Angelite Nurses: Hydrocephalus

Hydrocephalus

General information

Increased amount of CSF within the ventricles of the brain
May be caused by obstruction of CSF flow or by overproduction or inadequate reabsorption of CSF
May result from congenital malformation or be secondary to injury, infection, or tumor
Classification

Noncommunicating: flow of CSF from ventricles to subarachnoid space is obstructed.
Communicating: flow is not obstructed, but CSF is inadequately reabsorbed in subarachnoid space.

Assessment findings: depend on age at onset, amount of CSF in brain

Infant to 2 years: enlarging head size; bulging, nonpulsating fontanels; downward rotation of eyes; separation of cranial sutures; poor feeding, vomiting, lethargy, irritability; high-pitched cry and abnormal muscle tone
Older children: changes in head size less common; signs of increased ICP (vomiting, ataxia, headache) common; alteration in consciousness and papilledema late signs
Diagnostic tests

Serial transilluminations detect increases in light areas
CT scan shows dilated ventricles as well as presence of mass; with dye injection shows course of CSF flow

Nursing interventions: provide care for the child with increased ICP and for the child undergoing shunt procedures.

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