IDEAL MANAGEMENT

A. Laboratory Examinations

No specific blood tests are recommended

in the workup for hydrocephalus.

Genetic testing and counseling might be

recommended when X-linked
hydrocephalus is suspected.

Evaluate cerebrospinal fluid (CSF) in

posthemorrhagic and postmeningitic
hydrocephalus for protein concentration
and to exclude residual infection.

B. Diagnostic Procedures

Ultrasound imaging, which uses highfrequency sound waves to produce images,

is often used for an initial assessment for
infants because it's a relatively simple,
low-risk procedure. The ultrasound device
is placed over the soft spot (fontanel) on
the top of a baby's head. Ultrasound may
also detect hydrocephalus prior to birth
when the procedure is used during routine
prenatal examinations.

Magnetic resonance imaging (MRI) uses

radio waves and a magnetic field to
produce detailed 3-D or cross-sectional
images of the brain. To assess for Chiari
malformation or cerebellar or
periaqueductal tumors

Computed tomography (CT scan)

scanning: To assess size of ventricles and
other structures

Ultrasonography through anterior

fontanels in infants: To assess for
subependymal and intraventricular
hemorrhage; to follow infants for possible

ACTUAL MANAGEMENT

Blood Typing (Done)

Complete Blood Count ( Done)
Urinalysis (Done)
Fecalysis (Done)
Coagulation Test (Done)
Sodium & potassium test (Done)

Mother not attended prenatal care

and diagnostic procedures

progressive hydrocephalus

Skull radiography: To detect erosion of

sella turcica, or (after shunt insertion) to
confirm correct positioning of installed
hardware

MRI cine: To measure CSF stroke volume

(SV) in the cerebral aqueduct.

Diffusion tensor imaging (DTI): To detect

differences in fractional anisotropy and
mean diffusivity of the brain parenchyma
surrounding the ventricles; allows
recognition of microstructural changes in
periventricular white matter region that
may be too subtle on conventional MRI

Radionuclide cisternography (in NPH):

To assess the prognosis with regard to
possible shuntinghowever, due to its
poor sensitivity in predicting shunt
response when the ventricular to total
intracranial activity (V/T) ratio is less than
32%, this test is no longer commonly used

C. Treatment

Surgery

The most common treatment for

hydrocephalus is the surgical insertion of a
drainage system, called a shunt.

Surgical treatment is the preferred

therapeutic option in patients with
hydrocephalus. Most patients eventually
undergo shunt placements, such as:
Ventriculoperitoneal (VP) shunt (most
common)

D. Medication

Acetazolamide (ACZ) and furosemide

Advised for surgery not yet

scheduled

(FUR) treat posthemorrhagic

hydrocephalus in neonates. Both are
diuretics that also appear to decrease
secretion of CSF at the level of the choroid
plexus.

Zinc Sulfate
Paracetamol
Metronidazole
Ceftriaxone
Phenobarbital

E. Dietary

Until your baby is able to eat, he or she

will receive total parenteral nutrition
(TPN). This is an IV solution that contains
protein, fats, sugar, vitamins, and mineral.
It will supply all your baby's nutritional
requirements until she is able to take food
by mouth.

Breastfeed

F. Activity/Exercises
Physical Theraphy

Promoting achievement of physical

milestones such as sitting, standing,
crawling
Maximizing independence in mobility
Exercises to improve balance and
coordination
Exercises to stretch or strengthen tight or
weak muscles
Improving confidence and quality of life
Improving tolerance and stamina

NOT DONE

G. Surgery
VP shunting is a surgical procedure that
primarily treats a condition called
hydrocephalus.
VP shunts inside one of the brains
ventricles to divert fluid away from
the brain and restore normal flow
and absorption of CSF.
H. Rehabilitation/Referral

NOT DONE

Follow-up Check up
Medical evaluations to ensure proper shunt
function.
Family to provide education and guidance
as the baby grows and develops.

NOT DONE