Hydrocephalus
introduction
Hydrocephalus, also known years ago as “water on the brain”, is a condition where the circulation system of the body’s cerebrospinal fluid (CSF) is not functioning properly. The CSF accumulates in the brain and causes intracranial pressure. A shunt is usually placed to equalize the flow of CSF, which requires surgery. The diagnosis and surgery can be very frightening for the parents as well as the child
definition
Hydrocephalus is a condition characterized by an excess of cerebrospinal fluid (CSF) within the ventricular and subarachnoid spaces of the cranial cavity
INCIDENCE
It is found in 1-3 of every 1000 born children in world wide
Classification
Non communicating. In the non communicating type of congenital hydrocephalus, an obstruction occurs in the free circulation of CSF.
Communicating. In the communicating type of hydrocephalus, no obstruction of the free flow of the CSF exists between the ventricles and the spinal theca; rather, the condition is caused by defective absorption of CSF, thus causing increased pressure on the brain or spinal cord.
CAUSES
Obstruction. The most common problem is a partial obstruction of the normal flow of CSF, either from one ventricle to another or from the ventricles to other spaces around the brain.
Poor absorption. Less common is a problem with the mechanisms that enable the blood vessels to absorb CSF; this is often related to inflammation of brain tissues from disease or injury.
Overproduction. Rarely, the mechanisms for producing CSF create more than normal and more quickly than it can be absorbed.
PATHOPHYSIOLOGY
CLINICAL MANIFESTATION
Poor feeding. The infant with hydrocephalus has trouble in feeding due to the difficulty of his condition.
Large head. An excessively large head at birth is suggestive of hydrocephalus.
Bulging of the anterior fontanelles. The anterior fontanelle becomes tense and bulging, the skull enlarges in all diameters, and the scalp becomes shiny and its veins dilate.
Setting sun sign. If pressure continues to increase without intervention, the eyes appear to be pushed downward slightly with the sclera visible above the iris- the so-called setting sun sign.
High-pitched cry. The intracranial pressure may increase and the infant’s cry could become high-pitched.
Irritability. Irritability is also caused by an increase in the intracranial pressure.
Projectile vomiting. An increase in the intracranial pressure can cause projectile vomiting
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
conclusions
Nosebleeds are very common in young children, affecting most at some time or another. From the outset, it is important to be aware that nosebleeds will often settle down on their own, sometimes requiring medical treatment, but that major underlying causes (blood clotting problems or abnormalities in the nose) are very rare.
Hydrocephalus
introduction
Hydrocephalus, also known years ago as “water on the brain”, is a condition where the circulation system of the body’s cerebrospinal fluid (CSF) is not functioning properly. The CSF accumulates in the brain and causes intracranial pressure. A shunt is usually placed to equalize the flow of CSF, which requires surgery. The diagnosis and surgery can be very frightening for the parents as well as the child
definition
Hydrocephalus is a condition characterized by an excess of cerebrospinal fluid (CSF) within the ventricular and subarachnoid spaces of the cranial cavity
INCIDENCE
It is found in 1-3 of every 1000 born children in world wide
Classification
Non communicating. In the non communicating type of congenital hydrocephalus, an obstruction occurs in the free circulation of CSF.
Communicating. In the communicating type of hydrocephalus, no obstruction of the free flow of the CSF exists between the ventricles and the spinal theca; rather, the condition is caused by defective absorption of CSF, thus causing increased pressure on the brain or spinal cord.
CAUSES
Obstruction. The most common problem is a partial obstruction of the normal flow of CSF, either from one ventricle to another or from the ventricles to other spaces around the brain.
Poor absorption. Less common is a problem with the mechanisms that enable the blood vessels to absorb CSF; this is often related to inflammation of brain tissues from disease or injury.
Overproduction. Rarely, the mechanisms for producing CSF create more than normal and more quickly than it can be absorbed.
PATHOPHYSIOLOGY
CLINICAL MANIFESTATION
Poor feeding. The infant with hydrocephalus has trouble in feeding due to the difficulty of his condition.
Large head. An excessively large head at birth is suggestive of hydrocephalus.
Bulging of the anterior fontanelles. The anterior fontanelle becomes tense and bulging, the skull enlarges in all diameters, and the scalp becomes shiny and its veins dilate.
Setting sun sign. If pressure continues to increase without intervention, the eyes appear to be pushed downward slightly with the sclera visible above the iris- the so-called setting sun sign.
High-pitched cry. The intracranial pressure may increase and the infant’s cry could become high-pitched.
Irritability. Irritability is also caused by an increase in the intracranial pressure.
Projectile vomiting. An increase in the intracranial pressure can cause projectile vomiting
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
conclusions
Nosebleeds are very common in young children, affecting most at some time or another. From the outset, it is important to be aware that nosebleeds will often settle down on their own, sometimes requiring medical treatment, but that major underlying causes (blood clotting problems or abnormalities in the nose) are very rare.
Detailed Powerpoint Presentation on Wilms Tumour …. It includes definition with images, causes, sign and symptoms all treatment modalities with nursing responsibilities and recent research related to this...
It's about HYDROCEPHALUS
TO EXPLAIN ANATOMY OF HUMAN BRAIN
TO INTRODUCE HYDROCEPHALUS
TO DEFINE HYDROCEPHALUS
TO EXPLAIN INCIDENCE OF HYDROCEPHALUS
TO EXPLAIN ETIOLOGY OF HYDROCEPHALUS
TO EXPLAIN PATHOPHYSIOLOGY OF HYDROCEPHALUS
TO EXPLAIN CLINICAL MANIFESTATION OF HYDROCEPHALUS
TO ENLIST DIAGNOSIS & DIAGNOSTIC EVALUATION FOR HYDROCEPHALUS
TO DESCRIBE MANAGEMENT OF HYDROCEPHALUS
TO EXPLAIN COMPLICATION & PROGNOSIS OF HYDROCEPHALUS
Hydrocephalus by aram mustafa & Narnj wasman & Daroon Abdulrahmanaram mustafa
Introduction Of Hydrocephalus
Cause Of Hydrocephalus
Signs and Symptoms Of Hydrocephalus
Diagnosis Of Hydrocephalus
Possible Complications Of Hydrocephalus?
Diagnostic tests
Treatment
Shunt surgery
The operation
Detailed Powerpoint Presentation on Wilms Tumour …. It includes definition with images, causes, sign and symptoms all treatment modalities with nursing responsibilities and recent research related to this...
It's about HYDROCEPHALUS
TO EXPLAIN ANATOMY OF HUMAN BRAIN
TO INTRODUCE HYDROCEPHALUS
TO DEFINE HYDROCEPHALUS
TO EXPLAIN INCIDENCE OF HYDROCEPHALUS
TO EXPLAIN ETIOLOGY OF HYDROCEPHALUS
TO EXPLAIN PATHOPHYSIOLOGY OF HYDROCEPHALUS
TO EXPLAIN CLINICAL MANIFESTATION OF HYDROCEPHALUS
TO ENLIST DIAGNOSIS & DIAGNOSTIC EVALUATION FOR HYDROCEPHALUS
TO DESCRIBE MANAGEMENT OF HYDROCEPHALUS
TO EXPLAIN COMPLICATION & PROGNOSIS OF HYDROCEPHALUS
Hydrocephalus by aram mustafa & Narnj wasman & Daroon Abdulrahmanaram mustafa
Introduction Of Hydrocephalus
Cause Of Hydrocephalus
Signs and Symptoms Of Hydrocephalus
Diagnosis Of Hydrocephalus
Possible Complications Of Hydrocephalus?
Diagnostic tests
Treatment
Shunt surgery
The operation
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
Francesca Gottschalk - How can education support child empowerment.pptxEduSkills OECD
Francesca Gottschalk from the OECD’s Centre for Educational Research and Innovation presents at the Ask an Expert Webinar: How can education support child empowerment?
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
2. INTRODUCTION
Hydrocephalus is a condition in which an accumulation of cerebrospinal fluid (CSF) occurs
within the brain. This typically causes increased pressure inside the skull. Older people may
have headaches, double vision, poor balance, urinary incontinence, personality changes, or
mental impairment. In babies, it may be seen as a rapid increase in head size. Other symptoms
may include vomiting, sleepiness, seizures, and downward pointing of the eyes.
3. DEFINATION
Definition : Hydrocephalus is the
abnormal accumulation of
cerebrospinal fluid(CSF)in the
intracranial spaces. It occurs due to
imbalance between production or
absorption of CSF or due to
obstruction of the CSF pathways. Its
results in the dilatation of the
cerebral ventricles and enlargement
of head.
4. CSF circulation and pathway
Cerebrospinal fluid is secreted at the choroid plexus within the cerebral ventricles by ultrafiltration
and active secretion .
From the lateral ventricles CSF passes to the third ventricle through the foramina of monro.
From the third ventricle, it passes through cerebral aqueduct to the fourth ventricle.
From the fourth ventricle to CSF passes to the basal cisterns and subarachnoid spaces through the
foramina Luschka and magendie.
CSF is absorbed via the arachnoid villi into the venous channel and sinuses.
5.
6. Incidence
The incidence of hydrocephalus varies depending on the geographic location.
Hydrocephalus associated with meningomyelocele is found in about 4 per
1000 live births in the parts of northern Ireland
In Japan is about 0.2 per 1000 live births.
Incidence equal in males and females
15-25% of neonates with open myelomeningocele(a form of spina bifida)
56-600 children and adolescents younger than age 18 years have a shunt in
place.
8. TYPES OF HYDROCEPHALUS
1. COMMUNICATING
In this type, there is no blockage
between ventricular system,
The basal cisterns and the spinal
subarachnoid space
There may be failure in the
absorption of CSF or excessive
production of CSF in choroid plexus
2. NON COMMUNICATING
In this type of hydrocephalus, there
is obstruction at any level in the
ventricular system, commonly at
the level of aqueduct or at foramina
Luschka and or magendie.
The obstruction maybe
1. Partial
2. Intermittent
3. Complete.
9. pathophysiology
COMMUNICATING HYDROCEPHALUS:
Communication between the ventricular and Subarachnoid space
There is an interference with the absorption of CSF caused by on occlusion of the subarachnoid cisterns
around the brain stem
Interference with absorption of CSF
10. Path…..
Occlusion of the subarachnoid cisterns around the brain stem may be due to
Subarachnoid haemorrhage
Meningitis
Toxoplasmosis
cytomegaly virus infection
communicating hydrocephalus
Atrophy and convulsions can occur
11. Non communicating hydrocephalus
PATHOPHYSIOLOGY
Non communicating or obstructive hydrocephalus
Blockage between the ventricular and subarachnoid systems
Interference with the circulation of CSF
Stenosis of aqueduct of syvius
12. PATHO….
Inflammation and compression of aqueduct
Lesion can occur in brain stem resulting in
Aneurysm
Subdural haemorrhage
Atresia of the foramina
Obstructive hydrocephalus
13. Signs and symptoms
The symptoms of hydrocephalus tend to vary greatly from person to person and across different age
groups. Infants and young children are more susceptible to symptoms from increased intracranial
pressure like vomiting and adults can experience loss of function like walking or thinking.
1. There is accumulation of CSF in ventricles leading enlargement of the skull
2. Sutures becomes of anterior fontanelle
3. Tense bulging fontanelle
4. A “cracked pot “ sound is heard on percussion of skull (macewen’s sign)
5. Scalp veins are prominent and scalp appears shiny
6. The eyes may have a wide bridge between them and visible sclera above the iris( sun-setting sign)
14. Signs and symptoms
7.Neurologically, the infant may be fussy, restless,irritable, apathetic or have an altered or diminished
level of consciousness accompanied by sluggish pupillary response to light, posturing and spasticity of
lower limbs.
8.Feeding difficulty and high pitch cry
9. Increased intracranial pressure
10.Physical and mental retardation
15. Infants symptoms
1. Unusually large head size
2. Rapidly increasing head circumference
3. Bulging and tense fontanelle or soft spot
4. Prominent scalp veins
5. Downward deviation of eyes or sunset sign
6. Vomiting
7. Sleepiness
8. Irritability
9. Seizures
16. Children and Adolescents
1. Nausea and vomiting
2. Swelling of the optic disc or papilledema
3. Blurred or double vision
4. Balance and gait abnormalities
5. Slowing or loss of developmental progress
6. Changes in personality
7. Inability to concentrate
8. Seizures
9. Poor appetite
10. Urinary incontinence
17.
18. Adults
1. Headache
2. Nausea and vomiting
3. Difficulty walking or gait disturbances
4. Loss of balance or coordination
5. Lethargy
6. Bladder incontinence
7. Impaired vision
8. Impaired cognitive skills
9. Memory loss
10. Mild dementia
22. Medical management
1. Administer isosorbide pre operatively
2. Postoperatively administer: Acetazolamide dose 50mg/kg/day to diminishes CSF production
3. Frusemide
4. Antibiotics
5. Anticonvulsant
6. Oral glycerol: has also been used for the similar purpose
23. SURGICAL MANAGEMENT
AIMS: Medicine provide temporary relief but the main management is surgery for removal of
any space –occupying lesion and insertion of a shunt.
1. Ventriculoperitoneal shunt
2. Ventriculoatrial shunt (from ventricles to left atrium)
3. Ventriculopleural shunt (from ventricles to the pleural cavity )
4. Ventriculoureteric shunt ( from ventricles to the ureter)
25. Ventriculoperitoneal shunting
Ventriculoperitoneal shunting is surgery to
treat excess cerebrospinal fluid (CSF) in the
cavities (ventricles) of the brain
(hydrocephalus).
A tube (catheter) is passed from the cavities
of the head to the abdomen to drain the
excess cerebrospinal fluid (CSF).
A pressure valve and an anti-syphon device
ensure that just the right amount of fluid is
drained
26. Ventriculoatrial shunt
Ventricular shunts are used to drain
cerebrospinal fluid into extra-
cranial spaces. Ventriculoatrial (VA)
shunts are provided to transfer
cerebrospinal fluid from the
cerebral ventricle into the right
atrium of the heart.
27. Ventriculopleural shunt
The peritoneum is the preferred distal
terminus of a cerebrospinal fluid
(CSF) shunt. However, other anatomic
locations must be considered when the
peritoneum is not suitable, such as in
patients with infection or enough
adhesions to prevent effective CSF
absorption. Other potential distal sites
include the pleural space, gallbladder,
and cardiac atrium.
28.
29. Nursing management
Pre-operative nursing care:
1. Measure the head circumference of the child daily
2. Palpate the fontanelle for evidence of increased intracranial pressure.
3. the anterior fontanelle is bulging and tense.
4. The sutures are widely separated
5. Assess the pupillary response and level of consciousness
6. Monitor vital signs regularly
7. Provide calm and quiet environment ,and provide adequate rest
8. Position the body with neck adequately supported
30. Continues…
9.Provide water pillow or lamb’s wool may be used to keep head over it
10.Change the infant’s position frequently
11.The infant is prone to vomiting provide small ,frequent feeding with intermittent burping
12.Keep the infant clean and dry.
31. Postoperative care
1. Place the infant in flat position to prevent rapid CSF drainage
2. Check the vital signs every 15-30 minutes
3. Assess the neurological status and level of consciousness frequently
4. Regularly assess head circumference
5. Monitor the intake and out put chart
6. Restrict the fluid intake for first 24 hours
7. Provide regular skin care
8. If the fontanelle become sunken, notify the physician immediately, Aslo
immediately lower the head end of the bed to decrease the outflow of CSF
through the shunt
32. Continues....
9. Administer prophylactic antibiotic therapy to prevent infection
10.Home care :
While feeding positing the child
Recognizing the signs of increased intracranial pressure and
malfunctioning or blockage of shunt
Constipation can be prevented if the child has ventriculoperitoneal
shunt
Follow up care.
33. Nursing diagnosis
1.Imbalance cerebral tissue perfusion related to increased ICP
2.Imbalance nutrition, less than body requirement related to reduced oral intake
and vomiting
3.Risk for impaired skin integrity related to enlarged head
4.Anxiety related to the abnormal condition and surgical interventions
5.Risk for infection related to introduction of infecting organism through the
shunt
6.Risk for fluid volume deficit related to CSF drainage
7.Ineffective family coping related to life threatening problem of infant