HYDROCEPHALUS

Speaker: Dr Bhagirath.S.N

Moderator: Dr Sarika

Hydrocephalus

Causes

1. After closure of meningomyelocele (if chiari II malformation is present)

2. Congenital (aqueductal stenosis)

3. Intraventricular hemorrhage

Neonate

1. Cranial sutures are open-so pressure increases are blunted

2. But eventually, head increases in size and intra cranial pressure increases

Hydrocephalus

Clinical presentation

1. Lethargy

2. Vomiting

3. Cardio respiratory problems

Anesthetic Technique

1. Avoid increase in ICP secondary to awake tracheal intubation, crying, struggling, straining

2. Rapid sequence induction is preferred3. Volatile anesthetic agents, opioid and nitrous oxide are not

contraindicated. (Ketamine, Isoflurane, fentanyl) 4. Open-sutured cranium means there is no increase in intra cranial

pressure secondary to Ketamine and volatile anesthetic administration.

5. Extubation depends on whether periods of intraoperative apnea & bradycardia were seen.

Hydrocephalus

Management•Surgical-Ventriculo-peritoneal shunt