Hydrocephalus is a condition where excess cerebrospinal fluid accumulates in the brain's ventricles. It can be congenital, caused by genetic conditions or abnormalities present at birth. It can also be acquired later in life due to bleeding in the brain, brain injuries, or tumors blocking fluid flow. Symptoms include an enlarged head size, vomiting, irritability, and sleepiness. Diagnosis involves CT/MRI scans of the brain. Treatment options are surgical, typically involving placing a shunt to drain fluid or creating an opening to allow fluid to drain differently. Without treatment, hydrocephalus can cause brain damage or death.

1. HYDROCEPHALUS
Prepared by : Katherine Casacop

2. cerebral spinal fluid:
 Most of the cerebral spinal fluid (CSF) is created
by an area of the brain called the choroid plexus.
The CSF serves to protect the brain and spinal
cord, and also delivers nutrients to the brain and
takes away waste. Typically, CSF circulates
through the brain within ventricles, which are the
normal fluid-filled spaces in the brain.
 There are two lateral ventricles that drain into a
third ventricle and then into a fourth ventricle.
From there, the CSF surrounds the spinal cord
and brain. It is eventually reabsorbed into the
sagittal sinus, which is a large vein in the head,
and travels back to the body.

3. causes hydrocephalus?
Hydrocephalus may be congenital (born with
it) or acquired (developed).
When hydrocephalus is congenital, it may be
the result of a condition like spina bifida,
where the baby’s spine does not form
normally, or aqueductal stenosis, a narrowing
of the passage between the third and fourth
ventricles in the brain. Hydrocephalus may
also be caused by a genetic disorder.

4. Hydrocephalus is the most common
cause of abnormally large heads in
neonates. Hydrocephalus that
develops only after the fontanelles
have closed does not increase head
circumference or cause the
fontanelle to bulge but can markedly
and rapidly increase intracranial
pressure.

5. Acquired hydrocephalus occurs any
time after birth. It may occur due
to bleeding in the brain, sometimes
seen in premature babies or in
individuals who have experienced
traumatic brain injuries. It may
occur if there is a growing mass
causing obstruction to the flow of
CSF. Sometimes it may be
idiopathic, which means that it
develops without a known cause.

7. signs and symptoms of
hydrocephalus
Bulging fontanelles (soft spots
between the bones)
A large head circumference or a
rapid increase in head growth
Swollen veins on the scalp
Difficulty looking upward during eye
movements
Repetitive vomiting
Excessive irritability, possibly due to
head pain
Very sleepy and difficult to awaken

8. Assessment and Diagnostic findings
 Computed tomography (CT) scanning.
 Magnetic resonance imaging (MRI)
 Ultrasonography through anterior fontanelle in infants.
 Skull radiography.
 MRI cine
 Diffusion tensor imaging (DTI).
 Radionuclide cisternography (in NPH)

9. Treatment
 The most common treatment
options are placement of a shunt or
performing a third ventriculostomy.
 Another surgical option is an endoscopic
third ventriculostomy. It is helpful for
patients that have a blockage of CSF. In
this surgery, a small opening is made in
the bottom of the third ventricle, allowing
the CSF to leave the brain by a different
route.

10. A shunt is a long, flexible tube that
helps to redirect the flow of CSF.
Generally, one end is placed in the
ventricle of the brain and the other
end is placed in the peritoneal space,
an abdominal cavity. This is called a
ventriculo-peritoneal shunt.
Sometimes, the lower end of the shunt
may be placed into a chamber in the
heart or the space around the lungs.
The shunt has a valve that directs the
flow of CSF away from the brain.

11. This is a minimally-invasive approach as
surgeons use a small, lighted camera (an
endoscope) to view the surgical site. This
procedure may allow a child to live
without a shunt, however, there is the
possibility that the small opening may
close on its own. If this occurs, the child
will experience the signs and symptoms
of hydrocephalus once again.

12. Pharmacologic Therapy
Diuretics.
Anticonvulsants.
Antibiotics.

13. Surgical Management
Surgical intervention is the only
effective means of relieving
brain pressure and preventing
additional damage to the brain
tissue.

14. Nursing Management
Managing a child with
hydrocephalus warrants skill
and compassion for nurses and
all the members of the
healthcare team.

15. Nursing Interventions
 Preventing injury.
 Promoting skin integrity
 Preventing infection.
 Promoting growth and development.
 Reducing family anxiety.
 Providing family teaching.

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