High intracranial pressure is a diagnosis that many people are familiar with. It is quite common. At the same time, it is often put unreasonably, without conducting appropriate research. But the pathology is based on serious diseases. One of them is hydrocephalus. The symptoms of the disease are quite recognizable and can result in serious consequences.
A bit of anatomy
During normal human activity, the brain is constantly bathed in a clear liquid. She nourishes and protects him. Fluid circulates in the space between the pia and choroid of the hemispheres and the cerebellum. There are special places in the body - tanks in which it accumulates. They are located at the base of the skull. These tanks are connected to each other and the spinal cord. The gray matter contains fluid in the four ventricles. This is normal.
Cerebrospinal fluid is produced from the blood. The norm of the total volume is 150 ml. The process of fluid production and absorption are in balance. The disharmony of this balance entails seriouseffects. Fluid begins to accumulate in the brain. Either a decrease in absorption or an increase in production leads to this.
If the outflow of fluid is disturbed, then the patient develops hydrocephalus. Symptoms can be observed in both newborns and adults. The source of the problem is a narrowing of the channel between the ventricles or a violation of the absorption of fluid by the body. To understand the pathology, one should consider what the brain looks like (the photo is in the article). Often, an unpleasant ailment is diagnosed in newborns. According to statistics, every 500th child is born with the above-mentioned serious problem.
Sometimes an affliction is not a congenital disease. Medicine knows cases when the signs of hydrocephalus were acquired in the course of life. As a rule, the causes of its occurrence lie in past diseases. Often it is cerebrovascular disease of the brain that provokes the development of a terrible pathology.
Types of illness
Hydrocephalus is quite diverse in its forms and causes. Today in medicine there are several classifications of the disease.
According to the place of fluid accumulation, the disease is divided into types:
- Internal hydrocephalus. Fluid (liquor) accumulates in excess in the ventricles.
- External hydrocephalus of the brain. It is also called external. With this type of disease, the accumulation of cerebrospinal fluid is observed in the subarachnoid space. In other words, the fluid is localized near the cranium.
- General hydrocephalus. With this form, cerebrospinal fluid is contained throughout the brain. It is found both in the ventricles and in the subarachnoid space. This form has another name - mixed hydrocephalus.
Causes of illness in children
The main factor provoking illness in newborns is difficult childbirth. As a rule, we are talking about a long anhydrous period of the fetus or birth injuries received by the child.
Sometimes there is an accumulation of fluid in the brain of a child still in the womb. This pathology is associated with infections and viral diseases carried by a pregnant woman. Especially dangerous are herpes, toxoplasmosis, cytomegaly.
The most common is congenital hydrocephalus of the brain. Its signs begin to appear already in the first months of a child's life. However, older children can also be affected. There are many sources that provoke a serious illness. Among them are:
- brain tumors (both brain and spinal);
- meningitis;
- encephalitis;
- infectious diseases (tuberculosis);
- defects of the brain and blood vessels;
- hemorrhages;
- traumatic brain injury;
- genetic disorders.
Sometimes the source of a terrible disease cannot even be identified.
Causes of illness in adults
Not only babies have a terrible diagnosis. It can be placed at any age. Hydrocephalus occurs, or, as it is popularly called,dropsy of the brain, in adults due to past ailments:
- brain hemorrhage;
- stroke;
- brain surgery;
- meningitis;
- oncological diseases of the brain;
- traumatic brain injury;
- brain atrophy.
In most cases, it is cerebrovascular disease of the brain (atherosclerosis, stroke, arterial hypertension) that becomes a real focus for the development of dropsy.
Clinical signs of illness in children
Cerebrospinal fluid (CSF) performs the most important function in the body. It nourishes the brain with all useful substances and removes toxins from it. Timely outflow of fluid determines the normal operation of the main organ. Any violation of the withdrawal of cerebrospinal fluid is fraught with consequences. After all, the production of fluid does not change. As a result, the ventricles are full. As a result, their expansion is observed.
The most common symptoms diagnosed with hydrocephalus are:
- rapid head enlargement (takes the shape of a ball);
- the child is very whiny and irritable;
- baby vomits profusely and often;
- the fontanel rises above the surface of the skull, no pulsation;
- the eyes of a newborn are shifted down, vision deteriorates, sometimes strabismus occurs;
- may have seizures;
- lagging behind in physical and mental development;
- frequent tilting of the head;
- pallor of the skin;
- trembling of the chin and limbs.
In older childrenthe head does not increase, because the bones of the skull have already grown together. However, liquid still accumulates. The doctor will see this manifestation when he examines the brain in the picture. The photo will be very different from those images that he althy people have. As a rule, children suffer from severe headaches, vomiting, and a feeling of nausea. There may be a decrease in hearing, vision. Baby gets weak.
Symptoms of the disease in adults
The following signs of hydrocephalus are distinguished:
- dizziness, pain;
- nausea, vomiting;
- noises in the head;
- epileptic seizures;
- disorders of motor and neurological functions;
- decrease in efficiency, occurrence of apathy, depression;
- deterioration of vision.
A feature of the disease of the elderly is a normal or slight increase in intracranial pressure. A small deviation from the norm characterizes normotensive hydrocephalus. Squeezing of the gray matter due to fluid leads to the destruction of the brain.
If mixed replacement hydrocephalus is diagnosed, then internal pressure does not increase at all, since most often the cause of the disease lies in brain atrophy. Thus, the liquid simply fills the empty space. This space results from atrophy.
Features of external hydrocephalus
As noted above, this disease is characterized by the accumulation of fluid near the cranium. Liquor can freely communicate between the places of its localization. Such an external hydrocephalus of the braincalled open. The closed form implies the complete separation of all spaces with liquid.
The main symptoms of the disease are fatigue, weakness, drowsiness. There may be double vision, headache. In some cases - nausea, vomiting. The disease is accompanied by impaired coordination of movement, a change in gait. Sometimes urinary incontinence is added to such signs.
There are cases in which hydrocephalus develops imperceptibly. Symptoms are completely absent for a long time. The patient does not have an increase in blood pressure. Headache does not occur.
Moderate hydrocephalus is considered a very insidious form. It is characterized by the absence of symptoms for several years. At one point, the patient's condition deteriorates sharply. The source of the problem is a violation of cerebral circulation. As a rule, the diagnosis of "moderate hydrocephalus of the brain" in most cases is made by chance. The doctor notices the pathology during the study of the fundus.
Nuances of internal hydrocephalus
This type of disease characterizes the accumulation of fluid in the ventricles. Internal hydrocephalus can develop as a result of poor absorption of CSF into the tissues. The reasons for this phenomenon may be in past infections, strokes in the subarachnoid region, blockage of veins by blood clots.
A severe headache becomes a characteristic manifestation of the disease. Nausea, impaired visual and auditory functions are often connected to it. However, as withthe above form of the disease, moderate hydrocephalus may not manifest itself with any symptom at all.
General form of the disease
The development of such hydrocephalus is associated with the accumulation of fluid both in the ventricles and in areas near the skull. It is believed that it is mixed hydrocephalus that is provoked by the progression of brain atrophy. This form of the disease leads to the expansion of the ventricles and subarachnoid space. However, their increase provokes a decrease in brain tissue in the process of atrophy.
Mixed replacement hydrocephalus is a severe disease in which the brain space is replaced by cerebrospinal fluid. The risk group for this form of the disease includes people aged who are diagnosed with hypertension, atherosclerosis. This category is replenished with patients with instability of the vertebrae of the neck, who have suffered a concussion. At risk of getting a terrible diagnosis and people who are addicted to alcohol.
With this form, symptoms may be completely absent. Or it can manifest itself as frequent dizziness, constant drowsiness, nausea, vomiting.
Diagnosing an illness
Diagnosis is possible only after a complete examination of the patient. Initially, the fundus of the eye is carefully studied. Further, the patient is recommended to undergo additional studies, such as neurosonography, MRI, CT. A therapist (pediatrician), neonatologist, neurosurgeon or neuropathologist can suspect a terrible illness based on characteristic symptoms and make a primary diagnosis.
For babies under 2years, an effective method is often used - neurosonography. Such a procedure is possible until the fontanel of the newborn is closed. In infants, there are other areas of the skull that are characterized by very thin bone. These places are also excellent "ultrasonic windows". For example, the temporal bone is well suited for this study. This method allows you to determine the expansion of the ventricles, to identify the presence of volumetric formations (cysts, hematomas, tumors), to diagnose some brain defects. However, the above method is not sufficiently accurate. Therefore, it is better for babies to get an MRI.
A distinctive feature of adult diagnosis is the ability to listen to the patient's complaints. It is careful data collection and neurological examination that suggest the development of this pathology. However, such an examination is not enough to finally determine the diagnosis. Therefore, the doctor recommends an MRI for adult patients. It is this study that allows you to identify any pathology of the brain.
For adults, angiography, x-ray of the skull can be used instead of a CT scan. If the onset of the disease is associated with a viral infection, a laboratory test for DNA or antibodies of pathogens is prescribed. In adults, hydrocephalus is differentiated from brain tumors. In children - with complications of rickets.
Medicated treatment
With the slow progression of the disease, conservative therapy can be selected. In adults, this method of treatment determines the open form of the disease. It should be understood thatthe choice of how to deal with the disease is selected exclusively by the doctor.
Typically, cerebral hydrocephalus needs the following conservative treatment:
- Reduce high intracranial pressure. For such purposes, the doctor prescribes Diakarb, Furosemide. These drugs are taken for a long period. Often it is a matter of several months.
- Reducing the amount of liquid. The most optimal drugs are "Glycerin", "Mannitol".
- Strengthening blood vessels with full preservation of electrolyte balance. To achieve this effect, potassium preparations are used.
- Decrease in CSF production. An excellent remedy is Acetazolamide.
- Medical puncture. This procedure is only suitable for infants. This is a method of removing excess fluid from the brain through an ungrown fontanelle.
- Fortifying therapy. Patients, as a rule, are prescribed coniferous, s alt baths. A special course of vitamins is selected. Supplements this therapy with desensitizing drugs.
- Treatment of ailments that provoked the development of hydrocephalus. The relevance of this therapy is due to the acquired form of the disease.
If the above treatment fails, doctors recommend surgery. This procedure allows patients to achieve recovery, in some cases - even complete healing. And sometimes the operation is aimed at saving the patient's life.
Surgical treatment. Contraindications
Unfortunately effectivemedical methods of dealing with the disease at any stage have not yet been developed. The above treatment is used for mild forms of the disease. As a rule, such methods perfectly reduce intracranial pressure and protect the patient from complications. Doctors strictly control the dynamics of hydrocephalus.
If there are prerequisites for surgical intervention, some contraindications should be considered. None of the following operations can be performed if the patient has:
- current inflammation in the lining of the brain;
- irreversible processes (blindness, deafness, epilepsy, mental disorders).
Bypassing
In the event that the brain does not restore the mechanism of fluid withdrawal, the doctor prescribes surgical intervention. In such cases, only surgery can help. Hydrocephalus in the recent past was quite effectively eradicated by the only method - shunting.
The purpose of this intervention is to restore the output of CSF from the brain. For this, a shunt is installed. The ventricular catheter is placed in the lateral ventricles. A special valve regulates the outflow of fluid. A peripheral catheter is inserted into the atria or into the abdominal cavity. This helps to optimize the absorption of CSF. In some cases, after excision of one kidney, the fluid is drained into the ureter.
This operation has a number of possible complications and disadvantages. Among them are the following:
- shunt infection;
- mechanicalcorruption of the embedded system;
- shunt failure;
- slow CSF outflow.
Under the circumstances, there is a need for a second surgical intervention.
Endoscopic surgery
This method is the most common today. Endoscopy involves small incisions. This greatly reduces the risk of any complications. For the patient, the rehabilitation period is reduced. During the operation, the surgeon directs the outflow of fluid into the cisterns of the brain, which are able to normally absorb CSF. Thus, the normal circulation of the liquid is restored. Successful operation completely negates the need for a shunt. The patient returns to normal life.
Craniotomy
This intervention requires hydrocephalus of the brain, the causes of which lie in various obstacles to the outflow of fluid. As a rule, we are talking about aneurysms, tumors. Depending on the location, they are able to block the CSF pathways. In such cases, trepanation of the skull is used. As a rule, during surgery, new ways of outflow of fluid are created.
Consequences of illness
This disease can lead to encephalomalacia - tissue necrosis. As a result of a violation of the blood supply to areas of the brain, atrophy occurs. These processes are irreversible. Quite often, hydrocephalus can lead to disability. The symptoms are quite devastatingorganism. The patient may lose mental and motor abilities.
Dislocation syndrome is a common complication of the disease. It is characterized by compression of the brain and the occurrence of depressed consciousness, and often coma.
A congenital ailment can stop its development at any age. With such an outcome, the patient is completely or partially cured. In the case of rapid progression, babies very rarely survive to the age of 5-6 years.
Prevention measures
The most important rule is to fully comply with all doctor's recommendations for taking medication during pregnancy. At this stage, you should diligently avoid any infections, and especially viral ones. Before pregnancy, it is recommended to be vaccinated against those ailments that the expectant mother did not have before. Alcohol and tobacco should be completely excluded.
Adults need to be careful about their he alth. Diagnose diseases early and treat them properly. This is especially true for diseases of the central nervous system, blood vessels, heart, and spine. Head injury should be prevented. The best preventive measure for most ailments is an active, he althy lifestyle. Try to strengthen your immunity. Pay attention to normalization of weight. And no illnesses will scare you!
