Hydrocephalus pptx

HYDROCEPHALUS
PRESENTED BY….
MS. ANEETA SHARMA
NURSING LECTURER (CHILD HEALTH

INTRODUCTION
•Hydrocephalus refers to a condition where there is an
abnormal accumulation of cerebrospinal fluid (CSF) within the
ventricles (fluid-filled spaces) of the brain.
•This buildup can lead to increased pressure inside the skull,
potentially causing brain damage and developmental delays..
MS. ANEETA SHARMA
NURSING

DEFINITION
•Hydrocephalus is defined as an imbalance between production
and absorption of CSF.
•It is characterized by abnormal increase in the volume of
cerebrospinal fluid within the intracranial cavity resulting in
enlargement of the fetus head is called hydrocephalus.
MS. ANEETA SHARMA
NURSING

NORMAL PATHOLOGY OF CSF
CSF produced by choroid plexus
Lateral ventricles of the brain
3rd
ventricles of the brain
aqueduct of Sylvius
4th
ventricles of the brain
MS. ANEETA SHARMA
NURSING

foramen Magendie foramen Luschka
( medium aperture) ( Lateral aperture)
Cisterna magna
Subarachnoid space
Arachnoid villi
CSF is finally reabsorbed in to venous sinus
(superior sagittal suture)
MS. ANEETA SHARMA
NURSING

MS. ANEETA SHARMA
NURSING

INCIDENCE
•It occurs in approx. 3-4 per 1000 live birth.
MS. ANEETA SHARMA
NURSING

ETIOLOGY
(a) Congenital -
•Maternal infection (TORCH)
•Congenital brain defect
•Dandy-Walker syndrome
•Arnold Chiari malformation
•congenital brain tumor (CBT)
MS. ANEETA SHARMA
NURSING

(b) Acquired-
•Meningitis
•Encephalitis
•Brain tumor (medulloblastoma)
•Birth injuries MS. ANEETA SHARMA
NURSING

TYPES OF HYDROCEPHALUS
Communicating Non- Communicating
Hydrocephalus Hydrocephalus
MS. ANEETA SHARMA
NURSING

1-Communicating hydrocephalus-
Imbalance between production and absorption of CSF
No blockage in CSF flow
Communicating hydrocephalus
MS. ANEETA SHARMA
NURSING

2-Non-Communicating hydrocephalus-
Blockage in CSF fluid flow
Blockage occurs in cerebral aqueduct /aqueduct of Sylvius
Non-Communicating hydrocephalus-
MS. ANEETA SHARMA
NURSING

CLINICAL FEATURES -
INFANT-
•Head enlarge
•Suture become
widely separated
MS. ANEETA SHARMA
NURSING

•Delayed Clouser of
anterior fontanelle
•Tense bulging
fontanelle
MS. ANEETA SHARMA
NURSING

•Scalp veins are prominent, and scalp appear shiny
•Cracked pot sign is heard on percussion of skull is called
(Macewen's sign)
•Poor feeding
MS. ANEETA SHARMA
NURSING

•Sun setting sign
•High pitch cry
•Infant may have physical and mental retardation
MS. ANEETA SHARMA
NURSING

CHILDREN
•No enlargement of head but increased ICP
•Headache on awaking in the morning
•Nausea vomiting
•Irritability and high shrill cry
•Lethargy
•Confusion
•Impaired judgment and reasoning
•Affected motor activity ataxia
MS. ANEETA SHARMA
NURSING

DIAGNOSTIC EVALUATION-
•Physical assessment
•Head circumferences > 35cm
•Enlarging head
•Bulging fontanelle
•Enlarged scalp veins
•High Pich cry
MS. ANEETA SHARMA
NURSING

•Intracranial pressure monitoring-Intracranial pressure (ICP)
monitoring is a diagnostic test that measures the pressure inside the brain and
surrounding tissues. The test is used to treat a variety of neurological conditions,
including severe traumatic brain injury, stroke, brain bleeds, hydrocephalus, and
brain tumors
MS. ANEETA SHARMA
NURSING

•Ultrasonography
•CT Scan $ MRI (types of hydrocephalus)
•Amniocentesis-amniocentesis can be used to detect
hydrocephalus, a condition where cerebrospinal fluid (CSF)
builds up in the brain's ventricles.
MS. ANEETA SHARMA
NURSING

MANAGEMENT
1-Medical management-
•Medical management is only possible for communicating
hydrocephalus.
•Acetazolamide
•Glycerol
•Mannitol
MS. ANEETA SHARMA
NURSING

2-Surgical management-
V.A. Shunt (Ventriculoarterial shunt)-
• Shunt in between lateral ventricles and right atrium.
• ventriculoarterial (VA) shunt is a procedure that drains
cerebrospinal fluid (CSF) from the brain's cerebral ventricles
into the heart's right atrium.
MS. ANEETA SHARMA
NURSING

•V.P. Shunt (Ventricular peritoneal)-
•Shunt in between lateral ventricles and peritoneum.
•A ventriculoperitoneal (VP) shunt is a thin plastic tube that
drains excess cerebrospinal fluid (CSF) from the brain to
stomach to treat hydrocephalus
MS. ANEETA SHARMA
NURSING

3- Nursing management-
PRE-OPERATIVE CARE-
•Measures the head circumferences of the child daily.
•Palpate the fontanelles for evidence of increase ICP.
•Assess the level of consciousness.
•Monitor vital sign regularly .
•Use barrier nursing while providing care.
•A water pillow or lamb wool may be used to keep head over it.
•The infant is prone to vomit ,so provide small frequents feeding
with intermittent burping.
MS. ANEETA SHARMA
NURSING

POST-OPERATIVE NURSING CARE-
•Monitor vital sign frequently after surgery.
•Assess the neurological status and level of
consciousness.
•Maintain intake and output chart.
•Observe for any drainage from operated site.
•Prophylactic antibiotic must administer to infant.
•Teach parents about care of the child at home.
MS. ANEETA SHARMA
NURSING

Hydrocephalus pptx

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