Hydrocephalic syndrome: the complexity of diagnosis and treatment

For many years, pediatricians and pediatric neurologists have written off any developmental disorders and behavioral disorders to increase intracranial pressure.

In most cases, with the banal complaints of parents of young children, trembling in the upper limbs, poor appetite, convulsions and lag in physical and psycho-speech development, one diagnosis was made: intracranial hypertension or hydrocephalic syndrome.

Hypertensive hydrocephalic syndrome( HGS) is a condition in which the development of cerebrospinal fluid( cerebrospinal fluid) accumulates in large quantities in the cerebral ventricles, as well as under the cerebral membranes.

According to available statistics, in 97% of cases the diagnosis of hypertension-hydrocephalic syndrome was not based on any grounds.

Provoking factors

Modern medicine knows many causes of the syndrome, which can be both congenital and acquired.

If the hereditary factor is to blame for the appearance of the disease, then the pathology could provoke:

• the mother of the child has serious chronic diseases( for example, diabetes mellitus);
• during pregnancy, a woman experienced complications that required medical involvement( this category includes infections, such as cytomegalovirus, influenza, or toxoplasmosis);
• severe, late or premature birth;
• , the child has had ischemic or hypoxic brain damage;
• during childbirth the child suffered head injuries;
• showed intrauterine growth retardation;
• congenital anomalies of the brain.

As the acquired reasons why babies develop hydrocephalic syndrome, the following internal and external factors can be considered:

• in the child's body metabolic processes are disturbed;
• , after getting injured in the brain, fragments fell;
• with a strong mechanical effect, there was a fracture of the skull bones;
• foreign bodies entered the child's brain;
• stroke is one of the main causes of this syndrome;
• development of intracranial hypertension;
• transferred infectious diseases, for example, malaria;
• a tick bite that is an encephalitis carrier;
• development of various neoplasms( cysts, hematomas, malignant and benign tumors, abscesses).

Symptomatic age-dependent

Modern medicine classifies this disorder according to the age of the patients. That is why the hydrocephalic syndrome is isolated:

• in adults;
• in children;
• in a newborn child up to a year.

What to look for the parents of newborn babies

Hypertensive-hydrocephalic syndrome in newborns is usually accompanied by a characteristic symptomatology, thanks to which the staff of the hospital can suspect this pathology:

• the baby groans and publishes unusual sounds;
• the child refuses breast milk and does not even want to take breast;
• after feeding, there is often a regurgitation( fountain);The
• newborn cries systematically, for no reason.

In the presence of such symptoms, the timely response of the medical personnel of the maternity home is important. When a newborn is examined, the reduced muscle tone is easily determined. Conducting a test for reflexes( grasping, swallowing), also does not bring the expected results.

During examination of the organs of vision, a specialist can detect strabismus, swelling of visual discs, positive symptoms of the rising sun and Gref.

A few days after birth, some babies begin to convulsions and periodically tremble upper limbs( tremor).On the presence of hypertension-hydrocephalic syndrome may indicate tension and bulging fontanelle, the opening of the cranium of the cranium and the constant increase in the circumference of the head.

Symptoms in adult children

In children of the younger age group, hypertension-hydrocephalic syndrome is accompanied by the following symptoms:

• rasping or aching headaches( most often immediately after the morning awakening) in the area of ​​the brow, forehead or temples;
• gag reflex;
• dizziness;
• strabismus;
• obstructed head movements;
• change in the shade of the skin( during the development of pain syndrome);
• lethargy, drowsiness and general weakness;
• the retardation;
• absentmindedness;
• memory degradation;
• irritability( aggressive reaction to loud sounds and bright light);
• increased muscle tone of the lower limbs.

In children of the older age group, the symptomatology of hypertension-hydrocephalic syndrome manifests itself after a traumatic brain injury or against a background of a viral or infectious disease.

How to identify the syndrome in an adult patient

With regard to adult patients who develop hydrocephalic syndrome, this pathology is accompanied by the following symptoms:

• nausea;
• severe headache;
• gag reflex;
• problems with vision( bifurcation of objects);
• strabismus;
• loss of consciousness;
• coma;
• convulsions.

As a rule, in adults this pathology develops after a stroke, against the background of craniocerebral injuries, due to neuroinfections.

Malignant and benign neoplasms can also trigger the emergence of anxiety symptoms, which must be immediately responded to in time to receive medical care. \

Inspection and diagnosis of

After the emergence of anxiety symptoms, adults or children should receive qualified medical care. Diagnosis begins with a personal examination of the patient. If a small child was brought to the reception, the pediatrician first of all makes a measurement of his head. The patient's reflexes are necessarily checked.

To obtain a more accurate clinical picture, the doctor prescribes an additional hardware and laboratory examination:

• carries out computer and magnetic resonance imaging;
• examines and assesses the condition of the vessels of the fundus;
• is a spinal cord puncture;
• is carried out an ultrasound study of the size of the ventricles of the brain and its other anatomical structures.

Providing medical care to

Patients( and parents with sick children) who have anxiety symptoms of GHS should not engage in amateur activities and try to cope with the disease at home.

To prevent serious complications and unfortunate consequences of such a category of patients, timely medical care and complex therapy are needed.

The treatment of hydrocephalic syndrome is performed by narrowly specialized specialists of neurological centers. As a rule, neurosurgeons and neurologists, often attracting ophthalmologists, lead the patients. The course of treatment of such pathology is developed on an individual basis for newborns, adults and children.

Treatment of hypertensive-hydrocephalic syndrome in children under 6 months of age can be performed at home.

Regularly such patients are visited by a pediatrician and a visiting nurse. On certain days a small patient is taken to a medical institution for examination and a set of diagnostic measures. Therapy of this pathology in addition to therapeutic massage involves taking medications:

• diuretic for removing excess fluid and reducing the production of cerebrospinal fluid, for example, Diakarba;
• of the sedative , for example, Tazepam or Diazepam;
• nootropics ( preparations of this group improve blood supply to the brain), Asparkam, Actovegin, Piracetam;
• antibiotics ( if an infectious or viral lesion of the brain is detected);
• vascular drugs , such as Cinnarizine or Cavinton;
• venotonics , necessary for circulatory disturbances in the brain( Detralex);
• antitumor drugs , if the cause of the syndrome is neoplasm;
• medicines that improve the metabolism of neurons ( Sermion, Cerebrolysin, Fezam).

In parallel with drug therapy, patients are recommended to undergo a course of physiotherapy. In case of developmental disorders, corrective activities are prescribed. Children are forbidden to watch TV, listen to music, read, sit at a computer, exhaust the body with physical exertion.

In the treatment of children of the older age group and adult patients, doctors primarily seek to determine the cause of the development of this pathology. When a mechanical effect on the brain or when new tumors occur, surgical intervention is performed.

If the cause of the syndrome is neuroinfection, doctors prescribe antibacterial or antiviral treatment.

Complications and consequences of

A patient diagnosed with hydrocephalic syndrome may develop complications at any time. Such a category of patients is most often faced with such consequences:

• deafness;
• partial or total loss of vision;
• violation of defecation processes;
• fecal and urinary incontinence;
• epileptic seizures;
• delay not only physical, but also mental development;
• bulging fontanel, etc.

If the disease occurs in severe form, patients may also face more serious complications: paralysis, coma and death.

For the prevention of

To prevent the development of HGS, specialists recommend that regular preventive measures be taken at regular intervals:

• should be very responsible for the issue of pregnancy planning;
• timely prevent the spread of neuroinfectious diseases;
• to avoid stressful situations;
• does not overwork the body with physical and emotional stress;
• not to disregard psycho-emotional disorders;
• does not trigger infectious and inflammatory diseases;
• abandon bad habits and switch to a healthy diet.