What does it mean, expanded perivascular spaces of the brain? Conditions associated with this can be identified in infants with an ultrasound of the brain in early childhood or magnetic resonance imaging in adults. The severity of such changes may vary in intensity.
Such conditions are not an independent disease, they are the consequences of some pathology suffered in the past. This may be trauma, anomalies in the development of the embryo, brain tumors, an infectious process in the meninges, and other conditions. In accordance with this, a different nature of therapeutic correction is applied.
Causes of conditions associated with the expansion of the subarachnoid space
All causes can be both congenital and acquired. In the first variant, the pathology concerns infants. As for the secondoption, people of different age categories are subject to this. The following situations can lead to such states:
- Processes associated with inflammation of the meninges. We are talking about meningitis, meningoencephalitis, arachnoiditis. Moreover, all of them can be due to both infectious and non-infectious causes.
- Traumatic damage to the skull and brain.
- Defects in the development of the central nervous system.
- Processes associated with hemorrhage with localization under the meninges.
- Cerebral edema.
Inflammation as the main cause
Inflammations associated with both the membranes and the brain itself lead to the formation of adhesions in the cranial cavity. Naturally, this disrupts the circulation of the CSF, impedes its outflow and leads to the formation of hydrocephalus. This, in turn, causes the expansion of not only the ventricles of the brain, but also the subarachnoid space. This is especially true for the infectious process caused by meningococcus. A similar condition can be observed with tuberculosis, as well as with brain damage with treponema in syphilis.
When inflammation occurs, all pathomorphological and pathophysiological changes associated with it come to the fore. Significantly increases the permeability of the walls of blood vessels. The liquid part of the blood freely penetrates into the space between the cells, which forms edema. In addition, the production of the liquor itself is significantly increased. Pathologically, in this phase, thickening andplethora of the meninges and expansion of the space under the membranes of the brain.
Influence of the tumor
If you have to deal with tumors, then with their growth they compress the brain structures and worsen the outflow of cerebrospinal fluid. The expansion can be local or diffuse. Not only a malignant, but also a benign tumor can lead to such a condition.
Kidneys as a factor in pathology
Pathology of the kidneys can cause a moderate edematous syndrome, in which there will be a situation associated with the expansion of spaces under the meninges. Sometimes this may be due to poisoning with s alts of heavy metals. The cause may also be chronic alcohol intoxication.
Of course, all these conditions are more typical for adults. In children, the predominant causes are congenital anomalies. They may also be caused by birth trauma, which disrupts the circulation of fluid in the cranial cavity.
Symptom complex of expansion of perivascular spaces
The manifestation of pathology in children varies and is determined by the severity of the process. You can suspect the presence of such a condition by the following signs:
- In response to light, noise stimuli of medium intensity, the child responds with an extremely negative reaction.
- These babies often spit up.
- The child is unnecessarily restless, he has a sleep disorder.
- The pupils of the left and right eyes are different in size, may bestrabismus.
- The size of the head clearly does not correspond to age.
- The fontanel overgrows very slowly.
- The child often shudders, objectively one can observe a tremor of certain parts of the body.
As you can see, all these symptoms do not have any specificity, and it is impossible to establish an accurate diagnosis only from them. It is necessary to contact a pediatrician who will refer the child for a consultation with a pediatric neurologist.
As for adults, the dominant symptom will be a headache. It can have varying degrees of intensity. It also varies in duration. Dizziness, nausea, inability to fully perform their professional duties may join. The headache is especially pronounced in the morning. At the peak of pain, the patient feels a pronounced pulsation. Sometimes vomiting occurs. Patients are restless, anxious. With an increase in intracranial pressure, the headache also becomes more intense. Sleep is disturbed. Even if the patient manages to fall asleep, his sleep is interrupted and with obvious signs of anxiety. During the day, patients, on the contrary, show pronounced drowsiness.
Infinitely such a state cannot continue and there comes a moment when the symptoms characteristic of encephalopathy become distinct. This is due to dystrophic changes in the cerebral cortex. Memory becomes worse, there are violations of the organs of vision, the level of intelligence decreases. Patients constantly feel severe fatigue. Characterized by an endless repetition of headache attacks.
If expandedperivascular spaces of the basal nuclei, then changes in gait can be observed, coordination of movements can be significantly impaired, fine motor skills are upset. As a result, the ability to work and activity in the lifestyle are disrupted.
Diagnosis
Diagnostic measures include an external examination with a thorough history taking. Assistance in the diagnosis is provided by laboratory and instrumental research methods. These include a general clinical blood test, ultrasound of the brain, CT or MRI. Neurosonography is a good aid in making a diagnosis. The procedure is absolutely painless and available even in the hospital. Its accessibility for children is due to the presence of an open large fontanel. Cisternography is indicative, which involves an X-ray contrast study of the cerebrospinal fluid space. Adults usually have a CT or MRI.
Treatment
Corrective medical therapy depends on the underlying cause of the condition. If the culprit is an infection, then a course of antibiotic therapy is prescribed ("Sumamed", "Zinnat", "Flemoxin"). In the presence of a tumor, anticancer drugs are prescribed ("Cosmegen", "Adriblastin"). Symptomatic treatment is carried out. In the presence of seizures, anticonvulsants are prescribed ("Carbamazepine", "Primidon"). Measures are being taken to reduce swelling. In the presence of severe pain, analgesics and non-steroidal anti-inflammatory drugs (Spazmalgon, Pentalgin, Ibufen) are indicated.
If conservative therapy fails, resort to surgery. Shunting is used. According to the performed shunts, CSF is drained into the chest or abdominal cavity.
It should be said that often in adults, the expansion of the perivascular space can be asymptomatic. In this case, the diagnosis is difficult.
