Hydrocephalus

• Hydrocephalus 


  Imbalance of CSF absorption or production that is either the result of congenital complication or an acquired condition such as tumors, hemorrhage, infections, or trauma
•  Hydrocephalus results in head enlargement and increased ICP
• Hydrocephalus Types

  Communicating

  • Due impaired absorption within the subarachnoid space, obliteration of the subarachnoid cisterns, or malfunction of the arachnoid villi
• Hydrocephalus Types

  Non-communicating (obstructive)

  • Hydrocephalus occurs as a result of excess cerebrospinal fluid (CSF) due to structural blockage within the ventricular system
• Hydrocephalus Infant Clinical Manifestations

  Macewen’s sign - thin, widely separated bones of the head that produce a cracked-pot sound on percussion
• Hydrocephalus Infant Clinical Manifestations

  Sunset eyes
• Hydrocephalus Infant Clinical Manifesations

  Frontal enlargement - bossing sign
• Hydrocephalus Infant Clinical Manifestations

  Late signs: High, shrill cry and seizures
• Hydrocephalus Management

  Ventriculoperitoneal Shunt

  • CSF drains into the peritoneal cavity from the lateral ventricle
• Ventriculoperitoneal Shunt

  Positioning:

  • 1st 24 hours - FOB supine
  • 24-72 hours - Semi-fowlers (with sustained increased ICP) or turned to the unaffected side
• Hydrocephalus Clinical Manifestations

  Fontanel bulging: Anterior
• Hydrocephalus Management

  Monitor for shunt presence behind the ear
• Hydrocephalus

  DOC: Acetazolamide (Diamox)

  • to decrease production of CSF