TY - CHAP M1 - Book, Section TI - Hydrocephalus A1 - Fuchs, Susan A2 - Schafermeyer, Robert A2 - Tenenbein, Milton A2 - Macias, Charles G. A2 - Sharieff, Ghazala Q. A2 - Yamamoto, Loren G. Y1 - 2014 N1 - T2 - Strange and Schafermeyer's Pediatric Emergency Medicine, 4e AB - Hydrocephalus refers to the excess accumulation of cerebrospinal fluid (CSF). Most cases result from congenital or acquired obstructions to the flow of CSF from the brain to the spinal canal.Infants with hydrocephalus are often diagnosed on routine examination by finding head circumference disproportionately large for age or splitting of the cranial sutures.Older children with hydrocephalus will usually complain of headache, which is often progressive in nature, worse in the morning, awakens the patient from sleep, and is exacerbated by lying down or straining.It is imperative to begin treatment in the unstable patient before herniation occurs. Patients who are lethargic on presentation, those with a Glasgow Coma Scale <8, or those who deteriorate in the emergency department are intubated following rapid sequence induction procedures and ventilated to maintain Pco2 at 35 torr. If there are signs of herniation such as unequal pupils, fixed and dilated pupils, or posturing, mild hyperventilation can be helpful on a short-term basis.Patients who do not respond with an improved mental status after intubation and controlled ventilation may benefit from diuretic therapy with mannitol or furosemide.After the patient is stabilized, a computed tomography scan or magnetic resonance image of the brain is performed to define the lesion and plan definitive treatment. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1105683085 ER -