water

head

- a clear fluid that surrounds the brain and spinal cord

The excessive accumulation of CSF results in an abnormal widening of spaces in the brain called ventricles. This widening creates potentially harmful pressure on the tissues of the brain.

DIAGNOSIS
clinical neurological evaluation and by using cranial imaging techniques such as ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), or pressure-monitoring techniques.

Hydrocephalus is most often treated with the surgical placement of a shunt system. This system diverts the flow of CSF from a site within the central nervous system (CNS) to another area of the body where it can be absorbed as part of the circulatory process.

THERAPEUTIC MANAGMENT
acetazolamide (Diamox)
Ventricular endoscopy

Laser Surgery Removal of Tumor

Nursing Management
Nursing Management: 1. Teach the family about the management required for the disorder a. Treatment is surgical by direct removal of an obstruction and insertion of shunt to provide primary drainage of the CSF to an extracranial compartment, usually peritoneum (ventriculoperitoneal shunt) 1. The major complications of shunts are infections and malfunction 2. Other complications include subdural hematoma caused by a too rapid reduction of CSF, peritonitis, abdominal abscess, perforation of organs, fistulas, hernias and ileus. b. A third ventriculostomy is a new nonshunting procedure used to treat children with hydrocephalus.

 2. Provide preoperative nursing care a. Assess head circumference, fontanelles, cranial sutures, and LOC; check also for irritability, altered feeding habits and a high-pitched cry. b. Firmly support the head and neck when holding the child. c. Provide skin care for the head to prevent breakdown. d. Give small, frequent feedings to decrease the risk of vomiting. e. Encourage parental-newborn bonding. 3. Provide Postoperative nursing care (nursing interventions are the same as those for increased ICP) a. Assess for signs of increased ICP and check the following; head circumference (daily), anterior fontanelle for size and fullness and behavior.

 b. Administer prescribed medications which may include antibiotics to prevent infection and analgesics for pain. c. Provide shunt care 1. Monitor for shunt infection and malfunction which may be characterized by rapid onset of vomiting, severe headache, irritability, lethargy, fever, redness along the shunt tract, and fluid around the shunt valve. 2. Prevent infection (usually from Staphylococcus epidermis or Staphylococcus aureus) 3. Monitor for shunt overdrainage (headache, dizziness and nausea). Overdrainage may lead to slit ventricle syndrome whereby the ventricle become accustomed to a very small or slitlike configuration, limiting the buffering ability to increased ICP variations.

 4. Teach home care a. Encourage the child to participate in ageappropriate activities as tolerated. Encourage the parents to provide as normal lifestyle as possible. Remind both the child and parents that contact sports are prohibited. b. Explain how to recognize signs and symptoms of increased ICP. Subtle signs include changes in school performance, intermittent headache, and mild behavior changes. c. Arrange for the child to have frequent developmental screenings and routine medical checkups.