Hydrocephaly: not to miss time!
the Increased intra cranial pressure - the diagnosis which is known by almost all young parents as it is exposed in our country widely and often - are groundless, without carrying out necessary researches. Actually at the heart of this pathology - a serious illness, one of which - hydrocephaly.
Hydrocephaly (brain dropsy) is A little anatomy and physiology
(from gr.“ the hydra“ - water, “tsefalon“ - the head) is the state which is followed by increase in volume of ventricles of a brain. In a brain of the person there are several cavities which are reported with each other filled with a likvor (cerebrospinal fluid). These cavities are called ventricles. The ventricular system consists of two lateral ventricles which connect to a slit-like third ventricle (the III ventricle) which, in turn, via the thin channel (Silviyev a water supply system) connects to the fourth ventricle (the IV ventricle). Likvor is developed in vascular textures of ventricles and freely moves from lateral to the IV ventricle, and from it - to subweb space of a head and spinal cord (subweb (subarakhnoidalny) space the space between a brain and a firm brain cover is called) where it washes an external surface of a brain. In the same place there is its return absorption to the blood course. Likvor is a transparent, colourless liquid, by the form very similar to water, contains insignificant quantity of cages, protein and salts. At the baby the quantity of a likvor makes about 50 ml, at the teenager and the adult - to 120 - 150 ml. Likvor is constantly developed and soaked up, in days is produced by vascular textures of a brain to 500 ml of cerebrospinal fluid.Any violation in system of a likvoroproduktion, likvorotsirkulyation and absorption of a likvor conducts
to its excess congestion in brain cavities that is called hydrocephaly, or brain dropsy.
Types of hydrocephaly
When on the way of cerebrospinal fluid from lateral ventricles to an exit from the IV ventricle there is an obstacle and the likvor cannot freely get to subweb space, hydrocephaly is called not reported (closed, okklyuzionny). In other cases hydrocephaly carries the name reported (open). Hydrocephaly is primary (as the main disease) and secondary , i.e. complication of other diseases (tumors, malformations of the central nervous system (CNS) and vessels of a brain, etc.) . Classifications of hydrocephaly exists much, but these are the main and are used most often.
Violation of circulation and absorption of cerebrospinal fluid leads
of Display of hydrocephaly to its excess accumulation and increase of intra cranial pressure. It is differently shown at kids till 2 years and at more senior children.
the Main symptom of development of dropsy of a brain in children till 2 years is the accelerated growth of a circle of the head. Skull seams at kids did not grow yet, and the size of the head increases because skull bones are moved apart from within by the growing brain. In the same way the balloon when we inflate it increases in volume. There is a schedule of growth of a circle of the head. It is necessary to measure it everyone one - two months, it is done by the local pediatrician during routine inspections. If the head of the child grows quicker than normal indicators, then it is a disturbing symptom; it most often demonstrates development of hydrocephaly when the accelerated growth of the head happens at the expense of a surplus of cerebrospinal fluid in brain ventricles. Often it happens the first symptom of a disease. Besides the accelerated growth of the head of children it is possible to reveal increased in sizes and a vybukhayushchy big fontanel which has to be closed approximately by 1 year, but at hydrocephaly it can be open to 2 and even till 3 years. Bones of a skull become thinner, the forehead becomes disproportionately increased and acting. On a forehead and on a face the venous network appears. In more started cases can be looked down down (a symptom Gref). The tone of muscles of legs raises. Convulsive attacks can be observed.
the Child begins to lag behind in rates of psychomotor development. He does not hold a head in time, does not sit, does not get up, does not play. The sick child sluggish, apathetic, times is nemotivirovanno whining. Perhaps, the kid feels a headache: it can grab a head.the Majority of symptoms of increase of intra cranial pressure only the skilled pediatrician, the neuropathologist or the neurosurgeon can distinguish
, but parents can measure growth rates of the head and check according to special schedules. Anyway, the accelerated growth of a circle of a head of the child, and also unclear lag of rates of its development has to be the cause for serious inspection of the kid at the neuropathologist or the neurosurgeon for a hydrocephaly exception.At children 2 years are more senior than
seams of a skull grow, and increase of intra cranial pressure is shown in a different way. The classical picture is headaches with nausea and vomiting (is more often at night or in the morning), changes at an eye bottom (so-called hypostasis of a disk of an optic nerve which can be revealed by the oculist). Headaches, especially with nausea and vomiting, are symptoms which demand inspection from the neuropathologist or the neurosurgeon. They can be caused by hydrocephaly, a brain tumor, brain malformations. Pediatricians often forget about it, and children long time also are aimlessly treated concerning gastritis, pancreatitis, dyskinesia of bilious ways, poisonings and zheludochno - intestinal infections and so forth, and to the neuropathologist and the neurosurgeon get with delay in a serious condition. It is necessary to insist on carrying out consultation of the neurologist and inspection in case of unclear headaches, regular episodes of nausea and vomiting, decrease in sight, and in some cases it will allow to make the right diagnosis on early terms and to save the child`s life.Other symptoms of hydrocephaly are various
and depend on the reason which caused it. It can be epileptic spasms, sight violation, increase of a tone in legs, pelvic frustration (an incontience or a delay of urine), endocrine violations (lag in growth or giantism, premature sexual development, a hypothyroidism - decrease in production of hormones of a thyroid gland, obesity), decrease in progress at school and so forth
of the Reason of hydrocephaly at children
of the Reason of hydrocephaly are very diverse and substantially depend on age of the child.
- Hydrocephaly at a fruit. Modern types of prenatal diagnostics (for example, ultrasonic research - ultrasonography) allow to reveal hydrocephaly at yet not been born baby. In most cases various malformations of the central nervous system (CNS) are its reason. In 20% dropsy is connected with pre-natal infections (a cytomegalic inclusion disease, herpes, toxoplasmosis). Planning pregnancy parents have to pass researches on these infections which often proceed is hidden and to treat them. It will allow to avoid many problems with health of the kid. In rare instances hydrocephaly is caused by genetic disorders.
- Hydrocephaly of newborns. Most often (to 80%) dropsy at newborns is caused by malformations of a head and spinal cord and consequences of pre-natal infections. Approximately in 20% hydrocephaly is a consequence of a patrimonial trauma, especially at premature babies which is followed by intracerebral or intra ventricular hemorrhage and the joined meningitis (an inflammation of brain covers) that leads to violation of absorption of a likvor. Extremely seldom at this age tumors and vascular malformations of a brain which can also become the reason of development of dropsy come to light.
- Hydrocephaly at kids and children of advanced age (of 1 - 2 years is also more senior). There is a lot of reasons of development of hydrocephaly in such children. Tumors of a head and spinal cord concern to them; consequences of the postponed meningitis, encephalitis (a brain substance inflammation), various infectious diseases (for example, tuberculosis); malformations of a brain and vessels of a brain; consequences of hemorrhages; consequences cherepno - a brain trauma; genetic disorders. Sometimes the reason of hydrocephaly does not manage to be established.