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학습 자료 둘러보기 →A bulging anterior fontanelle and rapidly increasing head circumference are the most critical objective signs of shunt malfunction. These findings directly reflect rising intracranial pressure (ICP) as CSF accumulates in the ventricles due to obstruction.
Other late signs of elevated ICP include high-pitched cry, vomiting, irritability, and sunset eyes. Cushing's triad (hypertension, bradycardia, irregular respirations) is a late, ominous finding.
Do not palpate a bulging fontanelle aggressively. Assess the infant in a quiet, upright position. A full fontanelle while crying is normal; a tense fontanelle at rest is an emergency requiring immediate neurosurgical evaluation.
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