Lymphedema in Hydrocephalus: A Case Study

Abstract

Khulood Alrashid

Background: Lymphedema is a combination of pathologic condition characterized by excessive local accumulation of interstitial fluid which is rich in proteins [1-3]. It may be an isolated phenomenon or associated with a multitude of other disabling local sequelae or even life-threatening systemic syndromes. In its purest form, the central disturbance is a low output failure of the lymphvascular system, that is, overall lymphatic transport is reduced. Lymphedema can be either primary or secondary [4]. Hydrocephalus is a build-up of fluid in the brain. The excess fluid puts pressure on the brain, which can damage it. Congenital hydrocephalus is when a baby is born with excess fluid in their brain which will cause permanent brain damage such as: speech problems and vision problems [5]

Study Design: The case study was used to highlight the role of physical therapy interventions in the management of primary lower extremity lymphedema in patient with congenital hydrocephalus patient.

Case Description: 37 years-old Saudi female, case of congenital hydrocephalus, deaf, mute, blind with shunting. Patient with severe bilateral lower limb primary lymphedema, which altered her level of function. Referred to physical therapy department by vascular clinic. PT Management and Outcome: The patient received daily sessions of complete decongestive therapy (CDT) for two weeks included: multi-layer bandaging (compression therapy), manual lymphatic drainage, skin / nail care education and decongestive exercises. At the end of second week, the patient’s circumference measurements improved significantly, and her level of independency improved.

Discussion: The case study showed that the physical therapy interventions are safe, effective, in reducing lymphedema and overall quality of life (QOL) with hydrocephalus patients.

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