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ASUHAN KEPERAWATAN ANAK

DENGAN HYDROCEPHALUS
H A NNI FAH F I T RI ANI
2 2 0112170520
Hidrosefalus
Hydro (air) – cephalus (kepala)
Secara umum hidrosefalus dapat didefiniskan
sebagai suatu gangguan pembentukan, aliran,
maupun penyerapan dari cairan serebrospinal
sehingga terjadi kelebihan cairan serebrospinal
pada susunan saraf pusat, kondisi ini juga
dapat diartikan sebagai gangguan
hidrodinamik cairan serebrospinal
(Satyanegara, 2010 & Espay 2012)
EPIDEMIOLOGI

3 dari 1000

40% - 50%

3,16 dari 1000

Ibrahim, dkk (2012); Espay (2012); Melo, et al (2013)


KLASIFIKASI
ETIOLOGI

PRENATAL POSTNATAL
Beberapa penyebabnya terutama adalah Lesi massa menyebabkan sekitar 20% kasus
stenosis vermis serebelum, batang otak, dan hidrosefalus, kista arakhnoid dan kista
ventrikel 4 disertai dengan anomali neuroepitelial merupakan kedua terbanyak
inrtakranial lainnya. Hampir dijumpai di yang mengganggu aliran likuor. Perdarahan,
semua kasus myelomeningokel meskipun meningitis, dan gangguan aliran vena juga
tidak semuanya berkembang menjadi merupakan penyabab yang cukup sering
hidrosefalus (80% kasus) (Satyanegara, 2012; terjadi (Satyanegara, 2012 & Fazl., et al.
Kaye, 2005; Sahu, et al., 2009). 2006).
MANIFESTASI KLINIS
• Makrokrania (ukuran kepala lebih besar)
• Fontanel anterior yang sangat tegang
• Sutura tampak atau teraba melebar
• Kulit kepala licin
• Sunset phenomenon (kedua bola mata berdiaviasi ke atas &
kelopak mata atas tertarik)

Usia anak-anak
• Gejala hipertensi intrakranial
• Nyeri kepala
• Muntah
• Gangguan okulomotor
• Gejala gangguan batang otak (bradikardia, aritmia respirasi)
• Gejala lainnya yaitu spastisitas pada eksremitas inferior yang berlanjut menjadi gangguan berjalan
dan gangguan endokrin
PEMERIKSAAN PENUNJANG

Mendeteksi hidrosefalus pada periode prenatal, dpt Mgukur dilatasi ventrikel scr kasar &
pula digunakan utk mengukur & memonitor uk. menentukan sumber obstruksi. Dapat
ventrikel, terutama digunakan pada anak prematur menilai scr fungsional/ anatomikal
PENATALAKSANAAN

Terapi medikamentosa berguna Drainase likuor eksternal (EVD) Operasi Shunting untuk Endoscopic Third
utk mengurangi cairan dr Pada pasien yang berpotensi membuat saluran baru antara Ventriculostomy (ETD) terapi
pleksus khoroid (asetazolamid mengalami hidrosefalus transisi aliran likuor (ventrikel atau pilihan bagi hidrosefalus
100 mg/ kg BB/hari; furosemid dpt dilakukan pemasangan lumbar) dengan kavitas obstruktif. ETV juga
0,1 mg/kg BB/hari) dan hanya kateter ventrikular. Namun drainase (seperti peritoneum, diindikasikan pada kasus block
bisa diberikan sementara/ tidak operasi shunt yang dilakukan atrium kanan, dan pleura) shunt atau slit ventricle
dlm waktu yg lama karena pasca EVD memiliki risiko syndrome. Kesuksesan ETV
berisiko menyebabkan gngguan tertinggi untuk terjadinya menurun pada kondisi
metabolik infeksi. hidrosefalus pasca perdarahan
dan pasca infeksi.
PROGNOSIS

Pada pasien hidrosefalus, kematian dapat terjadi


akibat herniasi tonsilar yang dapat menyebabkan
penekanan pada batang otak dan terjadinya henti
nafas. Sedangkan ketergantungan pada shunt
sebesar 75% dari kasus hidrosefalus yang diterapi
dan 50% pada anak dengan hidrosefalus
komunikans
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the product, but they also must take into account supply costs, the product, but they also must take into account supply costs,
seasonal discounts, and prices used by competitors. seasonal discounts, and prices used by competitors.

In some cases. Must link the price to the real and perceived value In some cases. Must link the price to the real and perceived value
of the product, but they also must take into account supply costs, of the product, but they also must take into account supply costs,
seasonal discounts, and prices used by competitors. In some cases. seasonal discounts, and prices used by competitors. In some cases.
PROGNOSIS
With this in mind, the marketing department would inform the
department to create a prototype.

SUCCESSFUL PEOPLE DO WHAT UNSUCCESSFUL
PEOPLE ARE NOT WILLING TO DO. DON’T WISH IT
WERE EASIER; WISH YOU WERE BETTER”
BIG
CONCEPT
With this in mind, the marketing
department would.
IN TWO OR THREE COLUMNS
PROJECT ONE PROJECT TWO PROJECT THREE

With this in mind, the marketing With this in mind, the marketing With this in mind, the marketing
department would inform the department would inform the department would inform the
department to create a prototype. The department to create a prototype. The department to create a prototype. The
production department would then start production department would then start production department would then start
to manufacture the product, while the to manufacture the product, while the to manufacture the product, while the
marketing department. With this in mind, marketing department. With this in mind, marketing department. With this in mind,
the marketing department would inform the marketing department would inform the marketing department would inform
the department to create a prototype. the department to create a prototype. the department to create a prototype.
A PICTURE IS A WORTH A THOUSAND WORDS
With this in mind, the marketing department would inform the department to create a prototype. The production department would then
start to manufacture the product, while the marketing department.
WHAT BIG IMPACT? USE BIG IMAGE
USE CHARTS TO EXPLAIN YOUR IDEAS

ONE TWO THREE FOUR


USE CHARTS TO EXPLAIN YOUR IDEAS

PROJECT TITLE ONE TWO THREE FOUR

PROJECT ONE

PROJECT TWO

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750,000 USERS
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YOU CAN ALSO SPLIT YOUR CONTENT

PROJECT ONE PROJECT TWO PROJECT TREE


Refers to a good or service being offered by Refers to a good or service being offered by Refers to a good or service being offered by
a company. Ideally, a product should meet a a company. Ideally, a product should meet a a company. Ideally, a product should meet a
certain consumer demand. certain consumer demand. certain consumer demand.

PROJECT FIVE PROJECT SIX PROJECT SEVEN


Refers to a good or service being offered by Refers to a good or service being offered by Refers to a good or service being offered by
a company. Ideally, a product should meet a a company. Ideally, a product should meet a a company. Ideally, a product should meet a
certain consumer demand. certain consumer demand. certain consumer demand.
YOU CAN INSERT GRAPHS FROM GOOGLE SHEETS

TITLE ONE
35%
TITLE TWO
50%
TITLE THREE
70%
IPHONE MOCKUP
Some fifty years ago there was a curious case of whale
trover litigated. Likewise a fish is technically fast when it
bears a waif, or any other recognized symbol of
possession. These are scientific commentaries; but the
commentaries of the whale men themselves sometimes
consist in hard words and harder knocks.
IPAD MOCKUP
Some fifty years ago there was a curious case of whale
trover litigated. Likewise a fish is technically fast when it
bears a waif, or any other recognized symbol of
possession. These are scientific commentaries; but the
commentaries of the whale men themselves sometimes
consist in hard words and harder knocks.
MACBOOK MOCKUP
Some fifty years ago there was a curious case of whale
trover litigated. Likewise a fish is technically fast when it
bears a waif, or any other recognized symbol of
possession. These are scientific commentaries; but the
commentaries of the whale men themselves sometimes
consist in hard words and harder knocks.
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