Hydrocephalus is a serious disease that affects the tissues that surround the brain. Most often you can find this pathology in young children, however, adult patients are also not immune from this ailment. Over time, the disease can progress and cause severe health complications, even fatal ones. The fluid in the newborn in the head is cured. About this article.
Description of the disease
Today, almost one in five newborns can be diagnosed with increased intracranial pressure. Although in most situations it does not have any tragic consequences. But it is still worth checking the head for the presence of excess fluid in the head of the newborn. And in the event that the diagnosis is confirmed, then you should definitely think about taking all necessary measures for treatment.
Hydrocephalus of a newborn (or dropsy in another way) is the name of a complication, against the background of which in the area of the brain in newborns there is an accumulation of cerebrospinal fluid, otherwise referred to as cerebrospinal fluid. There are several variations of the disease, however, in children under the age of two years of life, all its symptoms are very similar to each other.
The term “hydrocephalus” is derived from two Greek words that mean “water” and “head”. In other words, this disease is an excess of fluid (water) in the head. From here comes the second name of the pathology, which sounds like dropsy of the brain. True, strictly speaking, this name is not entirely correct. The fact is that in the presence of hydrocephalus in the head in newborns, an excess is not observed at all of water, but of cerebrospinal fluid, that is, cerebrospinal fluid. Liquor is a liquid that is vital for the functioning of nerve tissues. It can be found in the spinal cord. The norms of fluid in the head of the baby will be considered below.
In addition, it is present in the brain. In it, such a substance as cerebrospinal fluid is concentrated in the four ventricles, which are located in the center of the skull. The upper two are located in both hemispheres, and the lower ones along the central cerebral axis. The ventricles, as a rule, communicate with each other using a system of tubes called the cerebral aqueduct. In addition, cerebrospinal fluid can enter the subarachnoid space, which separates the meninges with special tanks located at the base of the skull.
Types of disease
There are only three main forms of this pathology, in which there is fluid in the head of a newborn:
- open hydrocephalus;
- closed, or occlusal form;
- hypersecretory form of pathology.
The closed type of the disease occurs in cases where there is a physical obstacle that prevents the outflow of cerebrospinal fluid from the skull capacity intended for it into the systemic circulation. The cause of this variety is mainly cysts along with tumors or hemorrhages.
An open type of disease is usually observed when the mechanism of absorption into the systemic circulation of the cerebrospinal fluid is disrupted. With this option for the development of pathology, the cause of the disease is often the infection that was previously transmitted. For example, meningitis or the presence of blood in the area of the subarachnoid space.
Hypersecretory hydrocephalus is a relatively rare type of disease in question and is observed in about five percent of cases. It usually occurs as a result of excessive production of cerebrospinal fluid. A similar situation can happen, for example, due to the pathology of the vascular plexuses.
Functions of fluid in the head
The volume of cerebrospinal fluid, in fact, is relatively small. Normally, in newborns, it is usually 50 milliliters, and in adult patients, from 120 to 150 ml.
The functions of the fluid in the head of a newborn are very diverse:
- protection of nerve tissue from external mechanical stress;
- the removal of harmful substances from the brain and the delivery of nutrients into it;
- maintaining stable values of intracranial pressure.
The fluid in the head of the baby, like blood, can circulate inside the cranial cavity. Against this background, its composition is constantly updated. In adult patients, on average, this can occur three times a day, and in infants it is much more common - up to eight times a day. Every minute, 0.35 milliliters of cerebrospinal fluid is formed in adults, and approximately 500 milliliters per day. The pressure of cerebrospinal fluid in adults can vary widely enough, namely from seventy to one hundred and eighty millimeters of mercury.
Basically, cerebrospinal fluid forms in the ventricles of the brain. Two-thirds of this fluid can be generated by their vascular plexus, and everything else - with the help of membrane elements and meninges. In special veins that are located inside the skull, in its occipital parietal part, namely within the venous sinuses, its absorption is carried out.
Therefore, in the event that for some reason the cerebrospinal fluid circulation processes are disturbed, and it forms in a larger amount than necessary, or is simply not sufficiently rapidly absorbed, then an excess of this fluid is observed in the newborn in the cranial cavity. Such a syndrome in babies is called hydrocephalus.
Excess cerebrospinal fluid can manifest itself in different ways in children and adults. For example, in adults, hard bones of the skull, in this regard, excess fluid usually leads to increased intracranial pressure. The situation is quite different for young children under the age of three. They have fairly soft bones of the skull, and in this regard, hydrocephalus very often manifests itself in the form of an abnormal expansion of the head circumference.
Causes of fluid in the head of the baby
Dropsy in newborns can develop from banal prematurity. And in addition, from the presence or previous infectious diseases. For example, factors in the form of smoking, drinking and other bad habits of the mother, not only during pregnancy, but also in ordinary life can contribute to the development of this pathology in the newborn.
During the first few years of life, any head injury is very dangerous, as this can lead to an increase in production of cerebrospinal fluid. A tumor that occurs in the brain can significantly interfere with the healthy outflow of fluid in the head of a newborn baby. Which will create, in turn, excess pressure.
How is this pathology clinically manifested?
The fluid in the head of the newborn should circulate in the correct and normal mode, and if it is disturbed, this will certainly lead to hydrocephalus. The most important symptom is a change in the shape of the head in a fairly quick time. In this regard, it will be required every month to visit a pediatrician, who must measure his head, checking the condition with indicators of normal fluid in the head of the baby.
In addition, the fontanel in a newborn child is characterized by an increased size, since the seams of the skull are not yet fully formed. Over time, the symptoms can become more pronounced: a venous reticulum will appear on the face, and the shape of the forehead, in turn, will become more disproportionate. Cramps may occur from time to time. Newborns with hydrocephalus are prone to apathy and often cry.
Such children are noticeably lagging behind in development; their psychomotor abilities are impaired. This usually manifests itself in the fact that the child’s head is very poorly held. Moreover, such children begin to crawl late, walk and sit down. In addition, newborns with this disease often spit up to vomiting. Among other things, they observe constant drowsiness. All such symptoms may indicate the presence of increased intracranial pressure in the baby.
However, one should not hurry with the diagnosis only for certain similar characteristic signs, since usually only the appearance of the entire complex of the listed symptoms can indicate the presence of hydrocephalus. Only the attending doctor, as part of the study of the child, will be able to make the correct diagnosis and prescribe the required treatment for the accumulation of fluid in the head of the newborn.
Fundamentals of diagnosis and therapy in newborns
After determining the initial diagnosis, children are prescribed neurosonography along with an ultrasound scan of the brain, computed tomography, or magnetic resonance imaging.
If the diagnosis is confirmed, ventriculoperitoneal shunting is often performed. The essence of this operation is that cerebrospinal fluid is sucked out from the brain ventricles of the newborn into the abdominal cavity through silicone catheters. Less commonly, fluid can be diverted into the spinal canal or right atrium.
In the event that the operation was performed on time, the child has every chance of a normal life, which involves visiting children’s and school institutions. True, it is also necessary to take into account that the size of the head after the operation will most likely not decrease, since a change in bone tissue is always irreversible.
How to detect fluid in a baby’s head?
Diagnosis of the disease
There are several ways to determine the development of hydrocephalus. It is worth noting that in children this disease is much easier to detect. But in adult patients, the recognition of the described disease is sometimes difficult and problematic. Previously, many adults who suffered from hydrocephalus were diagnosed with various neurological and mental disorders. Moreover, of course, their therapy was not very effective. Only after the advent of modern diagnostic techniques did the situation radically change. And for the better.
If there is a lot of fluid in the head of the baby - this is mainly detected by the pediatrician in the process of a thorough examination of the child. Doctors can turn their attention to the obvious manifestations of hydrocephalus in the form of an increase in the head, bulging fontanel, divergence of the sutures of the skull, and in addition, changes in the appearance of the skin and characteristic neurological symptoms. To facilitate the diagnostic procedure, parents are advised to record the values of the baby's head circumference after a certain time interval. In case of suspected pathology, the pediatrician can write a referral to a neurologist, pediatric surgeon or neurosurgeon.
Treatment
Recently, great progress has been made in medicine in the treatment of hydrocephalus and the presence of fluid in the head of an infant. If a few decades ago more than half of patients with this disease died, then today the mortality rate is not more than five percent.
The choice of treatment for hydrocephalus directly depends on the etiology of the pathology, and in addition, on its form and degree of development. In some situations, etiotropic therapy is possible. However, in most cases, treatment is directed to removing fluid from the cranial cavity. Treatment of the progressive course of hydrocephalus in children can only be carried out by surgical methods. Unfortunately, conservative therapy is ineffective.
How to remove fluid in the head of a baby? Operations that are performed with a closed and open form of hydrocephalus may vary slightly. Previously, open dropsy of the brain was considered an almost incurable pathology. But in the middle of the last century, new technologies were developed that save the majority of small patients.
To remove excess fluid from the cranial cavity, shunting is usually performed. It consists in laying a kind of pipeline through which liquor is pumped into the remaining cavities of the body. Such tubes for most of the length are under the skin surface. Typically, fluid is diverted to the area of the peritoneum (ninety-five percent of cases), the area of the chest or atrium. In some situations, it has to be removed not from the brain, but from the spinal cord, from where it is sent to the abdominal cavity.
When such an operation is performed on a child, as the baby grows older and grows, the catheters will require lengthening, as well as replacement. It is worth noting that modern catheters are equipped with special valves that allow you to adjust the fluid pressure in brain containers. If there is no threat to life, the bypass surgery is performed as planned. As a temporary measure that allows you to lower the pressure of cerebral fluid, apply puncture in the spine.
Closed hydrocephalus often implies the need for quick surgical intervention, since with this form of the disease, compression of the respiratory centers can occur. Therefore, in a similar situation, they can conduct a temporary operation with the installation of a special container in order to divert CSF.
If the patient has closed hydrocephalus, all the efforts of the surgeon are directed to removing obstacles that impede the normal circulation of cerebrospinal fluid. In some cases, such an obstacle (in the form of a vascular aneurysm, cyst, hematoma, tumor) can be eliminated. Often, an endoscopic system is inserted into the cavity of the ventricles for this purpose. Surgical operation is carried out using special tools, a laser or an electrode, allowing to restore the functions of the brain pipelines.
However, sometimes, for example, with tumors, regardless of their benign or malignant nature, such operations are simply impossible. In this case, the surgeon lays the pipeline from the reservoir, within which the cerebrospinal fluid accumulates, into an alternative reservoir, where its absorption directly into the blood becomes possible.
In absolutely all cases, the main purpose of the operation is to restore the balance of withdrawal and generation of cerebrospinal fluid, disturbed for various reasons. Of course, when the disease is secondary, then the main forces must be directed to the therapy of the underlying disease, which caused an excessive amount of cerebrospinal fluid.
Complications of hydrocephalus
In the absence of therapy for the presence of fluid in the head of the baby, the disease in question can progress in most situations. This can lead to extremely negative consequences, which, among others, can threaten the patient with a fatal outcome. The main complications of hydrocephalus, as a rule, are:
- the appearance of cerebral edema;
- the occurrence of epileptic seizures;
- displacement of the brain of the child;
- development of coma, stroke, and respiratory failure.
The danger of excess fluid in the head of a baby, not everyone knows. With the development of hydrocephalus in children during infancy, a slowdown and a halt in the formation of new brain tissues are often observed. And this leads to a lag in the mental, mental and emotional development of the baby.
Pathology prognosis
The prognosis for the development of hydrocephalus in a newborn directly depends on how quickly, and in addition, the baby will be diagnosed and the therapy started. Children with hydrocephalus may well live a normal life, although, unfortunately, they are faced with a number of problems associated with the maintenance of surgical shunts.
But in the event that the treatment of this disease in the infant is not started in a timely manner, its further progression threatens the baby with a serious developmental delay, and in addition, speech impairment and an irreversible change in the brain, which will subsequently lead to disability.
Pediatric Tips
Hydrocephalus, or the accumulation of fluid in the head in an infant, is very often a congenital pathology. But is it possible to prevent such a condition long before its possible progression? In this regard, pediatricians are advised to examine both parents at once for prevention, and it is necessary to conduct a study at the genetic level. Among other things, doctors recommend timely treatment of existing infectious pathologies and protect the mother's body from their development throughout pregnancy.
In addition, in no case should you allow craniocerebral injuries of the newborn during childbirth. It is required to conduct timely diagnosis and treatment of such a pathological deviation as hydrocephalus. , , , .
. , . , . . ( ) .
. !