05/12/2025
*Neurosurgery*
_Hydrocephalus management_
Aims to _reduce intracranial pressure (ICP), restore CSF flow_ , and _prevent neurological damage._
*1. Initial (Emergency) Management*
Used when patient presents with signs of raised ICP (headache, vomiting, bradycardia, altered mental status).
A. Medical Measures (Temporary Relief)
Head elevation (30°) – improves venous drainage.
IV Mannitol (osmotic diuretic)
– draws fluid from brain → reduces ICP.
Hypertonic saline (3% NaCl) – alternative to mannitol for severe edema.
Controlled hyperventilation
– reduces PaCO₂ → cerebral vasoconstriction → ↓ ICP (short-term).
Avoid hypotension & hypoxia – worsens brain injury.
Acetazolamide (carbonic anhydrase inhibitor)
– ↓ CSF production (use in infants or communicating hydrocephalus).
Medical therapy is temporary; definitive management is usually surgical.
External Ventricular Drain (EVD)
A temporary device used to drain CSF from the lateral ventricle to an external collecting system to relieve increased int