Clinical meaning
Hydrocephalus results from imbalanced CSF dynamics: the choroid plexus produces approximately 500 mL/day of CSF, which flows from the lateral ventricles through the foramina of Monro, third ventricle, cerebral aqueduct, fourth ventricle, and into the subarachnoid space for reabsorption by arachnoid granulations. Obstruction at any point (obstructive/non-communicating) or impaired absorption (communicating) causes ventricular dilation and elevated ICP. The VP shunt bypasses the obstruction by directing CSF from a ventricular catheter through a pressure-regulated valve to the peritoneal cavity. The nurse manages comprehensive pre- and post-operative care, monitors for shunt complications (malfunction, infection, overdrainage), performs neurological assessments, and educates families on long-term shunt management.
Exam relevance
Risk factors: - Intraventricular hemorrhage of prematurity (most common cause in premature infants) - Neural tube defects: myelomeningocele, Chiari II malformation - Congenital aqueductal stenosis - CNS infections: bacterial meningitis, TORCH infections - Brain tumors (posterior fossa tumors in children) - Post-hemorrhagic or post-infectious hydrocephalus - Dandy-Walker malformation