One of the dangerous diseases that develops in people of different ages is dropsy of the brain, otherwise called hydrocephalus. This disease is characterized by an increase in the volume of the ventricles located in the brain. As a rule, the cause is the accumulation of excessively produced CSF. Most often, the disease is detected in infants, but it can also occur in older children, in adults.
Anatomical features
The human brain consists of a specific substance, the performance of which is due to constant contact with the cerebrospinal fluid. This term refers to the fluid that surrounds the brain tissue. The compound is colorless, transparent, designed to protect the brain and transport nutrients to its cells. From the outside, fluid circulation is organized between the meninges of the hemispheres, the cerebellum in a space called the subarachnoid. Dropsy of the brain develops when this mechanism is disturbed. Normally, the accumulation of cerebrospinal fluid is possible in tanks located at the cranial base. Thesethe elements are connected to each other in different directions, which ensures movement between the parts of the brain. Proper circulation of CSF through the tanks is the key to high-quality brain function.
In the head, the cerebrospinal fluid is located in the brain cavities - the ventricles. The hemispheres are equipped with two elements, the third is parallel to the central line, another one is between the brain stem, the cerebellum. A pair of holes is provided for connection with tanks. There should be about 150 ml of a substance here, which is completely renewed three times a day. Formation and absorption of fluid must balance each other, thus the volume is constant, pressure - too. When this balance is disturbed, dropsy of the brain develops.
This is important
Liquor accumulates either due to an imbalance or due to improper movement of substances in the body. The second option with dropsy of the brain is observed when the cerebrospinal fluid is produced in a normal volume, but is not absorbed by the cells, and this becomes the main factor in the pathology.
Where did the trouble come from?
In infants, the disease is more often observed against the background of infection of the mother's body during the period of gestation. Most often, the pathology is due to infection with cytomegalovirus. The changes it provokes in the mother's body lead to improper circulation of the brain fluid, the production of substances in too large a volume. However, these causes of dropsy of the brain are not exhausted. The disease can develop against the background of meningitis, encephalitis, poisoning or mechanical injury. Cases are known whendropsy was provoked by brain tissue tumors.
From medical statistics it is clear that to provoke dropsy of the brain in adults, children can outpouring of blood into the ventricles, subarachnoid department. A possible cause is problems with blood flow in the brain (ischemia, hemorrhagic type). The cause may be encephalopathy triggered by various factors, including alcohol abuse, lack of oxygen supply to the brain tissue.
What happens?
It is customary to distinguish between acquired and congenital forms of the disease. Pathogenesis allows us to formulate three types of pathology:
- occlusion;
- communicating;
- increased secretion.
Earlier, they talked about the fourth form of the disease, mixed. Other doctors called it external. Now such a disease is classified as atrophic processes of the brain, since it is atrophy that explains the reduction in the volume of organic tissues.
Another classification option allows us to talk about dropsy of the brain in adults and children:
- spicy;
- tune;
- chronic.
The first option develops in just three days, the second one in a month, and the third requires up to six months, and in some cases even more time.
Depending on the indicators of CSF pressure, the disease is classified into categories:
- high blood pressure;
- with normal;
- reduced.
Symptomatics
The key symptom of dropsy of the brain is increasedpressure, against the background of which excruciating headaches develop. The patient is sick, vomits, vision and hearing are soon disturbed. It is possible to suspect dropsy in an infant by the swelling of the fontanel, the tension of this zone. The child throws back the head, and the eyeballs are constantly shifting. This disease is both acute and chronic. In the first case, the described signs are observed in a pronounced form. The chronicle is characterized by similar manifestations, while the course is complicated, as the wrong treatment is often chosen or the course is started too late.
External dropsy of the brain in children, adults is open and closed. To determine which type the disease belongs to, clinical observations should be made. The external version is accompanied by a contraction of the brain, and the volumes previously occupied by the tissues are filled with cerebrospinal fluid. Such a disease proceeds imperceptibly, the symptoms do not differ. The patient has normal pressure, no pain syndrome. The person sees and hears normally. In old age, the disease may be accompanied by an increase in pressure. Quite often, pathology is accompanied by atherosclerosis.
Occlusion is a form of dropsy of the brain, the symptoms of which include severe pain, cravings for sleep, and nausea. The patient vomits. To a greater extent, the phenomena are expressed if the disease proceeds in an acute form. Specific studies show the axial location of the brain. When studying the state of the visual system, stagnation of the nerve disk is detected.
Manifestations: specifics
Symptoms of dropsy of the brain in adults, children usually begin with a headache. Patients who are able to describe their feelings note that the syndrome is more pronounced in the morning, immediately after waking up. Doctors attribute this to an increase in pressure inside the skull during a night's rest. It is possible to suspect deterioration if the patient begins to sleep. This development suggests that the state will change dramatically. This is due to the effect on the nervous system. If pressure rises in the subarachnoid space, there is congestion in the optic nerve discs. The second reason is the problems of the axoplasmic current.
Dropsy of the brain in adults, children can cause coma. There are disturbances in the functioning of the visual organs. Some patients constantly support the head in an unusual specific position. Since the medulla oblongata is compressed during the disease, there is a high probability of disruption of the respiratory organs and blood vessels. This can cause the patient to die soon.
Dissorptive form
If such a pathology flows chronically, dropsy of the brain in adults manifests itself as gait disturbances, paraparesis of the lower extremities. The problem is accompanied by enuresis, dementia. The first manifestations can be seen by the end of the third week after the illness that provoked dropsy. At first, the patient suffers from a violation of the cycle of night rest and awakening, after which activity decreases, and behavior becomes illogical, spontaneous. People lose initiative, become inert, indifferent, cannot remember numbers.
To identify the features of the violation, it is necessary to conduct an MRI, CT scan. Duringinstrumental examination, doctors receive information about the state of the cerebral ventricles, evaluate the subarachnoid spaces, determining the dimensions of these zones, the position, and deformity of the areas. Based on the information obtained from CT, MRI, you can choose the appropriate treatment for dropsy of the brain.
Therapeutic approach
The best prognosis for the treatment of dropsy of the brain, if the disease can be detected at an early stage. This is where medication comes into play. The situation is somewhat more complicated if the pathology is actively progressing - this forces an urgent operation. The very first method of surgical intervention invented was shunting. Its effectiveness is high if the disease develops in the form of occlusion. The main weak point is the patient's dependence on the quality of the shunt. Another option is drainage operations, in which excess fluid is removed from the brain tissue by external methods. This approach is fraught with complications, therefore it is practiced strictly when it is impossible to use other ways.
The most modern method of surgical intervention involves the use of an endoscope. If a tumor is found inside the ventricle, the neoplasm is removed. Sometimes septostomy, aqueductoplasty techniques are used, and a system of shunts is installed as needed. If necessary, the bottom of the third ventricle is treated with an endoscope using the ventriculocisternotomy method.
Statistics and diagnosis
In recent years, dropsy of the head is increasingly diagnosedof the brain in a newborn, and in adult patients, such cases also became more frequent. Predictions of survival, consequences are completely determined by how quickly the disease was identified, whether the therapy was chosen correctly. It is known that children, having received timely qualified assistance, then live a full long life. Of the severe complications, the likelihood of impaired speech function is noted. When installing a shunt, there is a risk of infectious processes, a malfunction of such a system. This forces urgent surgery.
Specialists say that the diagnosis in recent years is more common largely due to the deterioration of the environmental situation. A change in lifestyle, the dominance of bad habits, and a weakening of the immune system play a role. Officially, the process is recognized as irreversible. Of course, against this background, patients and their loved ones are interested in how long adults with dropsy of the brain live. It is impossible to say exactly, in different cases the situation develops in different ways. Many deaths are known, but many patients, having received adequate assistance in the shortest possible time, survived.
Children: some features
Depsy of the brain in a baby can develop already at the stage of gestation. It is possible to notice this on a planned ultrasound examination. Hydrocephalus is established at 18-20 weeks of gestation. Most often, the cause is infection of the female body, so a special check is carried out without fail if the mother has suffered any infection. The herpes virus can provoke hydrocephalus.
There are many cases when the disease developed during the first year of life. In most cases, it manifested itself against the background of infection of the body. Dropsy can be a consequence of meningitis, trauma, encephalitis. For some children, the explanation is heredity. Such a problem is possible if there are violations of the functioning of the vascular system. In most cases, it is impossible to establish exactly why a child has an illness, which makes it difficult to plan children in the future. As follows from statistical studies, hydrocephalus is diagnosed with a frequency of one case per 500-1000 babies, which is more often than Down syndrome. Hydrocephalus is the most common he alth problem in young children. Already today, more than a hundred factors are known that can provoke such a disaster. Dropsy is the most common reason an infant is referred for brain surgery.
Reality and fears
Medicine has advanced a lot these days, so pediatric hydrocephalus has ceased to be such a frightening diagnosis. On average, the death rate from this disease is no more than five percent, although a few decades ago, half of sick children died from dropsy. True, you can count on a positive outcome only if you managed to notice the symptoms in time, conduct an examination, identify the disease and take measures to treat it.
It is known that dropsy can develop against the background of a malignant tumor, thereforesuch a disease forces a full examination of the child, even if it was possible to quickly identify and cure it. There is a risk of inflammatory processes in the brain, malformations. Sometimes hydrocephalus in children appears against the background of rubella, mumps, neurosyphilis. Of the congenital malformations, Arnold-Chiari syndrome should first be mentioned. This disease can cause infringement of brain tissue, which leads to dysfunction of the respiratory organs, the vascular system. The syndrome is associated with a high risk of death. Sometimes a cyst is established in children, anomalies of the venous structure, underdevelopment of the holes for the exit of the cerebrospinal fluid, narrowing of the cerebral duct for fluid. Dandy-Walker syndrome, in which there is an abnormal structure of the cerebellum, can also cause hydrocephalus.
Risk group
More often dropsy of the brain in children is observed against the background of underweight (less than one and a half kilograms), as well as in premature babies born before 37 weeks of pregnancy. A certain risk is associated with the narrow pelvis of the woman in labor, insufficient oxygen supply during the gestation period, and suffocation during childbirth. Sometimes hydrocephalus is explained by colds and flu suffered by a woman during pregnancy. A certain risk is created by addiction to smoking, alcoholic beverages.
It is possible to suspect incorrect development by deformed proportions. Usually the head of the child is significantly larger than normal. The cranial bones of an infant are quite soft, so the head seems to swell due to pressure. A sick child cries a lot, although sometimes this is replaced by drowsiness. Throughthe skin on the head is clearly visible wreaths, the skin seems to be transparent, translucent. The child does not eat well, and the limbs are too tense. Psychomotor lags behind in development from a he althy baby. The patient vomits, food is regurgitated, and the child's weight is small. Babies are usually lethargic, cannot hold their heads, so normal skills are not formed in due time. Many suffer from seizures.
Consequences: what is possible?
Against the background of hydrocephalus, the development of autism, poor memory is possible. Such children hardly learn new information, speech is formed heavily, slowly, with a lag. Many suffer from the inability to coordinate movements, to concentrate. Against the background of dropsy, a decrease in intelligence is possible. Many children have visual impairment up to blindness.
Diagnostic features
If hydrocephalus is suspected, the doctor takes note of the child. If unhe althy tendencies are observed, special instrumental studies are prescribed. Neurosonography is a fairly effective modern approach to clarifying the patient's condition, optimal for examining babies up to the age of one and a half years, when the cranial bones are not yet fully formed. When the fusion is completed, ultrasound will no longer give such a high-quality picture, therefore, the technique is not used for older people. Neurosonography is carried out on a special machine - almost all domestic hospitals have such machines. There are no restrictions, contraindications to such a study, so you can not be afraid forchild - in the process of diagnosis, nothing bad will happen to him through the fault of the device.
