congenital hydrocephalus
Post on 14-Nov-2014
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Congenital Hydrocephalus
Hydro = WaterCephalus =
Head
Water on the Brain
Excess accumulation of cerebrospinal fluid in the ventricles of the brain
TreatmentSurgical implantation
of fixed pressure or programmable shunts
Shunts follow pathways into the pleural cavity, the peritoneal cavity or the right atrium
ComplicationsMost Common
Shunt ObstructionLife Threatening Pre-Hospital Emergency Involves Increased ICP
Sepsis Inflammation and Infection on the Shunt
Pathwayincluding peritonitis and meningitis
1.Hypertension
2.Bradycardia
3.Irregular Respirations
Cushing’s Triad
Emergency Treatment of ICPAdequate Airway Breathing & OxygenationRapid Transport to Pediatric Facility
For Patients with Impending Herniation (e.g. – Cushing’s Triad)
Aggressive Hyperventilation, PaCO2 <30 mm Hg
Sepsis
Px with shunts presenting with sepsis can be
assumed to have meningitis.
Take isolation precautions
Treat for shock and/or dehydration as needed
Diagnosis is confirmed with a lumbar puncture
ConclusionEMS Treatment of Hydrocephalus related
emergencies need to be decisive and rapid
Immediate Transport to a Pediatric Facility with Neurosurgical Capabilities
Slide 1 – Picture courtesy of http://www.urmc.rochester.edu/neuroslides/slide165.html
Slide 2 – Picture courtesy of http://www.popovic.com.au/surgery_cranial_conditions.html
Slide 3 –Picture courtesy of http://www.lucinafoundation.org/assets/braindura.jpg
Slide 4 –Picture courtesy of http://www.lucinafoundation.org/assets/hydrocephalus.jpg
Slide 5 –Picture courtesy of http://www.cancerhelp.org.uk/cancer_images/brain-shunt.gif
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