The body of a newborn baby is not yet perfect. It continues to form, and the further health of the baby will depend on how well it adapts in the new world. Therefore, it is important for parents to identify existing pathologies at an early stage in order to try to eliminate them in time. One of the ailments related to the period of infancy is the expanded interhemispheric gap.
An increase in the gap between the hemispheres and subarachnoid space in an infant: causes
The interhemispheric fissure and subarachnoid space can expand for a number of significant reasons:
- Diseases carried by a pregnant woman that can affect the development of the baby.
- Carrying out a cesarean section.
- The presence of accumulated fluid between the cerebral hemispheres.
If pathological changes were detected, then the doctors choose the observation tactics.
About the gap between the hemispheres
A gap between the hemispheres must be present, but its size cannot exceed 3 mm. If it is slightly enlarged, then we can talk about the anatomical features of the development of the child.
The disease is indicated by the condition when the interhemispheric gap is dilated and filled with fluid. Often, a baby is diagnosed with diseases such as rickets, hydrocephalus or intracranial pressure. But doctors do not make a diagnosis based on neurosonography, and the clinical picture is also important. This condition is also called dilatation. Sometimes an anomaly is detected immediately in the maternity hospital, and it also happens that parents detect suspicious symptoms by the age of 5-6 months.
At the examination of the newborn, the doctor will ask parents questions of the following plan:
- What is the baby’s dream, how many hours a day, what are the intervals of wakefulness, etc.
- The frequency of regurgitation.
- Is the child calm, does he have tantrums that last more than 5 minutes.
- Questions about the baby's reflexes, how he reacts to temperature changes, to light flashes, loud sounds.
- Examination of a child’s doctor for the presence of rickets, an enlarged fontanel, wide forehead and smooth nape with worn hairs may indicate a disease.
Neurosonography can detect abnormalities in the brain, but the results of this study must be correctly decrypted.
The doctor also measures the circumference of the head, which makes it possible to suspect hydrocephalus, the color of the skin, the presence of a marble pattern, checks the fontanel, eyes for the absence of strabismus or Gref’s syndrome (with it, the child rolls his eyes so that a protein is visible).
In what cases is urgent medical advice needed
You will need to contact a neurologist soon if the baby has the following symptoms:
- bad sleep;
- if the child is often very agitated;
- sharp sounds frighten him, which leads to crying or screaming;
- severe vomiting of a fountain;
- strabismus or various sizes of pupils appeared;
- head circumference increased above normal;
- protrusion and slow overgrowth of the fontanel;
- bulging eyes or rolled in such a way that only protein is visible;
- convulsive condition, or regular twitching in the chin, arms or legs;
- often there is blood from the nose;
- skin marble pattern;
- with a change in atmospheric pressure, the child becomes restless.
The increased interhemispheric gap in children in this case requires some treatment.
Is it possible not to treat?
If the gap between the hemispheres of the brain is slightly expanded, then this does not require treatment. Over time, everything will return to normal by itself. Also, therapy is not needed if the expanded interhemispheric gap in the child is the only sign of pathology, and the baby is no longer bothered by any symptoms. Many doctors do not consider this condition to be a disease, calling it an anatomical feature.
When to treat?
But often the expansion of the interhemispheric gap is accompanied by concomitant diseases, in this case, medications are prescribed to eliminate this pathology.
So, if there is rickets and the child lives in an area with a small amount of sunlight, preparations containing vitamin D will be prescribed.
If intracranial pressure is detected, then weak diuretics are prescribed, which contributes to the rapid outflow of fluid from the hemisphere. You will also need drugs like Asparkam or Diakarba, which contain potassium to prevent hypokalemia and hypomagnesemia. An indicator of the baby's health will be his well-being.
If neurological disorders are present, then you will need to take vascular medications to improve cerebral circulation (Actovegin, Ceraxon) and sedative medicines for the night (Bayu-Bai, Sleep Formula, Dormikind).
What to expect
According to statistics, 80% of newborns have neurological disorders that do not pose a particular threat to health and eventually disappear without consequences. But there are incompetent doctors who, not understanding the situation, are in a hurry to make a terrible diagnosis.
So, for example, with the expansion of the interhemispheric gap, some doctors assure the parents of the child that he has increased intracranial pressure. But these two diagnoses are not always present simultaneously. It should be understood that intracranial hypertension is a serious disease that requires special treatment. Therefore, it is impossible to make such a serious diagnosis as ICP based on the identification of cerebral hemispheres.
Neurosonography can answer many questions, but not all, and therefore, if the doctor makes a serious diagnosis on the basis of this study, parents should require additional examination of the baby.
Interhemispheric gap in the baby: norm indicators, diagnostic methods
As already mentioned, the dimensions of the slit should not exceed 3 mm. This is the norm of the interhemispheric gap. Indicators from 3 to 4 mm are stored in a child up to 6 months.
It is difficult to diagnose the disease in babies up to a year, since many methods for this age are not used. The most informative way is neurosonography. This procedure appeared not so long ago, only in the 90s of the last century.
Neurosonography resembles an ultrasound scan, thanks to the existing fontanelles, it is possible to study the intracranial space more thoroughly. The sensors must first be greased with a special gel, and then applied to soft places on the head of the baby. Thanks to the transmitted ultrasound, it is possible to determine the presence or absence of pathology, and also to determine whether there is an interhemispheric gap in the brain. The advantage of this study is its accessibility, it does not require preliminary preparation, and most importantly, the method is quite informative.
Preparation and method of neurosonography
This method does not require special preparation. During the procedure, the baby should be full and not thirsty. If the child fell asleep at this time, then this is even welcomed, since it is necessary that the head be motionless.
After the ultrasound of the baby’s head is performed, the result will be ready in 2 minutes.
Going to a neurosonography, do not forget to grab a diaper to lay it under the baby, as well as a bottle in case of a protracted procedure. Before going to the NSG, do not lubricate the place of the fontanel with any creams or ointments, even if there are indications for this. Otherwise, the sensor will be in poor contact with the skin, and the visualization of the internal image of the brain will deteriorate.
The procedure itself as a whole resembles a conventional ultrasound. First, the baby needs to be laid on the couch, then lubricate the sensor with a gel and begin a neurosonography session.
What is subarachnoid space
The subarachnoid space is a cavity formation between the membranes of the brain and spinal cord. It contains two types of fluid - cerebrospinal fluid and cerebrospinal fluid. If we talk about liquor, then normally it contains up to 140 ml. It flows from the fourth ventricle of the brain through special openings.
The expansion of the subarachnoid region occurs simultaneously with the growth of the head. In some cases, protrusion of the fontanelles occurs, and the period of their delay is delayed. With a local expansion of the interhemispheric gap in a child, we can talk about a violation of the cerebrospinal fluid circulation. But do not worry too much.
It happens that a child has an enlarged subarachnoid space along with an expanded interhemispheric gap. Sometimes such deviations cannot indicate a serious illness, just the brain of a newborn is actively developing. In case of doubt about the diagnosis, you need to contact another clinic and conduct a second ultrasound, which will refute or confirm the presence of pathologies.
Even if the diagnosis of dilated interhemispheric fissure has been confirmed, then most often the child is shown observation and regular examination of the brain.
Treatment methods and consequences
Treatment is prescribed in case of fluid accumulation in the subarachnoid cavity.
The basis of therapeutic measures is the following actions:
- The appointment of substances that contribute to the rapid withdrawal of excess fluid from the body. This is necessary if liquid builds up in the resulting space.
- Preparations containing potassium and magnesium. Most often, doctors prescribe a medicine called Asparkam, it goes well with diuretics.
- Vitamins of group B.
- With a lack of vitamin D in the baby's body, it should be replenished with the help of medicines.
With a clear increase in the subarachnoid cavity, therapeutic actions are prescribed, which are primarily aimed at eliminating the underlying disease.
If the doctor claims that this condition is always accompanied by cranial hypertension, then this is not so. An additional examination will be needed to identify this disease. Sometimes massage or electrophoresis can correct the situation.
If the pathology progresses, this can lead to serious consequences. The probability of developmental delay is high. Therefore, it is so important to start treatment as soon as possible, if necessary.
Conclusion
According to Dr. Komarovsky, the interhemispheric gap, if it is enlarged, does not pose a great danger to the child. Only a doctor can determine if treatment is necessary for a newborn baby. But even in this case, it is worth passing the examination again, as often even neurosonography can incorrectly determine the distance between two lobes of the brain. For example, if the child constantly turned his head during the examination.
A competent specialist will not prescribe serious drugs to the baby if he does not have concomitant symptoms. In this case, the child is constantly monitored, regularly examined and examined by a neurologist.