HYDROCEPHALUS

Presented by,
AMMARA UMER
HOUSE OFFICER

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INTRODUCTION

Hydrocephalus

“Water “Head”
”
 DEFINITION

𝗈 Hydrocephalus is the abnormal accumulation of cerebrospinal fluid in the

intracranial spaces.

or
𝗈 Hydrocephalus is an abnormal accumulation of cerebrospinal fluid (CSF) in
the ventricles and cavities of brain. This causes increased
intracranial pressure inside the skull and may cause progressive enlargement
of the head

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ETIOLOGY OF HYDROCEPHALUS

Acquired
• Inflammation
• Trauma
• Neoplasm space occupying
lesions
• Degenerative atropy of brain
• Arteriovenous
malformations, ruptured
aneurysm, cavernous sinus
thrombosis.

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CLINICAL FEATURES

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 Symptoms of hydrocephalus
Signs in babies:
• bulging at the soft spots
• gapping between skull bones
• increased head circumference
• prominent veins
• downward cast of the eyes (called "sunsetting")

https://quizlet.com/45510950/step
- 2-neurology-uworld-flash-cards/
Signs in older children &
adults: •
nausea/vomiting (may be worse in the morning)
• drowsiness
• head &/or neck pain
• balance problems
• confusion
• problems with motor skills
• double-vision
• squinting &/or repetitive eye movements
• urinary incontinence / bowel incontinence
 DIAGNOSTIC EVALUATION

Physical examination

Typical cracked-pot sound (Macewen’s sign)of the skull bone

Ophthalmoscopy

MRI

CT scan

Cranial ultrasonography and trans illumination test

Lumber puncture

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 COMPLICATIONS

Seizure

Herniation of brain

Persistent increased ICP.

Developmental delay

Mood Swings or Behavior Problems.

Hematoma.

Visual changes.

Infections.

Balance or vestibular complications

Incontinence
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How is hydrocephalus treated?

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NEEDS IDENTIFIED
𝗈 P HYS IC A L NEEDS:-
𝗈 Need to maintain personal hygiene.

𝗈 Prevention of skin breakdown

𝗈 Prevention or reduction of deformities.

𝗈 Maintenance of ideal weight.

𝗈 Change the position frequently.

𝗈 P HYS IOLOG IC A L NEEDS:-

𝗈 Prevention of injury and infection of sac.

𝗈 Provision of adequate nutrition.

𝗈 Prevention of infection of urinary tract.

𝗈 Regulation of bladder and bowel function.

𝗈 P S YC H O LO G I C A L NEEDS:-
● Relieve anxiety of parents.
● Maintain the psychology of the parents

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SURGICAL MANAGEMENT

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VENTRICULO-PERITONEAL SHUNT

LUMBOPERITONEAL SHUNT

VENTRICULOPLEURAL SHUNT VENTRICULOATRIAL SHUNT 12

How can physiotherapy help after hydrocephalus?

Aims of treatment will vary according to the child's needs and age.

To maximise their potential and quality of life.

Hydrocephalus can affect:

child's physical development

child's ability to achieve milestones

child's Balance and co-ordination

child's Mobility

child's Gait (walking) ability

Child’s Speech and behavior

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These goals should be achieved by:

Promoting physical milestones of achievement such as sitting, crawling, standing

Optimising mobility independence

Improving balance and coordination via exercise

Stretching tight muscles via exercise

Strengthening weak muscles via exercise

Increasing quality of life and confidence

Improving endurance and exercise tolerance

Reducing secondary impairment, such as obesity, contractures, and fractures, which could delay developmental skills.

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7 Specific positions for play & strengthening

1) Prone position aka tummy time

2) Rolling & getting into sitting
3) Sitting
4) 4 – point kneeling (crawling position)
5) Kneeling
6) Half – kneeling
7) Standing
Always #1: Prone position aka
tummy time
Rolling & getting into sitting
Sitting
4 – point/crawling position
Kneeling
Half kneeling
Standing
 REFERENCES
𝗈 Dorothy R. Marlow, Textbook Of Pediatric
Nursing, Fifth Edition, Page No 301-307
𝗈 Hoekelman, Primary Pediatric Care, secomd
edition, page no. 1286-1288.

Source:http://diseasespictures.com/hydrocephalus/
𝗈 Internet searching on google.com

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