If time does not detect the disease, then the person can even die. The effectiveness of treatment of hydrocephalus depends on when she was found. Fluid accumulates in the subarachnoid departments and ventricular system.
What it is?
Hydrocephalus (edema) of the brain - a disease in which there is an increase of volume of the cerebral ventricles. The main cause of the disease state is an excess production of liquor and its accumulation in the brain cavities. Hydrops occurs mainly in children aged newborn, however, it may be typical for the older age groups.
Factors of disease
Some of the most common causes of hydrocephalus of the brain in adults:
- Ischemic or haemorrhagic stroke;
- congenital hydrocephalus
- Neoplasm (tumor);
- Infectious diseases (meningitis, encephalitis);
- Traumatic brain injury;
- vascular pathology;
- Alcohol, and other toxic encephalopathy;
- Intraventricular hemorrhage. Moreover, it does not matter formed hemorrhage due to trauma or not;
- CNS disorders work.
Most often, the disease occurs in infants, but also develops in adults. At the moment, studies show that virtually any CNS disorders can trigger hydrocephalus.
Internal or closed hydrocephalus
This type of hydrocephalus is similar to the previous type, but in this case a large amount of cerebrospinal fluid is observed just inside the ventricles. The reason is a blockage forms neokklyuzionnoy likvoroprovodyaschih ways as a result of inflammatory adhesions, may also be the cause of intraventricular hemorrhage or tumors.
In the event of any injury or blockage may occur interventricular asymmetric brain hydrocephalus. Ventricular enlargement expands causing death of brain tissue, leading to flattening of convolutions.
Outdoor or open hydrocephalus
This type of disease is manifested due to excessive content of the cerebrospinal fluid in CAA. However, it should be emphasized that the cerebrospinal fluid in the ventricles of the brain itself, is normal. The reasons for which there is a development of this form is atherosclerosis, hypertension, and traumatic brain injury.
This form is characterized by the absence of various symptoms, namely, symptoms such as headache or increase in blood pressure. It should also be noted that in this case, often develops latent hydrocephalus, by which the volume of the brain can be significantly reduced, and the free space is filled with cerebrospinal liquid.
From the name it becomes clear that both the cerebrospinal fluid fills the brain ventricle and the subarachnoid space. Most often it occurs in older people due to lack of stability of the cervical vertebra, hypertension and atherosclerosis.
Symptoms of hydrocephalus, photos
When developing acute occlusive hydrocephalus in adults, the symptoms are due to signs of increased intracranial pressure:
- Nausea and vomiting - are also observed in the morning, after vomiting sometimes occur headache relief.
- Headache - is particularly pronounced in the morning upon awakening, which is explained by an additional increase in intracranial pressure during sleep.
- Symptoms axial dislocation of the brain - the rapid depression of consciousness of the patient up to the deep coma, the patient takes a forced position of the head, there oculomotor disorder. If there is a compression of the medulla oblongata, the signs of hydrocephalus manifests depression cardiovascular activity and respiration, which can be fatal.
- Drowsiness - this is one of the most dangerous symptoms of increased intracranial pressure, if there is a drowsiness, then coming fast enough sharp deterioration of neurological symptoms.
- Stagnation optic disc - a violation axoplasmatic current in the optic nerve and increasing the pressure in the subarachnoid space around it, leading to impaired vision.
If formed chronic hydrocephalus, the symptoms and the clinical picture is quite different from acute hydrocephalus in adults: Dementia - often the first symptoms appear 15-20 days after injury, myocardial hemorrhage, meningitis or other disease:
- Reducing the overall activity of the patient, it becomes inert, apathetic, indifferent, lack of initiative.
- Man confuses day and night, that is, the day experiencing sleepiness and insomnia at night.
- Disturbed memory - primarily the decrease of short-term numerical memory, the man with the wrong calls a month, day, forget your age.
- In later advanced stages of the disease may develop coarse mnestiko-intellectual impairment, when a person is unable himself to serve, to the questions that he asked, he can not answer or respond in monosyllables, is inadequate to think long to pause between words.
Apraxia walk - a syndrome, when a person in a prone position can easily be shown how to walk or ride a bicycle, and when it comes, you can not go straight, is widely spreading her legs, swinging, shuffles.
Urinary incontinence can be a symptom of this is not always, and it is late and non-permanent sign of hydrocephalus in adults.
At the present time to confirm and identify the causes of hydrocephalus following instrumental methods of investigation are applied:
- Fundus examination by an ophthalmologist. If the optic disc swelling, this indicates increased intracranial pressure, which can be a sign of hydrocephalus.
- Measurement of head circumference measuring tape (if the baby's head is growing by more than 1.5 cm per month, this is evidence of hydrocephalus; increasing the size of the head of an adult at any value indicative of hydrocephalus).
- Magnetic resonance imaging (MRI) - a "gold standard" in the diagnosis of hydrocephalus. This method allows not only to diagnose hydrocephalus, but also to identify its cause and the existing damage in the structure of brain tissue. The criteria for hydrocephalus MRI results are ventricular index of more than 0.5 and periventricular edema.
- Ultrasound examination of the skull (neurosonography - NSG). This method is used only in the first year of life, who can be considered the brain through the open fontanelle. Because children older than one year and adults overgrown fontanelle and cranial bones are too dense for them NLS method is not suitable. This method is very rough and inaccurate, so the results can be considered as the basis for MRI, but not for setting the diagnosis of hydrocephalus.
- Echoencephalography (EEG) and rheoencephalography (REG) - little information methods that nevertheless apply for "Diagnostic" hydrocephalus. Results REG and EEG studies can be completely ignored when deciding whether or not a person has hydrocephalus.
- Computed tomography (CT) - a method similar to MRI, but much less accurate, so is used relatively infrequently.
For accurate detection of abnormalities or suspected hydrocephalus need to evaluate symptoms, an MRI-study and fundus examination. If all the studies will produce results "for" hydrocephalus, the suspected presence of the disease is confirmed. If the data is any of the three studies do not indicate "for" hydrocephalus, the of this disease in humans is not, and existing symptoms provoked another pathology that needs to be identify.
Initial stages Hydrocephalus can be treated with medication. To this end, the following drugs are used:
- to reduce intracranial pressure and removing excess liquid (with the proviso that the CSF outflow saved) - Diacarbum (acetazolamide), mannitol and mannitol in combination with furosemide or Lasix. Required when such treatment is potassium level correction in the body, used for this purpose asparkam (Pananginum);
- to increase power of the brain tissue shows Cavintonum (vinpocetine) aktovegin (Solcoseryl) gliatilin, choline, cortexin Cerebrolysin, semaks, memoplant et al.
Clinically deployed hydrocephalus is subject to surgical treatment, medical methods to improve the condition for long.
Chronic hydrocephalus requires shunting operations. This type of surgery is the output of the excess cerebrospinal fluid in natural cavities of the human body by means of a complex system catheters and valves (abdominal cavity, pelvic cavity, auricle, etc...): ventriculoperitoneal, ventriculoatrial, kistoperitonealnoe bypass surgery. The cavities of the body takes place unhindered absorption of excess cerebrospinal fluid. These operations are traumatic enough, but with proper design can achieve the recovery of patients, their employment and social rehabilitation.
Acute hydrocephalus, both life-threatening condition requiring urgent neurosurgical treatment. It lies in the craniotomy and the imposition of external drainage, ensuring the outflow of excess fluid. This is called an external ventricular drainage. In addition, the drainage system, the introduction of drugs that thin the blood clots (since intraventricular hemorrhage - one of the most common causes of acute hydrocephalus).
To date, the first place among the invasive methods of treatment came less traumatic neuroendoscopic technique. It is still often performed abroad because of the high cost of the operation. This method is called as follows: Endoscopic ventrikulotsisternostomiya bottom of the third ventricle. The operation lasts 20 minutes. With this method of treatment is introduced into the ventricles of the brain with a surgical instrument Neuro (camera) at the end.
The camera allows you to show images on the projector and to precisely control all manipulations. At the bottom of the third ventricle creates additional hole connectable with basal cisterns than wound and cause hydrocephalus. Thus, as it would be restored physiological liquor flow between the ventricles and cisterns.
complications of the disease
Patients provided timely diagnosis who undergo therapy, it can survive without significant complications rest of your life.
In some cases, there is a speech disorder. There are problems with disruption of shunt infection or ingress during installation that it involves reinstallation. In the most complex and advanced cases of hydrocephalus in adults can be disabled.
The prognosis of the disease depends on the underlying cause, and time spent in the diagnosis and appropriate therapy assignment. There are some limitations to further activity. In some cases there may be a manifestation of disturbances of speech functions of the machine.
It is obvious that the treatment of hydrocephalus in adults should be symptomatic, that is, involving exposure of the underlying disease and its symptoms. Therapeutic measures directly aimed at the clinical manifestations of a particular disease, have been described in the sections of our site. However, once again like to warn patients and especially their families about inappropriate self-medication:
Neurologist only able to prevent progression and worsening of the pathological process, severity of disease, since it has the requisite knowledge and skill.
As for children, it requires special attention and responsibility of doctors, and of course, parents. Keep in mind that early diagnosis and prompt treatment can ensure the normal development of the baby and fulfilling future life. You can not give up under any circumstances, it is necessary to use all the methods proposed by modern medicine. And the disease will be defeated!