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1. By – SURESH KUMAR ( Nursing Tutor )
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2. HYDROCEPHALUS
Hydrocephalus is a condition that occurs
when fluid builds up in the skull and causes
the brain to swell. The name means “water
in the brain.” Brain damage can occur as a
result of the fluid buildup. This can lead to
developmental, physical, and intellectual
impairments. It requires treatment to
prevent serious complications.

3. HYDROCEPHALUS
Hydrocephalus is the buildup of Cerebro spinal
fluid(CSF) in the cavities (ventricles) deep within the
brain. The excess fluid increases the size of the
ventricles and puts pressure on the brain. CSF normally
flows through the ventricles and bathes the brain and
spinal column. But the pressure of too much
cerebrospinal fluid associated with hydrocephalus can
damage brain tissues

5. Causes of Hydrocephalus
Excess cerebrospinal fluid in the ventricles occurs for one of the following reasons:
Obstruction. The most common problem is a partial obstruction of the normal flow
of cerebrospinal fluid, 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 cerebrospinal fluid. This is often related to inflammation of
brain tissues from disease or injury.
Overproduction. Rarely, cerebrospinal fluid is created more quickly than it can be
absorbed, may be due to tumor

6. Sign and Symptoms
Common signs and symptoms of hydrocephalus in infants
include:
Changes in the head
An unusually large head
A rapid increase in the size of the head
A bulging or tense soft spot (fontanel) on the top of the head
Physical signs and symptoms
Vomiting

7. Sign and Symptoms
Sleepiness
Irritability
Poor feeding
Seizures
Eyes fixed downward (sunsetting of the eyes)
Deficits in muscle tone and strength
Poor responsiveness to touch
Poor growth

8. Diagnostic Investigations-
Physical examination-Observation.
Ultra-sonograpy.(USG)
X-ray Examination
CT Scan
MRI

9. Treatment-
One of two surgical treatments may be used to treat hydrocephalus.
Shunt
The most common treatment for hydrocephalus is the surgical insertion of a
drainage system, called a shunt. It consists of a long, flexible tube with a
valve that keeps fluid from the brain flowing in the right direction and at the
proper rate.One end of the tubing is usually placed in one of the brain's
ventricles. The tubing is then tunneled under the skin to another part of the
body where the excess cerebrospinal fluid can be more easily absorbed —
such as the abdomen (VP Shunt) or a chamber in the heart(VA Shunt).

10. Treatment-
Endoscopic third ventriculostomy is a surgical
procedure that can be used for some people. In the
procedure, surgeon uses a small video camera to have
direct vision inside the brain. surgeon makes a hole in
the bottom of one of the ventricles or between the
ventricles to enable cerebrospinal fluid to flow out of
the brain.

11. Nursing Management -
The head circumference of the baby should be
measured daily and recorded.
Vital signs are monitored such as heart rate ,
respiratory rate and temperature and recorded.
The balance diet is provided to maintain sufficient
nutritional status.

12. Nursing Management -
Pressure sore should be prevented by changing
position 2 hourly.
Care should be taken during turning so that head is
turned together with the body safely.
Eye care should be provided to prevent dry eyes if
eyes are not closed due to pressure.

13. Nursing Management -
Passive range of motion exercises are encouraged
to prevent contractures.
Parents should be explained about the disorder and
possible treatment to alleviate their anxiety.
Postoperatively nasogastric tube may be in place so
frequent suctioning is done.

14. Nursing Management -
 After surgery vital signs are monitored such as heart rate ,
respiratory rate and temperature and recorded.
To allow proper flow of the CSF throuth the shunt , the shunt
should be pumped and child should be positioned as ordered by the
surgeon.
Other Nursing interventions – includes all nursing care of
hospitalized child that we have discussed in previous lecture under
heading Nursing care of hospitalized child in the lecture “Child
Health Nursing”.

15. By – SURESH KUMAR ( Nursing Tutor )
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