Hydrocephalus In Children

WHAT YOU SHOULD KNOW:

• Hydrocephalus (HEYE-droh-SEF-ah-lus) is a condition when too much fluid collects in the ventricles of the brain. Ventricles are spaces inside the brain where a clear fluid called cerebrospinal fluid, or CSF, is produced. CSF normally flows from the ventricles into the lower part of the brain and up and down the spinal cord. CSF is then absorbed by blood vessels, called veins, into the blood system. CSF cushions the brain from injury and also delivers nutrients and removes wastes. Normally, there is a constant balance of CSF production and absorption, which helps control the pressure within the brain. With hydrocephalus, there is a problem with this balance causing an increased pressure on the brain. This increased pressure may then damage brain cells.
  
  
• Hydrocephalus may be caused by an increased production or decreased absorption of CSF. Problems in the flow of CSF, such as a block or clog, may also result in hydrocephalus. These conditions may result from maternal infections during pregnancy, fetal defects, head injuries, and tumors of the brain. The most common sign in infants and younger children may be a fast increasing head size. Other symptoms include fussiness, sleepiness, vomiting, and seizures. Older children may have blurring of vision, headaches, mood changes, learning problems, and memory loss. Tests may include a lumbar puncture, computed tomography scan, or magnetic resonance imaging of the head. Treatment includes diuretics (water pills), a shunt, and surgery. Ask your caregiver for more information about the different treatments for hydrocephalus.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

RISKS:

Hydrocephalus, if left untreated, causes an increased pressure inside the skull. This may damage the brain and cause life-long problems, such as retardation, cerebral palsy, seizures, and possibly death. Infection, an obstruction, or a shunt malfunction may happen if your child has a shunt. Treatment should begin as soon as possible to prevent brain injury. With treatment, such as a shunt and medicine, your child's quality of life may be improved. Ask your caregiver if you have any questions about your child's hydrocephalus and his treatments.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that your child may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your child's medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done to your child. Make sure all of your questions are answered.

Emotional support:

Stay with your child for comfort and support as often as possible while he is in the hospital. Ask another family member or someone close to the family to stay with your child when you cannot be there. Bring items from home that will comfort your child, such as a favorite blanket or toy.

IV:

An IV is a small tube placed in your child's vein. Caregivers use the IV to give your child medicine or liquids.

Neurologic signs:

These are also called neuro signs, neuro checks, or neuro status. During a neuro check, caregivers see how your child's pupils react to light. They may check his memory and how easily he wakes up. His hand grasp and balance may also be tested. How your child responds to the neuro checks can tell caregivers if his illness or injury has affected his brain.

Medicines:

Your child may have any of the following:

• Antibiotics: This medicine is given to help prevent or treat an infection caused by bacteria.
  
  
• Anticonvulsant medicine: Anticonvulsants are given to control your child's seizures.
  
  
• Anti-nausea medicine: This medicine may be given to calm your child's stomach and control vomiting (throwing up). Your child may have an upset stomach after surgery or taking pain medication.
  
  
• Diuretics: This medicine is to help decrease swelling in your child's brain.

Tests:

Your child may need one or more of the following:

• CT scan: This test is also called a CAT scan. An x-ray and computer are used to take pictures of your child's body. Your child may be given dye, also called contrast, before the test. Tell the caregiver if your child is allergic to dye, iodine, or seafood.
  
  
• Head circumference: This is the distance around your child's head. Caregivers may put a tape measure around your child's head to measure it.
  
  
• Intracranial pressure monitor: This is also called an ICP monitor. An ICP monitor is a small tube that is inserted through the skull (bones of your child's head). The tubing is connected to a TV-type screen. Caregivers use the ICP monitor to constantly measure the pressure inside your child's skull.
  
  
• MRI: An MRI uses a powerful magnet and radio waves to take pictures of the inside of your child's body. Caregivers may use the MRI to look at your child's brain, muscles, joints, bones, or blood vessels. Your child will need to lie still during his test. Never enter the MRI room with any metal objects. This can cause serious injury.
  
  
• Ultrasound: This is a test using sound waves to look at your child's brain. Pictures of your child's brain and ventricles show up on a TV-like screen. This may show changes in his brain or ventricles that may cause hydrocephalus.

Treatment options:

Your child may have any of the following treatments:

• Lumbar puncture: This procedure may also be called a spinal tap. A small needle is placed into your child's lower back. Fluid will be removed from around your child's spinal cord and sent to the lab for tests. The test is done to check for bleeding around your child's brain and spinal cord, and for infection. This procedure may also be done to take pressure off your child's brain and spinal cord, or to give medicine. Your child may need to be held in place so that he does not move during the procedure.
  
  
• Shunt: This is a surgical procedure where caregivers put a flexible tube into your child's ventricle. The tube helps drain out CSF into the abdomen (belly) or chest. Ask your caregiver for more information about the use of shunts in hydrocephalus.
  
  
• Ventriculostomy: Surgery using an endoscope to make a hole through the ventricles. This is to help drain CSF. An endoscope is a thin, flexible tube with a camera to help caregivers look into your child's brain and ventricles.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Hydrocephalus In Children (Inpatient Care)