استسقاء الدماغ

Definition

Hydrocephalus is excess CSF from blocked flow, poor absorption or overproduction.

Causes

• Congenital: aqueduct stenosis, or with spina bifida
• Acquired: haemorrhage, meningitis or tumour
• Normal-pressure hydrocephalus in older adults

Symptoms

• Infants: rapidly increasing head circumference, bulging fontanelle, separated sutures, sunset eyes, irritability, poor feeding
• Older children and adults: headache, vomiting, drowsiness, blurred vision
• Normal-pressure in older adults: gait difficulty, urinary incontinence and memory decline

Diagnosis

Cranial ultrasound through the fontanelle in infants; CT or MRI.

Treatment

• Ventriculoperitoneal shunt
• Or endoscopic third ventriculostomy

Shunt complications

• Blockage: headache, vomiting, drowsiness, irritability
• Infection: fever, redness along the tract, abdominal pain

Nursing care

• Daily head circumference in infants
• Post-operative positioning per surgeon
• Teach parents signs of shunt malfunction and infection

Exam point

A child with a shunt and headache, vomiting and drowsiness has shunt malfunction until proven otherwise.