External hydrocephalus of the brain is a rather serious disease, which is caused by an excess of the volume of cerebrospinal fluid, that is, cerebrospinal fluid. It is for this reason that the people call such a pathology dropsy. The cerebrospinal fluid itself does not cause any harm, its presence is mandatory for the brain, but only when its level is within normal limits. Most often, a violation of fluid circulation occurs due to vascular damage and traumatic brain injury. Slightly less common causes are stroke or infection by the patient.
External hydrocephalus is not only an acquired pathology, it can also occur in newborns (the cause of its development is intrauterine infections).
Types
Depending on what are the causes of violations and their forms, the following types of thisdiseases:
- Open hydrocephalus. Cerebrospinal fluid is produced, but the brain cells do not absorb it.
- Hydrocephalus closed. It is characterized by blockage or difficulty in the movement of fluid, as well as its accumulation in the brain tissues. In the form of obstacles that block the cerebrospinal fluid channels, blood clots, tumors, formations that appear due to the processes of inflammation transferred by the patient, hematomas can act.
- External hydrocephalus of the brain, non-occlusive (or replacement). The fluid fills the spaces in the brain structures that have become free due to a decrease in the amount of gray matter, that is, brain atrophy. This pathological form is dangerous if there is no timely therapy, since it is characterized by the onset of symptoms at a late stage of development.
- Moderate hydrocephalus. CSF fluid due to defects in its circulation directly accumulates in the subarachnoid space.
- Hydrocephalus hypotrophic. Appears with defects in the nutrition of brain tissues and is accompanied by a number of acute symptoms, including vomiting, decreased vestibular functioning, nausea, intense headaches.
- Hypersecretory hydrocephalus is the result of too high production of CSF, the brain tissues are not able to absorb a large amount of it, and the fluid in this case fills the cavities inside the skull.
External hydrocephalus, by its origin, can be acquired orcongenital. An acquired disease appears after ailments of the vertebral and vascular systems, intracranial injuries, an increase in tumors, inflammatory and infectious processes that affect the brain.
Mild illness
External hydrocephalus in adults in the first stage may not manifest itself. This is typical for a mild degree of the disease. With a slight degree of disorders of the brain system, the body is able to restore the fluid circulation on its own. Thus, the external hydrocephalus of the brain of the head of a mild degree has a very optimistic prognosis in terms of the features of therapy and consequences.
Symptoms in an adult
In an adult patient, in the absence of diagnosis, the pressure on the brain system increases, an external hydrocephalus of the brain of the head of a pronounced type appears, characterized by a number of specific symptoms:
- migraine and headaches;
- drowsy;
- nausea;
- impaired functioning of vision (double vision);
- excessive fatigue;
- weakness.
If signs of external hydrocephalus occur after an injury or illness, you should immediately contact a specialist.
Replacement Hydrocephalus
If the necessary treatment is not carried out in time, external replacement hydrocephalus of the brain of the head may appear, which is characterized by worse symptoms:
- gait and coordination disorders;
- features of dementia;
- involuntary urination.
Oftensuch symptoms are characteristic of age-related changes, and thus the consequences of the disease are even more complicated.
Diagnosis
Although there are quite a few diagnostic methods for determining an excessive amount of fluid in the brain of the head, the main value in the examination is most often given to CT, that is, computed tomography, and MRI, that is, magnetic resonance imaging. Such procedures help to quickly make the correct diagnosis.
Thanks to CT and MRI, the causes and symptoms of the pathology, its stage and, of course, the level of its neglect are determined. With the help of procedures, specialists examine the cranial cavity, the contours of the brain of the head and possible tumors and cysts.
When examining the brain for the presence of external hydrocephalus, a contrast agent is not required, but many doctors still advise introducing it into the body in order to simultaneously check the condition of the blood vessels. Of course, the effect of the circulatory system on the excess amount of cerebrospinal fluid is not too great, however, CT or MRI with contrast in some cases can diagnose other diseases, if any, in the patient's body.
In addition, specialists can record a patient for a procedure such as cisternography. This is one of the newest diagnostic methods for studying the brain of the head, which is aimed at analyzing the circulation of cerebrospinal fluid.
Other procedures
In addition to the listed outpatient research methods for determining hydrocephalus, inin some cases procedures such as:
- angiography - used to diagnose the condition of blood vessels, the presence or absence of cysts, tumors, blood clots and aneurysms;
- Ultrasound of the brain of the head;
- radiography;
- examinations for infections and viruses.
For a specialist, it is also obligatory to interview the patient about existing complaints. The patient must describe the symptoms that he has. Thanks to this, doctors will be able to make the correct diagnosis and choose the right therapeutic course, which will reduce the external manifestation of pathological signs.
Let's consider how external hydrocephalus is treated.
Medication therapy
Despite the fact that drug therapy is not the most effective, it is at the same time more gentle. Conservative treatment may be prescribed based on the patient's age, general condition, and type of hydrocephalus. The main attention is paid to diuretics, vasodilators and strong saluretics, which increase the outflow of CSF. At the same time, such pharmacological preparations are prescribed that slow down its production. The patient is also prescribed concomitant medications to treat external hydrocephalus.
The standard recipe includes the following:
- "Acetazolamide" - a drug that lowers the pressure inside the eye;
- "Glimarit", "Diakarb", "Manit" - diureticcharacter;
- barbiturates and painkillers;
- ethacrynic acid and "Furosemide" - drugs that remove s alt and excess water from the body;
- albumin solution at a concentration of 20% to adjust the composition of plasma and blood;
- solution of magnesium sulfate 25%, "Troxevasin" and "Glivenol" - drugs that improve blood circulation;
- Prednisolone, Methylprednisolone, Dexamethasone, Betamethasone are hormonal-type steroids that have an anti-inflammatory effect.
Conservative treatment only in some cases leads to recovery, its primary task is to alleviate the patient's condition and the development of hydrocephalus of the external type. If it is impossible to achieve a stable state within two to three months, surgical intervention is necessary. Drug therapy is also not allowed for diseases in acute clinical form.
Bypassing
In adult patients, one of the most effective treatments for external cerebral hydrocephalus is brain bypass surgery. Satisfactory results are achieved in 85% of cases. Thanks to a system of valves and tubes, an excess amount of CSF is removed by forced and natural methods to those cavities of the body in which the accumulation of fluid is not so critical.
Complete recovery is the main advantage of this technique, however, along with this, there is a possibility of inconvenience and complications for the patient, includingof which the most common are:
- occasional need for complete or partial shunt replacement;
- risk of hematomas due to intense fluid outflow;
- dependence on the functioning of the system;
- too low churn;
- possibility of epilepsy, bedsores, inflammation.
There are also contraindications for bypass surgery:
- neurological diseases;
- chronic hydrocephalus;
- blindness;
- epilepsy;
- mental disorders.
Endoscopy
Most often, the indication for endoscopy in adult patients is a tumor or traumatic formations. Thanks to this technology, it is possible to eliminate the obstacle that impedes CSF circulation without opening and trepanation of the cranium. With the help of an endoscope, instruments are inserted into those places where cerebrospinal fluid accumulates, through which excess fluid is sucked out to normal limits. Compared with this method, the advantages of endoscopy are obvious: its initial goal is to normalize the natural flow of cerebrospinal fluid, minimize injuries during surgery, and increase the likelihood of recovery. In addition, there is no foreign body in the body. Thanks to the endoscope, it becomes possible to completely eliminate neoplasms that caused blockage of the CSF circulation, as a result of which the patient's condition improves almost immediately after the operation. Often, this isthe only way to eliminate a malignant or benign tumor. The attending physician decides on the use of endoscopic intervention for external cerebral hydrocephalus in an adult.
Diet
Dietary prescriptions for adults with external hydrocephalus of the brain are focused on stabilizing the water balance in the body. The diet includes products that do not contain s alts and sugar:
- steamed lean meat;
- boiled eggs or steamed scrambled eggs;
- vegetables and herbs;
- stale bread;
- porridge.
From the patient's menu should be excluded dishes that contribute to the accumulation of fluid:
- confectionery and fresh baked flour products;
- fried, smoked, fatty meat, sausages;
- mushroom and fish soups;
- carbonated drinks;
- onion, garlic, radish.
Forecast
Prognosis of external cerebral hydrocephalus in adults is not always predictable. This is a fairly serious disease, the neglected form of which can lead to death. Even a successful and timely operation does not guarantee the absence of complications and some restrictions in the future. Experts note not only physiological, but also psychoneurological disorders. Moderate physical activity, regular walks will help the patient relieve stress. Practice shows that in most cases it is possible to fully recover after surgical treatment and return to a full life.
