Pathophysiology
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.