Hydrocephalus (cerebral edema) - a pathological condition resulting from accumulation of excess cerebrospinal fluid in the cranial cavity, or around the brain ventricles in internal conducting system brain.
Hydrocephalus in children may be associated with an increase in size of the head in the area of the cranium. The dimensions of the head hydrocephalus may be increased to 1.5-2 years before the cranial sutures had not zarascheny.
Causes
The brain is constantly surrounded by liquor - a liquid supply it to protect them from shocks and to support its work. Liquor circulates around the brain and within its conduction system for special run-off channels of the cranial cavity. The production of this fluid occurs constantly, but liquor is maintained appropriate balance its outflow.
If for various reasons, there is increased synthesis of liquid or disorder outflow excess CSF accumulates in the cranial cavity or ventricles of the brain - occurs hydrocephalus.
The causes of violations of production or outflow of fluid can be:
- malformations of brain development or okolomozgovye structures
- brain cysts, brain tumors, hemorrhages,
- brain infections, including pre-natal,
- brain injury and neck.
Kinds
Pediatric hydrocephalus may be of various kinds:
- congenital, combined with other malformations in hereditary syndromes
- The acquisition, which is formed after birth was originally a normal child.
Also, hydrocephalus can be:
- exterior when the fluid accumulates around the skull, and the skull expands, forming a large head,
- internal - the liquid accumulated inside the ventricles of the brain, head size does not suffer.
- mixed combine both forms.
Further decided to allocate communicating (open) hydrocephalus with the outflow of fluid and occlusal without outflow.
According to the occurrence rate is divided into acute, sharp and growing strongly, and the chronic form when liquid accumulates slowly.
The chronic form is divided into compensated and decompensated with severe manifestations.
symptoms of hydrocephalus
External hydrocephalus at an early age manifested typical symptoms:
- cerebral skull increased in size, cranial sutures diverge greatly increases the head size (60 cm or more), enhanced venous network in the skin.
- fontanels swell and increased up to the side,
- eye structure changes, there is a "symptom setting sun", a manifestation of the tunica albuginea between the pupil and eyelids.
- in congenital form of enlarged head size in the womb, which creates an obstacle for normal delivery.
Increasing the volume of the liquid gives manifestations intracranial hypertension - tremor of hands and chin after 4-6 months of life, seizures, problems with eye movements, decreased vision, paleness, nausea and vomiting, trouble heart.
In young children is clearly revealed neurodevelopmental disability, difficulty of movement, low mobility.
In children older than 2 years of growth, the head is not marked, but the symptoms of liquor hypertension abruptly appear in the accumulation of fluid. By joining mental disorders, memory loss, severe headache, cries of intellectual disability.
In rare cases, compensated hydrocephalus does not give symptoms.
Diagnostics
diagnostic base - is a detailed survey of parents and dynamic assessment of head growth in the first months. By increasing the size of the head more than 2-3 cm per month, sharp imbalances between the circumference of the chest and head, open cranial sutures and bulging fontanelle - are indirect signs of problems.
It is important to take into account the hereditary head size, as there are families with special structure of the skull and a big head without hydrocephalus.
To confirm the diagnosis and clarify the types and causes of hydrocephalus are needed:
- ultrasound examination of the brain through the anterior fontanelle to the measurement of the size of the ventricles,
- examination by an ophthalmologist with a tour of the fundus,
- skull radiography in two projections,
- conduct CT and magnetic resonance imagingEspecially when occlusal form.
To identify the causes of hydrocephalus appoint a puncture of the spinal cord with the study of the composition of cerebrospinal fluid, blood tests for fetal infections and other surveys.
hydrocephalus treatment
Conservative therapy is applicable only if no progressive forms of compensated hydrocephalus. The periodic reception of funds drove the excess fluid - diakarb, veroshpiron, especially in times of trauma or stress.
Showing solutions to improve the trophism of the brain (cavinton, Pantogamum), vitamins, homeopathy.
Most of hydrocephalus is treated by means of operations with the removal of tumors, cysts, as well as to create a shunt to help normalize the outflow from the brain fluid in the abdominal cavity. Shunts change as needed, as they can become clogged with inflammatory cells, and be rejected by the body to become slim.
Today, practice and endosurgery - introduction into the ventricles of the brain around particular anastomoses outflow obstruction, allowing the fluid to circulate normally. Such methods are practiced in occlusive disease forms.
The prognosis for treatment
The treatment of hydrocephalus may be lifelong, shunts may be years, but must be monitored. As you need to change them.
Forecast for life may vary depending on the form and extent of hydrocephalus. Children with the disease are disabled, but the degree of functional disorders may be different.
