Clinical manifestations of hydrocephalus in older children and adults.
The clinical manifestations of hydrocephalus in older children and adults are different from those of hydrocephalus in infants and children because of the closure of the bony suture in older children and adults.
(A) Characteristics of acute hydrocephalus
Clinical manifestations are generally headache, nausea, vomiting, and visual disturbance.
(B) Chronic hydrocephalus features
The main clinical features are chronic intracranial pressure increase, bilateral temporal or whole cranial pain, nausea, vomiting, optic nerve papillary edema or optic nerve atrophy, intellectual developmental disorders, motor dysfunction, etc.
(C) Normal intracranial pressure hydrocephalus features
The main clinical manifestations are: unstable gait, varying degrees of motor disorders, from slow walking, instability, balance disorders to inability to walk, and finally bedridden; mental disorders are one of the early symptoms, initially memory loss, and in severe cases dementia. Individual patients may have urinary and fecal incontinence. Children can be seen with head circumference in the normal range or slightly above normal, delayed psychomotor development, decreased intelligence, poor learning ability, motor impairment, etc.
Care.
1. Room temperature should be kept at 18~21℃, humidity at 55%, regular ventilation and air circulation to provide a quiet, neat, comfortable and safe environment for treatment and rehabilitation.
2, the diet should be easy to open the brain, meridians, strengthen the spleen and kidney, fill the brain, strengthen the body and easy to digest food.
3, make good psychological care, nursing staff should be kind, warm, patient care of the patient to understand in detail the patient’s condition, family, social environment, help the patient and family members to establish confidence to overcome the disease, actively cooperate with treatment, passive to active, to create an optimal psychological state to accept treatment and rehabilitation.
4.Measure the child’s head regularly and ask if there is any history of nausea and vomiting.
5.When the intracranial pressure increases, closely observe the changes of vital signs, especially the changes of consciousness and pupils, the occurrence of brain herniation and the triad of intracranial hypertension (headache, vomiting, optic papilledema), make special care records and record the amount of in and out.
6, the application of mannitol antihypertensive must be fast drip, within half an hour, do not leak into the subcutaneous, to prevent local skin tissue necrosis.
7.Prevent complications, avoid moving when intracranial pressure is increased, put a soft pillow under the head to the side and elevate 15-30°, aspirate respiratory secretions in time to keep the respiratory tract open, pay attention to protecting the cornea and preventing decubitus ulcers when unconscious.
8.Prepare for resuscitation of critically ill patients (instruments, drugs), and tracheotomy if necessary.
9, symptomatic care, notify the doctor to give sedatives when convulsions, oxygen when there are signs of hypoxia, heat treatment when hyperthermia.
10.Guide parents or assist the patient to do functional training, mainly active movement.
11.Treat for disease etiology and rehabilitation treatment principles, and do discharge instructions to preserve treatment.
Hydrocephalus diet notes.
1, modern research shows that substances closely related to the brain are mainly fat (unsaturated fatty acids), protein, sugar, vitamin C, vitamin B, vitamin E, calcium, trace elements zinc, copper, selenium, etc.. Containing more of these substances are: hare, pig, sheep, duck, chicken, quail, sparrow and other animal meat; oysters, octopus, sea fish; walnuts, sesame seeds, pine nuts, peanut kernels, pumpkin seeds, sunflower seeds, watermelon seeds, almonds, dried fruits, vegetable oils, etc.
2, vitamin C can promote the solidity of the cell structure, and can eliminate the relaxation or tension of the intercellular structure, so that the body’s metabolic function, is the necessary substances for brain development. Containing more of these substances are sour dates, fresh dates, strawberries, grapes, persimmons, kumquats, apples, pears, hawthorn, pineapple, turnip leaves, tomatoes, cabbage, green tea, potatoes, etc.
3, protein is one of the main components of brain cells, accounting for 30% to 35% of the brain stem weight, is the main material basis for the excitation and inhibition process of brain cells, in memory, language, thinking, movement, nerve conduction and other aspects have an important role, brain development and nutrition, and the adequate supply of protein has a close relationship.
Rich in protein are: eggs, wild boar, rabbit meat, wild duck, pheasant, quail, sparrow, etc.; non-farmed fish and shellfish such as oysters, octopus, squid, shrimp, etc.; beef, pork, chicken, etc. and soybeans and soybean products, peanut kernel, pinto beans, broad beans, sesame, walnuts and other dried fruits.