HYDROCEPHALUS

Question 1

CSF functions

Answer 1

• mechanical protection from trauma; cushions the brain and spinal cord
• supplies nutrients to nervous tissue
• removes waste products of cerebral metabolism

Question 2

An accumulation of an excess amount of the CSF within the
ventricles of the brain

Answer 2

hydrocephalus

Question 3

an imbalance with the CSF flow may be caused by

Answer 3

• increased fluid production
• obstruction within ventricular system
• defective reabsorption of CSF

Question 4

causes of hydrocephalus

Answer 4

• genetic abnormalities
• developmental disorders of the NS
• neural tube defect
• intraventricular hemorrhage
• meningitis, tumors, head injuries

Question 5

types of hydrocephalus

Answer 5

1. Congenital vs. Acquired
2. Communicating/Non-Obstructive vs.
   Non-Communicating/Obstructive
3. Overproduction of CSF

Question 6

• present @ birth
• caused by either
  events that occur
  during fetal
  development, or
  genetic
  abnormalities.

Answer 6

congenital

Question 7

• develops at the
  time of birth or at
  some point
  afterward.
• It can affect
  individuals of all
  ages and may be
  caused by injury or
  disease.

Answer 7

acquired

Question 8

• occurs when the flow of CSF is
  blocked after it exits the ventricles,
  and w/ impaired CSF reabsorption.
• ”Extraventricular Obstruction”
• Defective reabsorption of CSF

Answer 8

communicating / non-obstructive

Question 9

• occurs when the flow of CSF is
  blocked along one or more of the
  narrow passages connecting the
  ventricles.

Answer 9

non-communicating / obstructive

Question 10

causes of communicating hydrocephalus

Answer 10

• adhesions from inflammation
• cerebral atrophy
• compression of subarachnoid space
• head injury
• high venous pressure

Question 11

causes of non-communicating hydrocephalus

Answer 11

• aqueduct stenosis
• arnold-chiari malformation
• congenital abnormalities in the ventricular system
• mass lesions like tumor

Question 12

causes of overproduction of CSF

Answer 12

choroid plexus papilloma or carcinoma

Question 13

management of overproduction of CSF

Answer 13

surgery and choroid plexus coagulation

Question 14

risk factors

Answer 14

• premature birth
• pregnancy problems
• problems with fetal development
• lesions and tumor
• NS infection
• intraventricular hemorrhage

Question 15

diagnostic tests for hydrocpehalus

Answer 15

• prenatal ultrasound
• cranial utz
• xray
• mri
• ct or cat scan

Question 16

clinical manifestations

Answer 16

• increased HC
• cracked pot sound of head (Macewen’s sign)
• anterior fontanel tense and bulging
• frontal bossing
• sun setting eyes

Question 17

manifestations that can be seen in a child

Answer 17

*Irritability and lethargy
*Headache on awakening
*Nausea and vomiting
*Ataxia
*Nystagmus/Strabismus/Optic
Atrophy
*Hyperactive reflexes

Question 18

signs of increased ICP

Answer 18

change in LOC
bulging fontanels
high, shrill cry
cushing’s triad
seizures

Question 19

what is included in the cushing’s triad

Answer 19

• Hypertension
• Bradycardia
• Bradypnea

Question 20

meds that help reduce CSF production to temporarily relieve pressure.

Answer 20

diuretics - acetazolamide, furosemide

Question 21

Used to prevent or treat seizures, which may occur as a complication of hydrocephalus

Answer 21

anticonvulsants

Question 22

meds Used when hydrocephalus is due to or complicated by infection

Answer 22

antibiotics

Question 23

meds Used only in critical care settings to maintain blood pressure and cerebral perfusion

Answer 23

vasopressors

Question 24

what is done when there is refractory hypoxia and hypoventilation

Answer 24

endotracheal intubation

Question 25

medical device, typically a thin, flexible tube, inserted into one of the brain's ventricles to either drain cerebrospinal fluid (CSF) or measure intracranial pressure (ICP)

Answer 25

ventricular catheter

Question 26

* A ventricular catheter is passed from the cavities of the head to the abdomen to get rid of the excess cerebrospinal fluid (CSF). * used to treat hydrocephalus, shunt cerebrospinal fluid (CSF) from the lateral ventricles of the brain into the peritoneum (abdomen)

Answer 26

Ventriculoperitoneal shunt (VP Shunt)

Question 27

* enables cerebrospinal fluid (CSF) to flow from the cerebral ventricular system to the atrium of the heart * done when there is concurrent abdominal problem

Answer 27

*Ventriculoatrial shunt

Question 28

* considered as a treatment of choice for obstructive hydrocephalus. * It creates a bypass to allow CSF to reach areas of the brain where it is absorbed

Answer 28

Endoscopic Third Ventriculostomy (ETV)

Question 29

* procedure that reduces the choroid plexus- reduces production of CSF by cauterizing part of choroid plexus

Answer 29

Choroid Plexus Cauterization (CPC)

Question 30

post op intervention - position of child

Answer 30

supine on the unoperated / unaffected side

Question 31

* If increased ICP occurs, elevate the HOB to ___ degrees

Answer 31

15-30

Question 32

risk of shunts

Answer 32

bleeding, infection

Question 33

signs of shunt malfunction in infants

Answer 33

irritability, high shrill cry, lethargy and poor feeding

Question 34

signs of shunt malfunction in toddlers

Answer 34

*headache, lack of appetite

Question 35

signs of shunt malfunction in older children

Answer 35

change in LOC