Peds

1. Hydrocephalus

2. Prepared by :
Sowmya V R
Asst prof
Child health nursing dept
Subharti university

3. INTRODUCTION
• The term hydrocephalus is derived
from the Greek words “hydro”
meaning water and “cephalus”
meaning head. As the name implies,
it is a condition in which the primary
c h a ra c t e r i s t i c i s e xc e s s i v e
accumulation of fluid in the brain.

4. DEFINITION
• The excessive accumulation of cerebrospinal
fluid (CSF) results in an abnormal dilatation of
the spaces in the brain called ventricles.

5. What is Hydrocephalus?
• Also can be defined:
diverse group of
conditions which
result from impaired
circulation and
resorption CSF.

6. Hydrocephalus

7. Hydrocephalus

8. Third ventricle
Lateral ventricle
Fourth ventricle
brain

9. CSF Formation
• CSF is formed by the
choroid plexus .
• Normal CSF
production: 20 ml/h.

10. CSF pathway
• Flows from lateral ventricles
through foramina of Monro
into third ventricle
• Enters fourth ventricle
through aqueduct of Sylvius
• Enters subarachnoid space
• Reabsorbed by arachnoid
villi at top of brain

11. Pathophysiology /Mechanism of
hydrocephalus formation
* Obstruction of CSF pathway
* functional disturbance of CSF absorption
* Excessive production of CSF
CSF
Excessive accumulation
Cerebral ventricles or
subarachnoid space enlargement
Head enlargement
Increasing ICP
Cerebral dysfunction

12. A flash of CSF circulation

13. Types of hydrocephalus
• Obstructive hydrocephalus
– Congenital malformations
– After inflammation or hemorrhage
– Mass lesions
• Communicating hydrocephalus
– Overproduction of CSF
– Defective absorption of CSF
– Venous drainage insufficienc

14. Clinical features
• Symptoms in infants
– Poor feeding
– Irritability
– Reduced activity
– Vomiting

15. Clinical features
• Sign in infants
– Head enlargement.
– Dysjunction of sutures.
– Dilated scalp veins.
– Tense fontanelle: The anterior
fontanelle in infants may be
excessively tense.
– Sun set sign:

16. Clinical features
• Sign of children
– Papilledema.
– Failure of upward gaze.
– Macewen sign: A "cracked pot" sound is noted on
percussion of the head.
– Unsteady gait.
– Large head.
– Unilateral or bilateral sixth nerve palsy.

17. Diagnosis
How to diagnose hydrocephalus:
 Cases history.
 Symptoms and signs mentioned
above.
 diagnostic imaging like Skull
X-rays, echoencephalogram
ultrasound, CT, and MRI.
 Lumbar punctures
CT
MRI
ultrasound

18. Treatment of hydrocephalus
• Main therapy:
– Medical treatment: To decrease the ICP or
reduce the production of CSF with drugs.
– SURGICAL INTERVENTIONS.
• Shunt procedure:the main ways are V-P shunt
and V-A shunt, the most common is V-P shunt.
• Third Ventriculostomy

19. Shunt procedure
Ventriculo-Peritoneal
Shunt (V-P Shunt)
Ventriculo-Atrial shunt
(V-A Shunt)

20. Before and After

21. Third Ventriculostomy

22. BIBLIOGRAPHY
• Manoj Yadav “ Text book of child health
nursing with procedures” PV books, 2012
edition ,page no: 232-235.
• Parul Datta, pediatric nursing, Japee brothers
medical publishers, New Delhi, page no: 25
• C. Manivannan, Text book of pediatric
nursing, second edition page no: 16
• Wong’s essential of pediatric nursing seventh
edition, Mosby publications
• www.Shdeshare.com

23. Thank you!