1.

Hydrocephalus, also called water in the brain, is a condition where there is an abnormal build up of
CSF (cerebrospinal fluid) in the cavities (ventricles) of the brain. The build-up is often caused by an
obstruction that prevents proper fluid drainage.
2. 6. Signs and symptoms  Clinical features of hydrocephalus are influenced by the patient's age, the
cause of the hydrocephalus, the location of the obstruction, its duration, and its rapidity of onset.
 Symptoms in infants include poor feeding, irritability, reduced activity, and vomiting. 
Symptoms in children and adults include the following: 1. Slowing of mental capacity, cognitive
deterioration 2. A full or bulging fontanel (soft spot located on the top of the head) 3. Increasing
head circumference (size) 4. Headaches (initially in the morning) 5. Neck pain, suggesting tonsillar
herniation 6. Projectile Vomiting, more significant in the morning 7. Bulging eyes and an inability of
the baby to look upward with the head facing forward 8. Blurred vision: A consequence of
papilledema and, later, of optic atrophy 9. Double vision: Related to unilateral or bilateral sixth
nerve palsy 10. Difficulty in walking 11. Drowsiness 12. Seizures 13. Developmental delays 6
3. 7. 8. Diagnosis  Examination in infants may reveal the following findings: 1. Head enlargement
(head circumference ≥98th percentile for age), especially crossing percentiles on the growth chart
2. Disjunction/splaying of sutures 3. Dilated scalp veins 4. Tense/bulging fontanelle 5. Setting-sun
sign: Characteristic of increased intracranial pressure (ICP); downward deviation of the ocular
globes, retracted upper lids, visible white sclera above irises 6. Increased limb tone (spasticity
preferentially affecting the lower limbs) 8
4. 9. Diagnosis  Children and adults may demonstrate the following findings on physical
examination: 1. Papilledema (optic nerve swelling), although this does not develop acutely 2.
Failure of upward gaze: Due to pressure on the tectal plate through the suprapineal recess; the
limitation of upward gaze is of supranuclear origin 3. Unsteady gait 4. Large head 5. Unilateral or
bilateral sixth nerve palsy (secondary to increased ICP) 9
5. 10. Diagnostic tests  Ultrasound  Magnetic resonance imaging (MRI)  Computed tomography
(CT) scan 10
6. 11. Treatment  Babies born with hydrocephalus (congenital) and adults or children who develop
it (acquired) usually need prompt treatment to reduce the pressure on their brain.  If
hydrocephalus isn't treated, the increase in pressure will cause brain damage.  Both congenital
and acquired hydrocephalus are treated with either shunt surgery or neuroendoscopy. 11
7. 12. 
8. 14. 14  https://www.youtube.com/user/arammustafa85  For more information you can see video
about hydrocephalus in my channel
9. 15. NURSING CARE PLAN - Hydrocephalus Nursing Interventions Rationale 1-Assess vital signs
hourly, noting for any irregularity in breathing breathing and heart rate and rhythm and measure
the pulse pressure. Monitoring vital signs closely to recognize early signs of increased increased
intracranial pressure 2-Assess neurological status (such as mental status, motor, and balance,
reflexes (for newborns and infant) These assessments will determine changes in child neurological
conditions associated with ICP 3-Examine the pupils by noting its size, shape, equality, and
position position of the pupils, and their response to light. Pupil reaction which is controlled by the
cranial nerve III (Oculomotor nerve) is beneficial for assessing brain stem function. 4-Measure the
client’s head circumference and appearance of anterior fontanelle. Head circumference, if
increasing, or a tense bulging fontanelle reveals CSF accumulation. 5-Elevate the head of the bed
gradually about 15-45 degrees as indicated. Maintain the client’s head in neutral position. This
position will reduce arterial pressure by promoting venous drainage and enhance cerebral
perfusion. 6-Provide oxygen therapy as needed. Supplemental oxygen decreases hypoxemia levels
which may improve cerebral vasodilation and blood volume. 7-Administer diuretics
corticosteroids as ordered. Acetazolamide (Diamox) and furosemide (Lasix) may control
communicating hydrocephalus by reducing production of cerebrospinal fluid; Corticosteroids
reduce inflammation. 15