Intra cranial pressure. Part 1
to Imagine the woman who is interested in questions of children`s health and did not hear about intra cranial pressure - VChD, it is just impossible.
of the Phrase like “at us intra cranial“ or “we treat intra cranial pressure“ so strongly entered a lexicon of the average visitor of children`s policlinic that many just ceased to think of sense of these words.
Nevertheless, the frequency of talk, frequency of diagnosing and frequency of treatment - at all do not demonstrate that the concept “intra cranial pressure“ or the diagnosis “increase of intra cranial pressure“ are in turn clear to broad masses of workers.Though at first sight all it seems as is obvious to
. And the essence of problems (from the point of view of the inhabitant) looks approximately so. There is a head. There inside is a brain, vessels, in vessels pressure - it all know - and the grandmother has pressure, and at the grandfather. But grandmothers - grandfathers have a heart injured, and at the child all differently. Heart - that healthy, but pregnancy was unsuccessful, at the time of delivery there was not enough oxygen, either the umbilical cord was wound, or still what sore happened, or was knocked by the head, or medicine bad gave - here vessels and were damaged, pressure in the head high, from here and an array of problems now: the head hurts, cries, does not obey mother, sleeps badly, shivers a chin, pulls a leg, tiptoes, badly (incorrectly) speaks, fights in a sandbox, sucks a finger, tens more refuse food also if not hundreds of consequences of these damages - increases. And as above-mentioned complaints - symptoms are possible in a varying degree practically at each child, so there is easily explainable an existence, in fact, of epidemic of intra cranial pressure, and this epidemic gains steam. Of course, doctors actively fight against it, and most of children safely recovers - thanks to medicine or as the classic used to say: “Glory, glory to Aybolit! Glory to kind doctors!“
Attempt of the doctor to approach a problem of intra cranial pressure it is competent, modern, to treat as in the best world clinics - is not subject to realization. Because epidemic of treatment of VChD which captured the CIS countries is limited to these countries. I.e. our overseas friends from this subject are torn off in some way - whether misunderstand and devil-may-carely treat neurologic health of children, whether do not diagnose, whether they have other children?
Probably, something here not so: well as it can exist an illness which is found by children`s neuropathologists in our policlinics at least in 50% of children (it is most - presamy optimistic figure), and at the same time the illness which at all is absent outside the CIS.Is not present
, the phrase of VChD is, its increase is considered in scientific articles, moreover, tactics of fight against this very dangerous phenomenon is studied, but the list of the states which are followed by increase of VChD is very small, and all this more such terrible horror stories - diagnoses that it is possible to draw a conclusion easily: having increase of VChD, it is possible to get to the intensive care unit and intensive therapy rather, than to sit out waiting list for reception to the children`s neuropathologist in district clinic.I.e. globally here and there approaches to VChD are essentially excellent
: there this very rare, very dangerous (life-endangering and to health) the state, as a rule, demanding hospitalization and the urgent help, and at us is extremely widespread illness which is easily diagnosed, almost always easily cured and almost always in out-patient conditions.Is not present
, something here definitely not so. And, seemingly, it is necessary to understand: or we do not understand something, or we are amicably misled, or our children special - not such, as in all other world. As the last statement is submitted extremely improbable, and there is a wish to be stray and not understood not really - we will consider a subject slowly and one after another.
So, that such VChD and from where it undertakes? What on what presses and as all this leaves?
In a cavity of a skull the brain is, there is blood, there is a special liquid which is called a likvor (a synonym - cerebrospinal fluid). Likvor is formed of blood in special vascular textures, circulates, washing head and a back a brain then again - it is soaked up in blood through special venous sine. Likvor carries out a number of the major functions, without realization of these functions normal work of a brain is simply impossible.
Likvor does not stand still, and in the same way as blood, all the time moves. For the movement of blood there are vessels. For the movement of a likvor there are special anatomic cavities - ventricles of a brain and the spinal channel.
It is, so to speak, elementary if to be more precisely - superficially - primitive the anatomist - physiological information.
But can be understood now from where intra cranial pressure undertakes. So, a certain liquid is constantly formed and constantly soaked up. You, probably, already remembered school mathematics with problems about the pool and two pipes - precisely and with a likvor. - follows from one pipe (vascular textures), - flows into other pipe (venous sine). While flows, presses on pool walls (an internal surface of ventricles of a brain and the spinal channel).
Here, actually, and all.
Now some obvious conclusions.
Intra cranial pressure is at all, in the same way as all have noses, hands and bottoms. The phrase “at my child intra cranial“ at least is ridiculous and does not demonstrate in any way that at given the child there is something others do not have that.
Other question that the concrete figure indicating size VChD in a concrete interval of time is not concept stable what, actually, follows from that fact, as VChD all the time changes. Both formation of SMZh, and speed of its movement, and activity of absorption depends on a set of factors: the child sleeps or is awake, lies, sits or costs, is silent or shouts, normal body temperature or raised, and in general what temperature around - is comfortable, either hot, or is cold. Communication of the VChD level with all listed parameters is not represented at first sight obvious, but an elementary illustration: if in the room hot and the child actively sweats, there is a blood condensation, as a result - the speed with which vascular textures will make a likvor decreases. It is clear, that very many displays of the most various diseases will influence in turn the VChD level - both vomiting, and cough, and long crying, and a painful incubation on a pot in connection with a lock and a lot of things are many other things.
I in this aspect of quite pertinent.
At absolutely healthy child who does not have a hypertensive illness at all, the level of arterial pressure will be able to fluctuate in rather wide limits. It was run, cried, laughed, frightened - raised; fell asleep, calmed down, recovered the breath - went down. But the concrete and obvious physiological fact of fluctuation of arterial pressure in anybody does not cause desire to run for the child with a tonometer and constantly to correct this pressure.
of S VChD a situation just the same, but the logic and common sense do not give the answer to an elementary question: why so much attention is paid to the VChD level and its fluctuations? Why talk about VChD is so popular, and it allegedly treatment is so widespread?we will give the Answer to
a bit later, and now let`s talk about really increased intra cranial pressure (a synonym - intra cranial hypertensia).