HYDROCEPHALUS

- an excess in CSF in the

ventricles or the subarachnoid space
Types

1. Communicating
- fluid reaches into the spinal cord

2. Obstructive
- obstruction is within the ventricles
Classifications

1. Congenital – cause is unknown

- may be caused by maternal infections

2. Acquired
 Three Main Causes of Excessive CSF

1. overproduction of CSF
2. obstruction of the passage of CSF in the
aqueduct of Sylvius (before 4th ventricle)
- most common
3. interference with the absorption of CSF from
the subarachnoid space
Diagnostic Tests

1. Sonography – ultrasonography

2. Computed Tomography Scan

3. Magnetic Resonance Imaging

Clinical Manifestations

1. fontanelles widen and bulging

2. separated skull sutures
3. enlarged head diameter
4. shiny scalp with visible veins
5. bulging eyebrows
6. sunset eyes
Changes in the Vital Signs

1. decreased PR and RR

2. increased BP and BT
Signs of Increased Intracranial Pressure

1. strabismus
2. hyperreflexia
3. optic atrophy
4. irritable or lethargic
5. shrill, high-pitched cry
After birth, early detection of hydrocephalus
can be done by:

1. measuring head circumference within

1 hour after birth and before discharge

2. measuring head circumference to all

children under 2 years during clinic visits
Therapeutic Management

1. Acetazolamide (Diamox) – for overproduction

2. Removal of tumor
3. Laser surgery
4. Ventricular Endoscopy
5. Shunting – bypassing the point of obstruction
 Ventriculoperitoneal Shunting (VP Shunting)

- removes excessive CSF from the

ventricles and shunts it to the
peritoneum
Endoscopic Ventriculostomy
Nursing Interventions
1. reposition head every 2 hours
2. talk, smile, play with the child frequently
3. provide mobile/musical toys
4. provide colorful pictures
5. after shunting:
- elevate head of the bed to 30 degrees
- side-lying with the unaffected side
- adequate pain management
- assess signs of increased ICP