Hydrocephalus
•Enlargement of the head due to a problem with Cerebral Spinal Fluid
•Caused by:
–Production
—excessive amounts
–Absorption
—inadequately absorbed or obstruction of flow
•May be congenital or acquired
–Improper formation of the ventricles of the brain
–Tumor, trauma, hemorrhage, infection
Hydrocephalus: Signs & Symptoms
•Increasing head circumference
•Shrill high-pitched cry
•Lethargy, listlessness
•Perhaps irritability
•Strabismus—sclera seen above the eyes–“sunset eyes”
•Indicative of increased intracranial pressure
Hydrocehpalus: Nursing Care & Treatment
•Pre-Operative Care
–Daily head measurement
–Assessment of fontanels
–Special care for feeding
•Treatment
–Surgical shunt or by-pass with 24-48 hours
–Ventriculoatrial (V-A) or Ventriculoperitoneal (V-P)
Hydrocephalus: Post-Op Care
•Includes all pre-op care
•Watch for signs of increased ICP
–Irritability
–Vomiting
–Vital signs changes
–Increasing head size
•Assess shunt line
–Infection
–Obstruction
Hydrocephalus: Parent Teaching
•To watch for and report signs of increased ICP.
•That the child will need to have a revision of the shunt periodically to accommodate growth.
•Treat the child as normal as possible with limitations on contact sports or activities.
