Hydrocephalus
Treatment:
The goal of treatment is to minimize or prevent brain damage by improving CSF flow.
Surgical interventions are the primary treatment of hydrocephalus. This includes direct removal of the obstruction, if possible. Surgical placement of a shunt within the brain may allow CSF to bypass the obstructed area if the obstruction cannot be removed. Shunting of CSF to an area outside of the brain (such as to the right atrium of the heart or to the abdominal peritoneum) is an alternative to shunting within the brain. Surgical cautery or removal of the parts of the ventricles that produce CSF may (theoretically) reduce CSF production.
Antibiotics are used aggressively at any sign of infection. Severe infections may necessitate removal of a shunt.
Follow-up examinations should continue throughout the child's life to evaluate the child's developmental level and to treat any intellectual, neurologic, or physical impairments. Public health/visiting nurses, social services, support groups, and local agencies provide emotional support and assist with the care of the child with hydrocephalus.
Expectations (prognosis):
Untreated hydrocephalus has a 50 to 60% death rate, with the survivors having varying degrees of intellectual, physical, and neurologic disabilities.
Prognosis for treated hydrocephalus varies depending on the cause. If the child survives for one year, over 80% will have a fairly normal life span. Approximately one-third will have normal intellectual function, but neurologic difficulties may persist.
Hydrocephalus that is caused by disorders not associated with infection carries the best prognosis (probable outcome), although hydrocephalus caused by tumors has a very poor prognosis.
Complications:
- shunt dysfunction (kinking, obstruction, separation of tubing, or similar problems)
- infection
- intellectual impairment
- neurologic damage (decrease in movement, sensation, function)
- physical disabilities
- complications of surgery
Calling your health care provider:
Call your health care provider if symptoms indicate hydrocephalus. This disorder should be brought to the health care provider's attention promptly. Also call if the condition deteriorates to the point that the child cannot be cared for in the home.
Go to the emergency room or call the local emergency number (such as 911) if emergency symptoms occur, including difficulties with sucking/feeding, high-pitched cry, fever, lethargy or somnolence, stiff neck (unwillingness to bend or move the neck or head), problems with breathing, seizures, irregular heartbeat, or no heartbeat.
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