Hydrocephalic syndrome (hypertensive-hydrocephalic syndrome or HGM) is a condition which characterized by excessive production of cerebrospinal fluid (CSF), accumulating under the meninges and ventricles of the brain.
Hydrocephalic syndrome, as the term is adopted only in the former USSR and in modern Russia. Western doctors hydrocephalic syndrome refers to any brain pathology.
The syndrome often present in the diagnosis of pediatric neurology, and usually with good reason. GGS - it is a rare pathology, and in 97% of cases diagnosed hydrocephalic syndrome has no right to exist.
Kinds
Depending on the age of the patient, the following types of hydrocephalic syndrome:
- hypertension-hydrocephalic syndrome in newborn children;
- SHS in children;
- GGS adults.
Causes
Allocate causes of congenital hydrocephalus syndrome (SHS neonates) or acquired.
Congenital causes of hydrocephalus syndrome
- During pregnancy and childbirth complications;
- hypoxic (bradycardia, hypoxia and fetal intrauterine growth retardation) and ischemia (trauma during birth) brain damage;
- miscarriage (Up to 36-34 weeks);
- head trauma during birth (subarachnoid hemorrhage);
- intrauterine infections (toxoplasmosis, Influenza, cytomegalovirus infection, etc.);
- congenital malformations of brain development;
- delayed delivery (42 weeks later);
- Anhydrous long time (more than 12 hours);
- chronic maternal diseases (diabetes, etc.).
Acquired causes hydrocephalic syndrome:
- tumor, abscess, hematoma, cerebral parasitic cysts;
- foreign bodies in the brain;
- fractures of the skull with the introduction of debris into the brain;
- causeless intracranial hypertension;
- infectious diseases (malaria, tick borne encephalitis);
- postinsult violations;
- metabolic disorders.
Hydrocephalic syndrome symptoms
Clinic hypertension-hydrocephalic syndrome to explain two concepts:
- hypertension (increased intracranial pressure)
- hydrocephalus (increased amount of cerebrospinal fluid in the brain).
Signs of hydrocephalic syndrome in newborn infants
Parents report that the child is not taking the breast, constantly crying for no apparent reason, sometimes groans.
A baby
- decreased muscle tone ( "sealskin feet" and "heel of the foot")
- mild congenital reflexes (swallowing, grasping)
- may cause tremor (shaking), convulsions and
- marked regurgitation fountain, there is a cross-eyed
- On examination, the doctor observed positive symptom Graefe (white stripe between the pupil and the upper eyelid) and a symptom of the rising sun (the iris is almost half hidden behind the lower eyelid)
- also characterized disclosure cranial sutures (particularly sagittal) and bulging and tension fontanels
- increased head circumference growth is observed in the dynamics of (1 cm each month)
- when viewed from the fundus observed swelling of the optic disc
Clinical manifestations in children SHS
Symptoms of hypertension-hydrocephalic syndrome in older children usually develop after a previous infection or injury to the brain.
A characteristic feature is a headache, often occurs in the morning, nausea and vomiting following it. Pains are in the nature of stupid, aching or bursting and localized in the temples, forehead and brow.
Children complain that they find it difficult to raise his eyes and lowered his head. Often there are dizziness (younger children define it as "swing on a swing" or "unstable objects").
During an attack of pain in the patient's notes pale skin, weakness and lethargy. Their annoying bright lights, loud sound.
Also characteristic walk "on tiptoe" of the higher tone the leg muscles, strabismus, drowsiness and slow thinking, poor memory and attentiveness.
Hydrocephalic syndrome in adults
GGS adult develops due to cranial trauma, tumors, and neuroinfections after stroke.
Signs of hydrocephalic syndrome are similar to the symptoms of HHS in older children:
- blurred vision (diplopia, strabismus)
- severe headaches,
- nausea and vomiting,
- impairment of consciousness up to coma and convulsions.
Diagnostics
Hydrocephalic syndrome diagnosis is difficult. Not all instrumental methods help to establish the diagnosis in 100% of cases. In infants counts regular measurement of head circumference and checking reflexes.
Also used in the definition of GHS:
- Score retinal vessels (edema, hyperemia or vasospasm, hemorrhage);
- neurosonography (ultrasound of the anatomical structures of the brain, in particular, the size of the ventricles);
- lumbar puncture spinal cord for taking CSF with a view to measuring its pressure (the most reliable method);
- CT scan (CT) And nuclear magnetic resonance (NMR).
hydrocephalic syndrome treatment
Treatment of hydrocephalic syndrome engaged in neurology and neurosurgery involving ophthalmologists. Patients with HHS need to be observed and receive treatment in a specialized neurological center.
Treatment in newborns
Children up to 6 months require outpatient treatment.
The main therapeutic measures:
- the appointment of diuretics - diakarba (reduces CSF production and withdrawal of fluid from the body)
- reception nootropics - improves blood flow in the brain (piracetam, aktovegin, asparkam)
- also shown sedatives (diazepam, tazepam)
- massage
Treatment of infants long enough, within a few months.
GHS treatment in older children and adults
In adults and older children therapy depends on the cause of hydrocephalus syndrome.
If it was the result of CNS, then spend the appropriate antiviral or antibiotic therapy.
In the case of craniocerebral injury and tumor surgery is indicated.
Complications and prognosis
Complications of hypertension-hydrocephalic syndrome are possible at any age:
- delayed mental and physical development;
- blindness;
- deafness;
- coma;
- paralysis;
- bulging fontanelle;
- epilepsy;
- incontinence;
- fatal outcome.
The most favorable prognosis with hydrocephalic syndrome in infants. This is due to the fact that they had observed a transient increase in blood pressure and cerebrospinal fluid that will stabilize with age.
In older children and adults, relatively favorable prognosis depends on the cause of GGS, timeliness and adequacy of treatment.
