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Large Head Child's Diagnosis: Hydrocephalus
- 1. A Child With a Large Head
- 2. Ahmed was delivered by caesarean section and transferred to the paediatric intensive care unit (PICU). On admission to the nursery he weighs 3.4 kg (7.5 lb) and is 8 cm (20 in.) in length. His vital signs was : • Temperature : 37° C (98.6° F) • Pulse : 144 beats/minute • Respirations: 40 breaths/minute CASE
- 3. CASE He has bulging fontanels and a high-pitched cry. His head circumference is 40 cm (15.8 in.) and his chest circumference is 34 cm (13.4 in.). In the lumbar region of his spine, the nurse notes a sac-like projection.
- 4. CASE When Fatima and Sultan visit the nursery, they stroke Ahmed and caress his fingers and toes. Fatima begins to cry and comments to the nurse, “I so wanted to breastfeed Ahmed, but now I guess I can’t”
- 5. WHAT IS THE DIAGNOSIS ? Abdullah Ibrahim Bin Eid - 437014987
- 6. Hydrocephalus Derived from the Greek words "hydro" meaning water and "cephalus" meaning head. The excessive accumulation of CSF results in an abnormal widening of in the brain ventricles. This widening creates potentially harmful pressure on the tissues of the brain. In US The incidence of congenital hydrocephalus is 3 per 1,000 live births , and sex incidence is equal in males and females
- 7. Types of Hydrocephalus Hydrocephalus could be congenital or acquired Hydrocephalus may also be communicating or non-communicating. Hydrocephalus ex-vacuo and normal pressure hydrocephalus.
- 8. Anatomy of Brain Ventricles Abdulaziz Abdullah Albinhamad - 437021228
- 10. Brain Physiology Relevant to Hydrocephalus
- 12. Symptoms & Signs Abdullah Ali Aljalfan - 437021254
- 15. Infants Common signs and symptoms of in infants include: * Changes in the head An unusually large head A rapid increase in the size of the head
- 16. Physical symptoms Vomiting Sleepiness Poor feeding Seizures Eyes fixed downward (sunsetting of the eyes)
- 17. Older children and adults may experience different symptoms because their skulls cannot expand to accommodate the buildup of CSF.
- 18. Neurological exam The type of neurological exam will depend on a person’s : age Muscle condition Sensory status Movement status Psychiatric condition
- 19. Brain imaging Ultrasound. Magnetic resonance imaging (MRI) Computerized tomography (CT)
- 20. Complications & Management Abdullah muteb Almutairi 437014753
- 21. The complications are: Brain damage Seizures Infection Nerve damage Impaired growth
- 22. Complications The severity of complications depends on: Underlying medical or developmental problems Severity of initial symptoms Time of diagnosis and treatment
- 23. Management Management and treatment of hydrocephalus include surgical insertion of shunt between the ventricular and the right atrium or peritoneum .
- 24. Complications of shunt: shunt: a hallow plastic tube (cather) that is placed in the ventricular of the brain. The tube is attached to a valve and is then threaded under the skin from the brain to either the abdomen (ventriculoperitoneal) or heart (Ventriculoatrial ). Shunt infection: Shunt obstruction. Subdural hematoma. Shunt malfunction.
- 26. Management Endoscopic third ventriculostomy (ETV) is a surgical procedure in which an opening is created in the floor of the third ventricle using an endoscope placed within the ventricular system through a burr hole. This allows the cerebrospinal fluid to flow directly to the basal cisterns, bypassing the obstruction.
Editor's Notes
- Hydrocephalus may be congenital or acquired. Congenital hydrocephalus is present at birth and may be caused by either events or influences that occur during fetal development, or genetic abnormalities. Acquired hydrocephalus develops at the time of birth or at some point afterward. This type of hydrocephalus can affect individuals of all ages and may be caused by injury or disease. Hydrocephalus may also be communicating or non-communicating. Communicating hydrocephalus occurs when the flow of CSF is blocked after it exits the ventricles. This form is called communicating because the CSF can still flow between the ventricles, which remain open. Non-communicating hydrocephalus — also called "obstructive" hydrocephalus — occurs when the flow of CSF is blocked along one or more of the narrow passages connecting the ventricles. One of the most common causes of hydrocephalus is "aqueductal stenosis." In this case, hydrocephalus results from a narrowing of the aqueduct of Sylvius, a small passage between the third and fourth ventricles in the middle of the brain. There are two other forms of hydrocephalus which do not fit exactly into the categories mentioned above and primarily affect adults: hydrocephalus ex-vacuo and Normal Pressure Hydrocephalus (NPH). Hydrocephalus ex-vacuo occurs when stroke or traumatic injury cause damage to the brain. In these cases, brain tissue may actually shrink. NPH is an abnormal increase of cerebrospinal fluid in the brain's ventricles that may result from a subarachnoid hemorrhage, head trauma, infection, tumor, or complications of surgery. However, many people develop NPH when none of these factors are present. An estimated 375,000 older Americans have NPH.