REFERENCES Muttaqin, Arief. 2008, “Asuhan Keperawatan Klien dengan Gangguan System Persyarafan”. Jakarta: Salemba Medika. Mitayani. 2011. “Asuhan Keperawatan Maternitas”. Jakarta: Salemba Medika. Vivian Nanny Lia Dewi. 2011. “Asuhan Neonatus, Bayi dan Anak Balita”. Jakarta: Salemba Medika. Nuzulul Zulkarnain Haq. 2011. Asuhan Keperawatan Hidrosefalus: Diagnosa , Intervensi dan Rasional Keperawatan, accessed on May 7th 2015, <http://nuzulul-fkp09.web.unair.ac.id/artikel_detail-35563-Kep%20Neurobehaviour-Askep%20Hidrosefalus.html#popup

1. By:
Aprijal Khairil Bhakti
Winda Permatasari

2. Introduction
• CSF is produced continuously in the CNS
• The total volume of CSF -> 125 ml
• Secretion speed choroid plexus -> 500-750 ml / day
• CSF Pressure -> 13 mmHg
• Function of CSF:
1. protects the central nervous system of trauma (pressure /
impact)
2. maintaining appropriate fluid environment for the brain
3. provide protection against mild collision and other
mechanical injuries (as bumpers / buffer).
4. makes the brain remain stable in place even though there
is collisions of the outsiders.

4. DEFINITION
• Hydrocephalus is a
buildup of cerebrospinal
fluid active system that
causes dilatation of the
ventricles of the brain.
(Mitayani, 2011: 197)

5. CLASSIFICATIONS
1. Based on the blockage
a. Obstructive hydrocephalus
Increased intracranial pressure caused by an obstruction in
one of the establishment of the CSS, among other things koroidalis
plexus and the release of the fourth ventricle through the foramen
luscka and magendi.
b. Communicant hydrocephalus KS
An increase in intracranial pressure without any blockage in
one of the establishment of the CSS.
2. Based on acquisition
a. Congenital hydrocephalus
At birth, the brain is formed of small or disrupted due to brain
growth driven by the amount of fluid in the head and high
intracranial pressure.
b. Hydrocephalus obtained
Brain growth occurs already perfect and then an interruption
due to the high intracranial pressure.

6. ETIOLOGY
0-2 years
• congenital abnormalities
• intrauterine infection
• intrakranial bleeding due
to trauma
• bacterial and viral
meningoencephalitis, as
well as tumor or
arachnoid cyst.
2-10 years
• posterior fossa tumors
• stenosis akuaduktus

7. CLINICAL MANIFESTATIONS
 Have an enlarged skull
 Vomiting and headaches
 The head looks bigger than the body
 Fontanelle large dilated and did not
close in time, palpable tension and
stand
 Wide forehead, scalp thin, taut and
shiny
 Widening scalp veins

8. CLINICAL MANIFESTATIONS
 cracked pot flower pots cracking sound when
performed percussion head
 sunset sign of eyes
 eyeball irregular movement
 Damage to nerves that can give symptoms of
neurological disorders, such as: impaired
consciousness; seizures; sometimes vital
center disruption.

9. DIAGNOSTIC EXAMINATION
fronto-
occipital head
measurement MRI CT Scan

10. TREATMENT
• Treatment causal
• Installation of a drain ->
Shunting
• In a state of emergency with
very high intracranial pressure -
> puncture ventricle through the
anterior fontanelle that still
open, to issue a number of
liquor to decompress.

11. ASSESSMENT
• Health history
a. Health history of previous disease
A history of infection of the meninges, premature birth,
head trauma.
b. Health history of current disease
Enlargement of the skull, headache, neurologic complaints
such as eye always downward, motor development
disorders, visual disturbances, seizures, nausea and
vomiting, and loss of consciousness.
c. History of family disease
Maternal history of intrauterine infection: viral and
bacterial.

12. PHYSICAL EXAMINATION
a. General condition
• A decrease in consciousness
• Changes TTV (Increased systolic blood pressure, bradicardia,
increased respiratory rate.
b. Head
• The existence of enlargement of the skull
• Sutures were still open looks fronto-occipital head circumference that
continues to expand
• Suture increasingly stretched with convex and tense fontanelle
• Veins commonly seen protruding scalp
• In the percussion head, sounds like a cracked flower pot (cracked pot
sign).

13. PHYSICAL EXAMINATION
c. Eye
• The eyes always look down
• There is edema of the brain nerve II pupil at funduscopic examination
• The eyeball is pushed down by the pressure of supra orbital bone thinning
• Sclera looks over the iris
• Irregular movement of the eyeball.
d. Gastrointestinal System -> Nausea and vomiting due to increased intracranial
pressure.
e. Extremity
Motor development disorders.
Psychology and social
a. Maternal anxiety due to the physical changes the baby and also due to lack
of knowledge of information.
b. The relationship of mother and others will be disrupted because of defects
in the baby.

14. NURSING DIAGNOSE
1. Increased intracranial pressure related to the accumulation of
cerebrospinal fluid.
2. Sensory perception disorders related to occipital lobe
suppression due to increased ICP.
3. Lack of knowledge related to the disease suffered by his/her
son.
4. The risk of ineffective breathing patterns related to decreased
cough reflex.
5. Impaired growth and development related to enlargement of
the head.
6. High risk of infection related to the installation of drain / shunt.
7. Nutrition less than body requirements related to vomiting
secondary to cerebral compression and irritability.