A CASE REPORT OF

HYDROCEPHALUS
S.Y. 2020-2021
 I. Introduction
Hydrocephalus is a condition in which fluid accumulates in the brain, typically in young children,
enlarging the head and sometimes causing brain damage. It is caused by an imbalance between how
much cerebrospinal fluid is produced and how much is absorbed into the bloodstream.
Cerebrospinal fluid is produced by tissues lining the ventricles of the brain. It flows through the
ventricles by way of interconnecting channels.

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.

Excessive pressure on the brain from hydrocephalus can permanently impact the brain in infants or
children, which may affect their physical and cognitive development.
There are types of hydrocephalus:
Acquired Hydrocephalus
Congenital hydrocephalus
 II. OBJECTIVES
At the end of the presentation of the case study, student nurses will be able to:
• Understand what Hydrocephalus is.
• Clearly understand the causes and predisposing factor of Hydrocephalus.
• Describe and understand the general medical and surgical management,
pharmacologic management, and as well as nursing responsibilities for patients with
Hydrocephalus.
• Discuss the general and specific pathophysiology of Hydrocephalus
• Identify the drug prescribed to the client with Hydrocephalus by their action, side
effects, indication, contraindication, and nursing responsibilities
• Identify the specific medical and surgical management specific treatment in
Hydrocephalus
• Identify nursing diagnosis appropriate to the patient and discuss nursing care plans
to provide holistic care to the patient.
 III. ASSESSMENT AND CLINICAL
MANIFESTATION
• Enlarged fontanelles
• Separated suture line
• Bossing of forehead
• Increased head circumference
• Sunset eyes
• Lethargy or irritability
• Shill cry
 Hyperactive reflexes
 Increase temperature and blood
pressure
 Decrease pulse and respiration
 IV. DIAGNOSTIC TEST/ LABORATORY FINDINGS

Computerized Tomography (CT) 

scan is a specialized X-ray technology
that can produce cross-sectional views
of the brain. Scanning is painless and
quick. CT scan for hydrocephalus are
usually used only for emergency exams.
Magnetic Resonance Imaging
(MRI) 
uses radio waves and a magnetic
field to produce detailed 3D or cross-
sectional images of the brain. It can
show enlarged ventricles caused by
excess cerebrospinal fluid.
Ultrasound
uses high-frequency sound waves to
produce images, is often used for an
initial assessment for infants
because it is a relatively simple and
low-risk procedure.
 V. Anatomy and Physiology

THE BRAIN
The brain is an amazing three-pound organ that controls all functions of the
body, interprets information from the outside world, and embodies the
essence of the mind and soul. Intelligence, creativity, emotion, and memory
are a few of the many things governed by the brain. Protected within the
skull, the brain is composed of the cerebrum, cerebellum, and brainstem.
The central nervous system (CNS) is composed of the brain and spinal cord.
The peripheral nervous system (PNS) is composed of spinal nerves that
branch from the spinal cord and cranial nerves that branch from the brain. 
The movement of cerebrospinal fluid
The brain contains cavities called ventricles. Cerebrospinal fluid is made
in the ventricles, then flows down channels through the brain, then flows
out near the base of the skull to the surface of the brain and spinal cord. It
is absorbed just below the top of the skull.

If the movement of CSF is obstructed along any part of this journey, the
fluid will build up behind the blockage. The ventricles enlarge with fluid
and pressure rises inside the skull (intracranial pressure).
 VII. DRUG STUDY
REPRESENTED CLASSIFICATI INDICATION CONTRAINDICATI SIDE EFFECT ADVERSE NURSING
DRUG ON ON EFFECT RESPONSIBILITIES

Generic Name: Carbonic It works by It is contraindicated -dizziness -Tingling of -Monitor signs of

acetazolamide anhydrase decreasing the in patients with the hands/feet hypersensitivity reactions and
inhibitors production of -lightheadedness anaphylaxis, including
Brand Name: fluid inside the -type 1 and type 2 -hearing loss pulmonary symptoms
Diamox eye. It is also diabetes mellitus -Increased amount (tightness in the throat and
used to decrease of urine, especially -easy chest, wheezing, cough,
a buildup of body -severe liver disease during the first few bleeding/bruisi dyspnea) or skin reactions
fluids (edema) days as your body ng (rash, pruritus, urticaria).
caused by heart adjusts to the
failure or certain -severe kidney medication. -fast/irregular -Be especially alert for
medications disease heartbeat dermatitis, exfoliation, and
-blurred vision other severe skin reactions that
electrolyte imbalance -new or might indicate Stevens-Johnson
(such as acidosis or -dry mouth worsening eye syndrome.
low levels of pain
potassium or sodium -loss of appetite -Notify physician immediately
in your blood) about any hypersensitivity
-nausea reactions.

-vomiting -Monitor any changes in vision

to help document drug
-diarrhea effectiveness in decreasing
glaucoma.
REPRESENTE CLASSIFICATI INDICATION CONTRAINDICATI SIDE EFFECT ADVERSE NURSING
D DRUG ON ON EFFECT RESPONSIBILITIES

-Monitor signs of acid-If used

as an anticonvulsant, document
the number, duration, and
severity of seizures to help
determine if this drug is
effective in reducing seizure
activity.
-base and electrolyte
imbalances (acidosis,
hypokalemia).

-Assess signs of paresthesia

(numbness, tingling) or muscle
twitching.

-Perform objective tests

including
electroneuromyography and
sensory testing to document
any drug-related neuropathic
changes.
 REPRESENTED CLASSIFICATI INDICATION CONTRAINDICATI SIDE EFFECT ADVERSE NURSING
DRUG ON ON EFFECT RESPONSIBILITIES

Generic Name: Diuretic -used to reduce -Diabetes -nausea or -allergic -Assess fluid status.
furosemide extra fluid in the vomiting reaction
body (edema) - a type of joint -Monitor daily weight, intake
Brand Name: caused by disorder due to excess -Diarrhea -kidney failure and output ratios, amount and
Lasix conditions such uric acid in the blood location of edema, lung sounds,
as heart failure, called gout. -Constipation -irregular skin turgor, and mucous
liver disease, and heartbeat membranes.
kidney disease. - severe liver and -feeling like you or
kidney disease the room is -too little -Notify health care professional
This can lessen spinning (vertigo) potassium in if thirst, dry mouth, lethargy,
symptoms such the blood. weakness, hypotension, or
as shortness of -headache oliguria occurs.
breath and too much
swelling in your -blurred vision potassium in -Monitor BP and pulse before
arms, legs, and the blood (for and during administration.
abdomen. This potassium-
drug is also used sparing
to treat high diuretics)
blood pressure.
 REPRESENTED CLASSIFICATI INDICATION CONTRAINDICATI SIDE EFFECT ADVERSE NURSING
DRUG ON ON EFFECT RESPONSIBILITIES

Generic Name: Cephalosporins Treatment of the -Hypersensitivity to -Injection site -Convulsions -Assess patient’s sensitivity
cefriaxone lower respiratory cephalosporins and reactions (swelling, reaction to penicillin or other
tract, bacterial penicillin soreness) -Swollen cephalosphorins.
Brand Name: septicemia, tongue
Forgram meningitis, bone -Patients with vitamin -Diarrhea - Obtain C&S before beginning
and joints k deficiency Hives of drug therapy to identify if
infection -Anemia correct treatment has been
-Hematological initiated.
disease -Dizziness
-Watch for seizures. Notify
Chills physician immediately if
patient develops seizure
activity.

-Monitor allergic reactions.

 VIII. MEDICAL AND SURGICAL MANAGEMENT
MEDICAL MANAGEMENT
PHARMACOLOGIC MANAGEMENT
Carbonic Anhydrase Inhibitors - it works by decreasing the production of fluid inside the eye. It is also used
to decrease a buildup of body fluids (edema) caused by heart failure or certain medications.
 - Diamox
 -acetazolamide
Diuretic - used to reduce extra fluid in the body (edema) caused by conditions such as heart failure, liver disease,
and kidney disease.
 - Lasix
 forusemide
Cephalosporins - treatment of the lower respiratory tract, bacterial septicemia, meningitis, bone and joints
infection.
 - Forgram
 cefriaxone
SURGICAL MANAGEMENT

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.

Endoscopic third ventriculostomy - is a surgical procedure that can be used

for some people. In the procedure, your surgeon uses a small video camera to have
direct vision inside the brain.
X. Evaluation
After conducting this case report the researchers acquire a lot of knowledge
regarding the disease of Hydrocephalus about the different assessment and clinical
manifestations of the said disease. The students also study about the specific
diagnostic tests, laboratory findings, including the particular medical and surgical
management that the healthcare provider may implement with the patient suffering
from hydrocephalus. The researchers identify and study the anatomy and
physiology of the affected system of the disease as well as pathophysiology to clearly
understand the origin and also the disease process. The students also work out
suitable and effective nursing care plans to meet the needs and give their best
possible care to their patients in the near future.