One of the dangerous diseases that develops in people of different ages is dropsy of the brain, otherwise called hydrocephalus. This disease is characterized by an increase in the volume of the ventricles located in the brain. Typically, the cause is the accumulation of excessively produced cerebrospinal fluid. More often, the disease is detected in infants, but can also occur in older children, in adults.
Anatomical features
The human brain consists of a specific substance, the performance of which is due to constant contact with cerebrospinal fluid. This term refers to brainwashing fluid. The compound is colorless, transparent, designed to protect the brain, transport nutrient components to its cells. On the outside, fluid circulation is organized between the cerebral membranes of the hemispheres, the cerebellum in a space called subarachnoid. Dropsy of the brain develops in violation of this mechanism. Normally, the accumulation of cerebrospinal fluid is possible in tanks located at the cranial base. These elements are interconnected in different directions, which provides movement between the departments of the brain. Proper circulation of cerebrospinal fluid through tanks is the key to the quality of the brain.
In the head, cerebrospinal fluid is located in the brain cavities - ventricles. The hemispheres are equipped with two elements, the third - parallel to the center line, another - between the brain stem, cerebellum. A pair of holes is provided for connection to the tanks. There should be about 150 ml of a substance that is completely renewed three times a day. The formation and absorption of fluids must balance each other, thereby the volume is constant, the pressure too. In violation of this balance, dropsy of the brain develops.
It is important!
Liquor accumulates either due to a lost balance, or due to improper movement of substances in the body. The second option with dropsy of the brain is observed when the cerebrospinal fluid is produced in a normal volume, but is not absorbed by the cells, and this becomes the main factor in the pathology.
Where did the trouble come from?
In infants, the disease is more often observed against the background of infection of the mother's body during the period of gestation. Most often, the pathology is due to infection with cytomegalovirus. The changes he provokes in the maternal body lead to improper circulation of brain fluid, the production of substances in too large a volume. However, the causes of dropsy of the brain are not exhausted by this. The disease can develop against the background of meningitis, encephalitis, poisoning, or mechanical injury. Cases are known when dropsy provoked tumors of brain tissue.
From medical statistics it is clear that provoking dropsy of the brain in adults, children can spill blood into the ventricles, subarachnoid section. A possible cause is blood flow problems in the brain (ischemia, hemorrhagic type). The cause may be encephalopathy, provoked by various factors, including alcohol abuse, insufficient oxygen supply to the brain tissue.
What happens?
It is customary to distinguish an acquired and congenital form of the disease. Pathogenesis allows us to formulate three types of pathology:
- occlusion;
- communicating;
- increased secretion.
Earlier they talked about the fourth form of the disease, mixed. Other doctors called it external. Now such a disease is attributed to atrophic processes of the brain, since it is atrophy that explains the reduction in the volume of organic tissues.
Another classification option allows you to talk about dropsy of the brain in adults and children:
The first option develops in just three days, the second - in a month, and the third requires up to six months, and in some cases even more time.
Depending on the indicators of cerebrospinal fluid pressure, the disease is classified into categories:
- with increased pressure;
- with normal;
- with reduced.
Symptomatology
A key symptom of dropsy of the brain is high blood pressure, against the background of which painful headaches develop. The patient feels sick, vomits, and vision and hearing are soon impaired. Suspected dropsy in a baby can be due to bulging fontanel, the tension of this zone. The child throws back the head, and the eyeballs are constantly shifting. Such a disease is both acute and chronic. In the first case, the described signs are observed in pronounced form. The chronicle is characterized by similar manifestations, while the course is complicated, as they often choose the wrong treatment or start the course too late.
External dropsy of the brain in children and adults is open and closed. To determine what type of disease belongs, clinical observations should be made. The outer variant is accompanied by a contraction of the brain, and the volumes previously occupied by the tissues are filled with cerebrospinal fluid. Such a disease proceeds imperceptibly, the symptomatology does not differ. The patient has normal pressure, there is no pain. A person normally sees and hears. In old age, the disease can be accompanied by an increase in pressure. Quite often, pathology is accompanied by atherosclerosis.
Occlusion is a form of dropsy of the brain whose symptoms include severe pain, sleepiness, and nausea. The patient is vomiting. To a greater extent, the phenomena are expressed if the disease proceeds in an acute form. Specific studies show the axial location of the brain. When studying the state of the visual system, stagnation of the nerve disk is revealed.
Manifestations: specificity
Symptoms of dropsy of the brain in adults, children usually begin with a headache. Patients who are able to describe their feelings, note that the syndrome is more pronounced in the morning, immediately after waking up. Doctors explain this by an increase in pressure inside the skull during a night's rest. Deterioration can be suspected if the patient begins to sleep. This development suggests that the state will change dramatically. This is due to the effect on the nervous system. If pressure increases in the subarachnoid space, stagnation in the optic nerve discs is observed. The second reason is the problems of axoplasmic current.
Dropsy of the brain in adults, children can cause coma. Disorders of the visual organs are observed. Some patients constantly support their heads in unusual unusual position. Since the medulla oblongata is compressed during a disease, there is a high probability of disruption of the respiratory organs and blood vessels. This can cause the patient to die soon.
Resorptive form
If such a pathology occurs chronically, dropsy of the brain in adults manifests itself as gait disorders, paraparesis of the lower extremities. The problem is accompanied by enuresis, dementia. The first manifestations can be noticed by the end of the third week after the disease, which caused dropsy. First, the patient suffers from a disturbance in the cyclical nature of night rest and awakening, after which activity decreases, and behavior becomes illogical, spontaneous. People lose initiative, turn into inert, indifferent, cannot remember numbers.
To identify the features of the violation, it is necessary to conduct an MRI, CT scan. During the instrumental examination, doctors receive information about the state of the cerebral ventricles, evaluate the subarachnoid spaces, determining the dimensions of these zones, position, and deformation of the sites. Based on the information obtained by CT, MRI, you can choose the appropriate treatment for dropsy of the brain.
Therapeutic approach
The best forecasts for the treatment of dropsy of the brain, if the disease could be detected at an early stage. Medical methods are applicable here. The situation is somewhat more complicated if the pathology is actively progressing - this forces an urgent operation. The very first surgical intervention invented is bypass surgery. Its effectiveness is high if the disease develops in the form of occlusion. The main weak point is the patient's dependence on the quality of the shunt. Another option is drainage surgery, in which excess fluid is removed from the brain tissue by external methods. This approach is fraught with complications, so it is practiced strictly when it is impossible to use other ways.
The most modern method of surgical intervention involves the use of an endoscope. If a tumor is detected inside the ventricle, the neoplasm is removed. Sometimes septostomy and aqueductoplasty techniques are used, and a system of shunts is placed as needed. If necessary, the bottom of the third ventricle is treated with an endoscope according to the method of ventriculocysternotomy.
Statistics and diagnosis
In recent years, dropsy of the brain in a newborn has been increasingly diagnosed, and such cases have also become more frequent in adult patients. The forecasts of survival and consequences are completely determined by how quickly the disease was determined, whether the therapy was correctly selected. It is known that children, having received timely qualified help, then live a full-fledged long life. Of the serious complications, the probability of impaired speech function is noted. When installing a shunt, there is a risk of infectious processes, malfunction of such a system. This forces an urgent surgical intervention.
Experts say that the diagnosis is more common in recent years, largely due to the deterioration of the environmental situation. A change in lifestyle, the dominance of bad habits, and the weakening of the immune system play a role. Officially, the process is recognized as irreversible. Of course, against this background, patients and their loved ones are interested in how many adults live with dropsy of the brain. It is impossible to say for sure, in different cases the situation develops in different ways. Many fatal outcomes are known, but many patients, having received adequate help as soon as possible, survived.
Children: some features
Dropsy of the brain in a baby can develop already at the stage of gestation. It is possible to notice this on a planned ultrasound examination. Hydrocephalus is established at 18-20 weeks of gestation. Most often, the reason is the infection of the female body, so a special check is carried out without fail if the mother suffered any infection. Herpes virus can provoke hydrocephalus.
There are many cases when the disease developed during the first year of life. In most cases, it was manifested against the background of infection of the body. Dropsy can be a consequence of meningitis, trauma, encephalitis. Some children have an explanation - heredity. Such a problem is possible if disturbances in the functioning of the vascular system are observed. In most cases, it is not possible to establish exactly why the disease began in the child, which complicates the planning of children in the future. As follows from statistical studies, hydrocephalus is diagnosed with a frequency of one case per 500-1000 infants, which is more often than Down syndrome. It is hydrocephalus that is the most widespread health problem in young children. Already today more than a hundred factors are known that can provoke such a disaster. Dropsy is the most common reason for referring a baby to brain surgery.
Reality and fears
Medicine these days has stepped far forward, so childhood hydrocephalus has ceased to be such a frightening diagnosis. On average, the mortality rate from this disease is no more than five percent, although a few decades ago, half of sick children died of dropsy. True, you can count on a positive outcome only if you managed to notice the symptoms in time, conduct an examination, identify the disease and take measures to treat it.
It is known that dropsy can develop against the background of a malignant tumor, so this disease forces a full examination of the child, even if it was possible to quickly identify and cure it. There is a risk of inflammatory processes in the brain, malformations. Sometimes hydrocephalus in children appears against the background of rubella, mumps, neurosyphilis. Of congenital malformations, Arnold-Chiari syndrome should be mentioned first. This disease can cause infringement of brain tissue, which leads to dysfunction of the respiratory organs, vascular system. The syndrome is associated with a high risk of death. Sometimes a cyst, anomalies of the venous structure, underdevelopment of the holes for cerebrospinal fluid discharge, narrowing of the cerebral duct for the fluid are established in children. Dandy-Walker syndrome, in which an abnormal structure of the cerebellum is observed, can also cause hydrocephalus.
Risk group
More often, dropsy of the brain in children is observed against the background of insufficient weight (less than one and a half kilograms), as well as in premature babies born before 37 weeks of pregnancy. A certain risk is associated with a narrow pelvis of the woman in childbirth, insufficient oxygen supply during the gestation period, asphyxiation during childbirth. Sometimes hydrocephalus is due to colds and flu suffered during pregnancy. A certain risk is addiction to smoking, alcoholic beverages.
You can suspect improper development by deformed proportions. Usually the baby’s head is significantly larger than normal. The cranial bones of the baby are quite soft, so due to pressure the head seems to swell. A sick child cries a lot, although sometimes this is replaced by drowsiness. Through the skin on the head, wreaths are clearly visible, the skin as if transparent, translucent. The child eats poorly, and the limbs are too tense. Psychomotor development lags behind a healthy baby. The patient vomits, food burps, and the baby's weight is small. Kids are usually sluggish, cannot hold their heads, so normal skills do not form in due time. Many suffer from convulsions.
Consequences: what is possible?
Against the background of hydrocephalus, autism, weak memory are possible. Such children hardly learn new information, speech is formed heavily, slowly, with a lag. Many suffer from the inability to coordinate movements, to concentrate. Against the background of dropsy, a decrease in intelligence is possible. Many children experience visual impairment up to blindness.
Diagnostic Features
If hydrocephalus is suspected, the doctor takes note of the child. If unhealthy trends are observed, special instrumental studies are prescribed. Neurosonography is a rather effective modern approach to clarifying the patient’s condition, optimal when examining babies up to one and a half year old, when the cranial bones are not yet fully formed. When the fusion is completed, the ultrasound will no longer give such a high-quality picture, therefore, for older age the technique is not used. Neurosonography is performed on a special machine - almost all domestic hospitals have such. There are no restrictions, contraindications to such a study, so you can not be afraid for the child - in the process of diagnosis, nothing bad will happen to him through the fault of the device.