the terrain is tarmac from this point, which is ideal for wheelchair, but it is also used as a service road for this café, not heavy traffic, but access non-the-less.

When you’re ready, again follow the pathway in the direction we have been heading, the path moves ever so slightly downhill here and just at the bottom you will meet up with a junction where other walks I referred to, converge with our main track, keep following the main path along the lakeside you will see fields on your right and naturally grown plants to you left, a path heading down to a bird hide will appear on your left if you want to take advantage, though the viewing openings may be a little high to

Follow the path to the left

Follow the path to the left

view from a wheelchair. Continue around the pathway following it to the left, you will see on your right a caravan and camping site, ideal for those from out of town who want to explore this and local areas. Walking along the path you will leave the caravan and camping site and come upon a children’s play area before traveling over a small bridge to a junction in the road. At this point turn left.

You will be walking in the road here, it’s narrow with passing places for vehicles and a drop to a brook on one side and the lake on the other side of the road for quite a length, so do take care as you come along this stretch. Once again you will see footpaths leading from this road that take you into some of the areas hamlets and fields.

Care at all times along this stretch of the walk

Care at all times along this stretch of the walk

My suggestion is to walk on the right hand side of the road. It’s always advisable to walk facing oncoming traffic and also as we reach the point where there is a footpath, it will be easier when we turn back off this road into the Visitor Centre car park, to be on the correct side of the road. As you reach the footpath, do take it, you will pass another pump house and drain hole and depending upon water levels, you may just see overflow water being pumped away to the rivers and fields. Another point of caution at this point, you will be walking along [although it is a road] the wall of the reservoir – any breeze blows like a gale across the water at this point and you may feel the chill and if your unsteady, be prepared as there is a grassy bank at the side of the footpath, if you lose your balance, you may tumble!

As you walk along the footpath, you will see the turn-off on your right to the Visitor Centre car park and where your walk began. When you get to this point you will have completed approximately 2.5 miles (4.0km) and could chose to call it a day, go the café and have a cup of tea, or you could reverse the route and walk around again in the opposite direction, [It’s fun and you will get a completely different perspective] or just complete it again, the same way around – if you are in a power chair, do check on your battery reserves – If you started your walk from the Water Sports Centre car park, you will need to follow this road to the end, at ‘The Wine Press’ and then turn left following the ‘Promenade’ walkway along the lakeside until you reach the car park you left from.

I hope you find this guide useful and informative, I’d love to get your feedback on it and if you can add to it, please let me have any information you feel I should consider. I’d also love to see your photographs of your walk and I can add a scrapbook of pictures to help others see how accessible this walk really is, and encourage them to get outside and enjoy the great outdoors.


Autism (NHS Choices)

Autism spectrum disorder (ASD) is a condition that affects social interaction, communication, interests and behaviour. It includes Asperger syndrome and childhood autism.

The signs of ASD typically start to develop in childhood.

It’s estimated about 1 in every 100 people in the UK has ASD. More boys are diagnosed with it than girls.

There’s no “cure” for ASD, but a range of educational and behavioural support programmes can help people with the condition.

Read about help and support available for people with ASD.

Signs and symptoms

People with ASD tend to have problems with social interaction and communication.

They can find it hard to understand other people’s emotions and feelings, and have difficulty starting conversations or taking part in them properly. Language development may be delayed.

People with ASD are often only interested in certain things, have repetitive behaviours, and like to stick to a set routine. They tend to get upset if these routines are disrupted.

Children and young people with ASD frequently experience a range of cognitive (thinking), learning, emotional and behavioural problems. For example, they may also have attention deficit hyperactivity disorder (ADHD), anxiety, or depression.

About half of those with ASD have some degree of learning difficulty. However, many people are able to be independent with appropriate support.

Read more about the symptoms of ASD.


About epilepsy

In the UK, there are over 600,000 people with epilepsy.

Any one of us can have a one-off epileptic seizure. But if you have epilepsy, it means you have had more than one epileptic seizure. And you could have some more in the future.

Around five people in every 100 will have an epileptic seizure at some time in their life. Out of these five people, around four will go on to develop epilepsy

There are many types of epilepsy. Some types of epilepsy start when you are very young, and some in later life. Some types last for a short time and other types can last for the whole of your life.

The causes of epilepsy

In around six out of 10 people, doctors don’t know the cause of their epilepsy. For many of these people, it is just part of how they are made that makes them more likely to have a seizure.

Some people do have a cause for their epilepsy. One cause can be brain damage. There are a number of things that can cause brain damage. These include:

  • a difficult birth
  • a brain infection, such as meningitis
  • a stroke
  • a serious brain injury.

There doesn’t have to be damage to your brain for you to have epilepsy. You could have a medical condition in which it is quite common to also have epilepsy. Some of these conditions are tuberous sclerosis and cerebral palsy. In some people with a learning disability, the cause of their learning disability can also cause their epilepsy.

When epilepsy begins in later life, it’s more usual for doctors to find a cause. For example, you may be recovering from a stroke . Or, you may have had an accident or illness at some time in your life that left some scarring on your brain.

About epileptic seizures

Electrical activity is happening in our brain all the time. A seizure happens when there is a sudden burst of intense electrical activity in the brain. In this information this intense electrical activity is called ‘epileptic activity’.

Seizure types

There are many different types of seizure. They can be classed by where in the brain the epileptic activity starts.

Focal (partial) seizures

In these seizures, the epileptic activity starts in just a part of your brain. You may stay alert in this type of seizure. Or you may not know what is going on around you. Parts of your body may move and you can’t stop it. Or you may have unusual sensations or feelings. Sometimes, other people may not be aware that you are having a seizure.

Focal seizures can be very brief or last for minutes. Sometimes, epileptic activity starts as a focal seizure, spreads to the rest of your brain and becomes a generalised seizure.

Generalised seizures

These seizures involve epileptic activity in both halves of your brain. You lose consciousness during this type of seizure, although sometimes it can be so brief that no one notices. Sometimes it can last for many minutes. The muscles in your body may stiffen and/or jerk. You may fall down.

Things that trigger seizures

Some things make seizures more likely for some people with epilepsy. These are often referred to as ‘triggers’. Triggers are things like stress, not sleeping well and drinking too much alcohol. Some people say they have more seizures if they miss meals. Not taking your epilepsy medicine is another common trigger. A very small number of people with epilepsy have seizures triggered by lights that flash or flicker.

Avoiding triggers lowers the risk of having a seizure.

Wheel-walk #1 – Fleetwood (Lancashire)

Setting off

Setting off

Name:       Fleetwood Esplanade


Address:  The Esplanade, Fleetwood

Post Code: FY7 6BN

Distance: 3.4 miles (5.5km) appx

Ground Type: Tarmac & Concrete



Area and History

The Victorian town of Fleetwood, in Wyre, is nestled at the meeting point of the majestic River Wyre and the Irish Sea and with its long stretch of sandy beach, it’s a popular seaside destination for families. Fleetwood is believed to be the first planned town of the Victorian Era and Queen Victoria herself passed through it on her way from London to Scotland in 1847. Fleetwood’s Victorian buildings and monuments are still some of its most appealing attractions. The Mount is a leafy, seven-acre park built on a large sand dune. For fantastic sea views go up to the stately Pavilion, built in 1902, at the summit. If you continue your wheel-walk across The Esplanade you’ll come to the Marine Hall, a 1930s architectural gem, which is surrounded by the attractive, flower-filled Marine Gardens where there’s also a bowling green, pitch and putt and children’s playground. Fleetwood is also a well-known shopping destination with a fantastic range of historic and modern shopping venues. Fleetwood Market is housed in an attractive Victorian building and is one of the largest covered markets in the North West. Its 250 stalls sell all manner of goods. Alternatively, visit Freeport Fleetwood, a modern, waterfront outlet shopping village which has 45 bargain clearance shops including Next, M&S, and Gap.

Fleetwood is located on the Fylde Peninsula, 8 miles (13 km) north of Blackpool on the western side of the mouth of the River Wyre. The town itself is on a peninsula, almost 2 miles (3 km) wide, bounded to the west by the Irish Sea to the north by Morecambe Bay, and to the east by the River Wyre. Access to Fleetwood is thus restricted, and for many years there were only two roads into and out of the town. A large sandbank, the North Wharf, extends some 2 14 miles (3.6 km) north into Morecambe Bay, and is exposed at low tide. The river channel forms the eastern boundary of the bank. Together with the larger Bernard Wharf on the other side of the river, this makes navigation of the river difficult. Conversely, the port is highly sheltered from the prevailing westerly winds.

The Mound

The Mount

Like the remainder of the Fylde, the land is extremely flat, the highest point being the Mount, the large sand dune in the northern part of the town, from which the original street plan radiated. Parts of Fleetwood, especially to the north and west, are barely above sea level at high tide, and a large retaining sea wall runs along much of the western edge of the town. Nevertheless, Fleetwood was flooded in 1927, and again in 1977. The latter flood, although much smaller, affected more properties as there had been considerable development in the 1960s in the lower-lying parts of the town. The soil is broadly sandy, but there is considerable marshland to the south and east, by the river. The town itself encompasses an area of just under 4 square miles (10 km2).

In common with the rest of the coastal areas of the UK, Fleetwood has a maritime climate. Prevailing winds and weather patterns are north-westerly, leading to a slightly higher average precipitation than the country as a whole, although the absence of high ground in the immediate vicinity moderates this. As with most coastal areas, frost and snow are uncommon. Temperatures are close to the national average.

This is a linear route, and so I have identified a natural point at the Coastal Watch Station, where you can turn around and head back and eventually you will return to the point you set off. Though it can be extended if energy and battery power remain and I’ll explain more later.

The walk

Though I make reference to ’Beach’ this walk in fact takes the esplanade and promenade from Fleetwood towards Cleveleys, and on this walk, stopping at Rossall, and back again if you wish. It is primarily a linear route, though you can deviate slightly if you want to add a little variety to the walk. Don’t underestimate the time and distance in the walk even for an able bodies companion, it is flat all the way but quite easily could turn into a 10 – 12 mile round trip if you add a couple of walks together.

Power chair batteries need to be capable of this distance comfortably or you will need to make arrangements for a return journey, possibly via bus or tram. We chose to start our walk at Fleetwood. If you make your way to the North Euston Hotel, there are Public Conveniences directly opposite the entrance with disabled/baby changing facilities. Do remember to bring some loose change (20p when we were last there—change is not given) or your RADAR key. We find that we need frequent ‘convenience’ stops and this, and my other walks do refer to these to help your planning.

Starting point

Starting point

If you cross over the road onto the esplanade, you will stay on that walkway all the way which is ideal and free from vehicles and wide tarmac or concrete under foot. Have your back to Fleetwood Lower Lighthouse now disused and head south. Lower Lighthouse is one of three – Fleetwood is the only town in Great Britain to have three – Lower Lighthouse is 44 feet tall, Upper Lighthouse (Pharos) is 93 feet tall. Both designed by Decimus Burton and opened in 1840 and the Pharos was rebuilt in 1906. For many years these two lighthouses were painted white, with red tops, but in the twentieth century they were sandblasted back to their original stone. The third lighthouse was also built in 1840 and was situated one and a half miles out to sea in an area known as Wyre Light. This was a wooden structure and most of which was destroyed by fire on 1948. It does however live on in the book ‘The Sea Swallow’ by Gareth Thompson.

You will find the footpath wide and easy to walk along. I would urge you not to just put your head down and walk, but do take time to look at what is going on around you, even at this early stage of the walk. Since the burning down of the pier, Fleetwood has received considerable investment and this Victoria treasure has many landmarks all around. As you start walking you may see Fishermen, Jet Skiers, Sailing boats and many people just having a great time.

Down to the beach

                                                                     Down to the beach

As you walk past the former Fleetwood Pier site – this was burned down in 2008 and the site now

has planning consent to build a two story, eighteen-bedroom hotel and approach the Marine Hall, take the road to your right and head slightly downhill following the path past beach huts on your left and the beach on your right. The Marine Hall was also rebuilt in 2011/12 to create a modern outdoor entertainment area, with outdoor stage and colonnade.

Head towards the beach and follow the pathway around to the left where you will pass between the Marine Hall and beach and follow the path.

Distant Coastal Watch Tower

Distant Coastal Watch Tower

This is a straight path, but I would urge you to take your time and look about you as you walk. If your party includes able bodies walkers, there are plenty of benches they can take advantage of and you will see your destination in the distance as the Coastal Watch Tower stands high on the horizon with an uncanny ‘lean’ towards the sea. Sadly, when you reach this point, there is no lift to the viewing level, but if stairs can be managed, there are magnificent views out across the Irish Sea, a huge Nautical Wind Farm, and looking North, you will see the South Cumbrian Coast line and a little nearer, the Heysham Nuclear processing plant from this level. Do not be deterred id you are unable to access it as the views from the footpath are equally impressive.




As you approach this point you will pass a number of Groynes that are in place to help prevent the beaches being washed away. Within each section you will likely see Sea Fishing, as well as picnics and good family fun.

As you arrive at the Coastal Watch Station, there is a free to enter information office, with may leaflets and volunteers to explain their purpose and how they interact and work with the RNLI, Coast Guard and other services. You can easily spend an hour at this point and if you have brought your picnic, it’s an ideal spot to take a break. Disabled Easy Access toilets are sited within this tower too. Around the back you will find these and again RADAR key accessed (or 20p)

When you have reached this point, there are some choices for you:

  • For the purpose of this guide, I suggest that you begin to retrace your steps to you starting point. This will allow you to see the walk from a completely different perspective, and likely the tide will be at a different place for your return journey and so present you with a vastly new landscape. You may like to stop at the Marine Hall when you arrive at that point and explore the gift shops, café’s and entertainment or just sit in the sun on the green.
  • You can continue to retrace your steps, but as you come upon the connecting roads on your right, you can opt to follow these through to the main road and walk in parallel to the promenade but alongside the park’s and boating lakes back to your starting point. This will add variety to the walk if ‘just’ retracing your steps does not seem that exciting.
  • The third option to consider is to continue along the promenade in the direction you were heading, it is a fabulous walk and leads you eventually to Cleveleys. I cover this walk in my wheel-walking #7 – Cleveleys (Lancashire) but you can look to incorporate both together. A word of caution however, is that as this is a linear walk, a point comes when you will need to return and that journey may be done in the way you arrive or to have transport to take you back. A return walk would cover approximately 12 miles and so I would urge you to consider, both fitness and stamina, and also battery life if using, Power Chair or scooter.

I hope you find this walk and guide of interest and it has excited you to venture outside and in this case, to explore our coastal wonders. I would love to hear from you if you chose to use this guide. Are there any points I should include to make it better? Do you have a walk you think I should explore and include? I would also love to see your photographs as you follow my guide.



Hydrocephalus (NHS UK)
Symptoms of hydrocephalus
Hydrocephalus (fluid on the brain) causes slightly different symptoms depending on the type of hydrocephalus and the age of the person affected.
Congenital hydrocephalus
Babies born with hydrocephalus (congenital) often have distinctive physical characteristics. Physical signs in a baby include:

• an unusually large head
• their scalp may be thin and shiny with easily visible veins
• a bulging or tense fontanelle (the soft spot on the top of their head)
• their eyes may appear to be looking down; this is known as the ‘setting-sun sign’ because the eyes resemble the sun setting below the horizon
• the muscles in your baby’s lower limbs may appear stiff and be prone to muscle spasms

As well as these physical signs, congenital hydrocephalus can also cause symptoms such as:

• poor feeding
• irritability
• being sick
• drowsiness

Acquired hydrocephalus
Hydrocephalus that develops in adults or children (acquired) can cause headaches. The headache may be worse in the morning after waking up because the fluid in your brain doesn’t drain so well while you’re lying down and may have built up overnight. Sitting up for a while may improve your headache. However, as the condition progresses, the headaches may become continuous.

Other symptoms of acquired hydrocephalus include:

• neck pain
• feeling sick
• being sick (which may be worse in the morning)
• drowsiness, which can progress to a coma
• changes in your mental state, such as confusion
• blurred vision or double vision
• difficulty walking
• not being able to control your bladder (urinary incontinence) and, in some cases, your bowel (bowel incontinence)

Normal pressure hydrocephalus
Unlike the other two types of hydrocephalus, the symptoms of hydrocephalus that develop in older people (normal pressure hydrocephalus or NPH) usually develop slowly, over the course of many months or years.

NPH has three sets of distinctive symptoms. It affects your:

• mobility (how you walk)
• urinary system
• mental abilities
These are discussed below.

How you walk
The first noticeable symptom of NPH is a change in how you walk (your gait). You may find it increasingly difficult to take the first step when you want to start walking. Some people have described it as feeling as though they’re frozen to the spot. You may also shuffle rather than take proper steps.
As the condition progresses, you may become increasingly unsteady on your feet and be more likely to fall, particularly when turning.

Urinary symptoms
The change in the way that you walk is often followed by bouts of urinary incontinence, which may include symptoms such as:

• a frequent need to urinate
• an urgent need to urinate
• loss of bladder control

Mental abilities
The normal thinking process also starts to slow down. This can take the form of:

• being slow to respond to questions
• reacting slowly to situations
• being slow to process information

These symptoms may indicate that you have mild dementia. They should start to improve when NPH is treated.