The most common complaint a doctor hears from his patients is a headache. Both adults and children complain about it. It is impossible to ignore this. Especially if there are other symptoms. Parents should pay special attention to the child's headaches and the behavior of the baby, because he cannot say that it hurts. Perhaps these are the consequences of a difficult birth or congenital anomalies, which can be found out at an early age. Maybe it's liquorodynamic disorders. What is it, what are the characteristic signs of this disease in children and adults and how to treat, we will consider further.
What does liquorodynamic disturbances mean
CSF is a cerebrospinal fluid that constantly circulates in the ventricles, CSF pathways and in the subarachnoid space of the brain and spinal cord. Liquor plays an important role in metabolic processes in the central nervous system, in maintaining homeostasis in brain tissues, and also creates a certain mechanical protection for the brain.
Liquor dynamic disorders are conditions in which the circulation of cerebrospinal fluid is impaired,its excretion and reabsorption. These processes are regulated by glands that are located in the choroid plexuses of the ventricles of the brain, which produce fluid.
In the normal state of the body, the composition of the cerebrospinal fluid and its pressure are stable.
What is the mechanism of violations
Let's consider how CSF-dynamic disorders of the brain can develop:
- The rate of production and release of CSF by the vascular plexuses increases.
- The rate of CSF absorption from the subarachnoid space slows down due to the overlap of the narrowing of the liquor-bearing vessels due to subarachnoid hemorrhages or inflammatory diseases of the meninges of the brain.
- Decreased production of CSF during normal absorption.
The rate of absorption, production and release of CSF affects:
- On the state of cerebral hemodynamics.
- Hematoencephalic barrier condition.
The inflammatory process in the brain contributes to an increase in its volume and an increase in intracranial pressure. As a result - a violation of blood circulation and blockage of the vessels through which the cerebrospinal fluid moves. Due to the accumulation of fluid in the cavities, partial death of intracranial tissues may begin, and this will lead to the development of hydrocephalus.
Classification of violations
Liquorodynamic disorders are classified in the following areas:
How the pathological process proceeds:
- Chronic.
- Acute phase.
2. Development stages:
- Progressive. Intracranial pressure is growing, and pathological processes are progressing.
- Compensated. Intracranial pressure is stable, but the cerebral ventricles remain dilated.
- Subcompensated. Great danger of crises. Unstable state. The pressure can rise sharply at any moment.
3. In what cavity of the brain is the CSF localized:
- Intraventricular. Fluid accumulates in the ventricular system of the brain due to obstruction of the CSF system.
- Subarachnoid. Liquorodynamic disorders of the external type can lead to destructive lesions of the brain tissues.
- Mixed.
4. Depending on CSF pressure:
- Hypertension. Characterized by high intracranial pressure. The outflow of cerebrospinal fluid is disturbed.
- Normotensive stage. The intracranial pressure is normal, but the ventricular cavity is enlarged. This condition is typical most often in childhood.
- Hypotension. After surgery, excessive outflow of CSF from the cavities of the ventricles.
Congenital causes
There are congenital anomalies that can contribute to the development of liquorodynamic disorders:
- Genetic disorders in fetal development.
- Agenesis of the corpus callosum.
- Dandy-Walker syndrome.
- Arnold-Chiari syndrome.
- Encephalocele.
- Stenosisaqueduct of the brain primary or secondary.
- Porencephalic cysts.
Reasons acquired
Liquorodynamic disorders can begin to develop for acquired reasons:
- Injuries of the spinal cord and brain.
- Various infectious diseases and parasitic infections affecting the nervous system.
- Neoplasms inside the skull that block the CSF pathways.
- Thrombosis.
- Intrauterine hypoxia in the first two days after birth.
- Papillomas of the choroid plexus.
Symptoms of CSF disorders in adults
Liquorodynamic disorders of the brain in adults are accompanied by the following symptoms:
- Severe headaches.
- Nausea and vomiting.
- Fatigue.
- Horizontal involuntary movements of the eyeballs.
- Increased tone, muscle stiffness.
- Convulsions. Myoclonic seizures.
- Speech disorder. Intellectual problems.
Symptomatic disorders in infants
Liquorodynamic disorders in children under one year old have the following symptoms:
- Frequent and profuse regurgitation.
- Unexpected crying for no apparent reason.
- Slow overgrowth of the fontanel.
- Monotone crying.
- Child is lethargic, sleepy.
- Sleep disturbed.
- Seam separation.
Over time, the disease progresses more and more, and signs of liquorodynamic disorders become more pronounced:
- Chin tremor.
- Twitching limbs.
- Involuntary shudders.
- Life support functions disrupted.
- Irregularities in the functioning of internal organs for no apparent reason.
- Possible strabismus.
Visually you can see the vascular network in the nose, neck, chest. When crying or tensing muscles, it becomes more pronounced.
Also, a neurologist may note the following signs:
- Hemiplegia.
- Extensor hypertonicity.
- Meningeal signs.
- Paralysis and paresis.
- Paraplegia.
- Grefe's symptom.
- Horizontal nystagmus.
- Lagging behind in psychomotor development.
You should visit your pediatrician regularly. At the appointment, the doctor measures the volume of the head, and if the pathology develops, changes will be noticeable. So, there may be such deviations in the development of the skull:
- Head grows rapidly.
- Has an unnaturally elongated shape.
- The large and small fontanelles swell and pulsate.
- Sutures are coming apart due to high intracranial pressure.
All these are signs that the syndrome of liquorodynamic disorders in the baby is developing. Hydrocephalus progresses.
I would like to note that it is difficult to identify CSF crises in infants.
Signs of liquorodynamic disorders in children after a year
After a year, a child's skull is already formed. The fontanelles are completely closed, and the sutures are ossified. If there are liquorodynamic disorders in a child, there are signs of increased intracranial pressure.
There may be complaints like this:
- Headache.
- Apathy.
- Worry for no reason.
- Nausea.
- Vomiting without relief.
And the following signs are also characteristic:
- Disturbed gait, speech.
- There are violations in the coordination of movements.
- Vision is falling.
- Horizontal nystagmus.
- In a neglected case of "bobbing doll's head".
And also, if liquorodynamic disorders of the brain progress, the following deviations will be noticeable:
- Child does not speak well.
- Use standard, learned phrases without understanding their meaning.
- Always in a good mood.
- Delayed puberty.
- A convulsive syndrome develops.
- Obesity.
- Disturbances in the endocrine system.
- Lagging behind in the educational process.
Diagnosis of disease in children
In children under one year of age, diagnosis primarily begins with a survey of the mother and the collection of information about how the pregnancy and childbirth went. Further, complaints and observations of parents are taken into account. Then the child needs to be examined by such specialists:
- Neurologist.
- Ophthalmologist.
For clarificationdiagnosis, you will need to undergo the following tests:
- Ultrasound.
- Computed tomography.
- MRI.
- Neurosonography.
Diagnosis of disease in adults
With headaches and the symptoms described above, you need to see a neurologist. To clarify the diagnosis and prescribe treatment, the following studies may be prescribed:
- Computed tomography.
- Angiography.
- Pneumoencephalography.
- ECHO of the brain.
- MRI.
If there is a suspicion of a syndrome of CSF disorders, a lumbar puncture with a change in CSF pressure may be prescribed.
When diagnosing adults, much attention is paid to the underlying disease.
Treatment of CSF disorders
The earlier the disease is detected, the more likely it is to restore lost brain functions. The type of treatment is selected based on the presence of pathological changes in the course of the disease, as well as the age of the patient.
In the presence of increased intracranial pressure, as a rule, diuretics are prescribed: Furosemide, Diakarb. Antibacterial agents are used in the treatment of infectious processes. Normalization of intracranial pressure and its treatment is the main task.
To relieve swelling and inflammation, glucocorticoid drugs are used: Prednisolone, Dexamethasone.
Also, steroids are used to reduce cerebral edema. It is necessary to eliminate the cause that caused the disease.
As soon as revealedliquorodynamic disorders, treatment should be prescribed immediately. After undergoing complex therapy, positive results are noticeable. This is especially important during the development of the child. Speech is improving, progress in psychomotor development is noticeable.
Surgical treatment is also possible. It can be assigned in the following cases:
- Medication is ineffective.
- Liquorodynamic crisis.
- Occlusive hydrocephalus.
Surgical treatment is considered for each case of the disease separately, taking into account the age, characteristics of the organism and the course of the disease. In most cases, brain surgery is avoided so as not to damage he althy brain tissue, and complex drug treatment is used.
It is known that if the syndrome of liquorodynamic disorders in a child is not treated, mortality is 50% up to 3 years, 20-30% of children survive to adulthood. After surgery, the mortality rate is 5-15% of sick children.
Mortality is on the rise due to delayed diagnosis.
Prevention of CSF disorders
Preventive measures include:
- Observation of pregnancy in the antenatal clinic. It is very important to register as early as possible.
- Timely detection of intrauterine infections and their treatment.
At the 18-20th week, ultrasound shows the development of the fetal brain and the state of the cerebrospinal fluid of the unborn child. At this time, you can determine the presence or absence of pathologies.
- Correct choice of delivery.
- Regular follow-up with a pediatrician. Measurement of the circumference of the skull, if there is a need to conduct an examination of the fundus.
- If the fontanel did not close in time, it is necessary to conduct neurosonography and consult a neurosurgeon.
- Timely removal of neoplasms that stop the CSF pathways.
- Regular follow-up with a doctor and conducting the necessary studies after suffering injuries of the brain and spinal cord.
- Timely treatment of infectious diseases.
- Prevention and treatment of chronic diseases.
- Quit smoking and alcohol.
- Recommended to play sports, lead an active lifestyle.
Any disease is easier to prevent or take all measures to reduce the risk of developing pathology. If liquorodynamic disorders are diagnosed, then the earlier therapy is started, the greater the chance that the child will develop normally.
