The brain is the main organ in the body. The functioning of all organ systems, the general condition and quality of life depend on its functioning. With the development of some pathologies, the brain begins to suffer due to a lack of oxygen, and this can lead to serious consequences. One of these diseases is cerebral ischemia of the 2nd degree in newborns, the consequences can be disastrous if urgent measures are not taken and therapy is not started. Let's look at what this pathology is and whether it is possible to get rid of it.
The concept of cerebral ischemia
Not everyone understands the name of the disease, as "cerebral ischemia of the 2nd degree in newborns." What can the doctor explain and choose treatment tactics. This pathology is a condition in which the supply of the brain with blood is disrupted. In newly born infants, this pathology, as an independent disease, is not often diagnosed.
Most often, newborns are diagnosed with ischemic encephalopathy, in which brain cells are damaged due to poor blood supply, that is, a lack of oxygen.
If the diagnosis is “cerebral ischemia of the 2nd degree in newborns”, how to treat this pathology is determined by the attending physician depending on the state of the body and related diseases.
Causes of ischemia
This pathology in newborns can develop for several reasons:
- If placental blood flow was impaired during gestation.
- After birth, respiratory distress was observed.
- Respiratory distress syndrome.
- Congenital pneumonia.
- Frequent bouts of respiratory arrest.
- Aspiration.
- Congenital malformations.
Whatever the reasons, cerebral ischemia of the 2nd degree in a newborn can have serious consequences if therapy is not started in a timely manner.
The development of pathology in a child
Together with blood, oxygen is distributed throughout the body. It is vital for the normal functioning of all organs. With a lack of it, redistribution of blood flow occurs and, first of all, oxygen-rich blood is received by the heart and brain. It turns out that the remaining organ systems begin to suffer from its lack.
If the pathology is not timely detected and the reasons that provoked it are not eliminated, then the lack of oxygen will gradually begin to negatively affect the state of nerve cells - they begin to die. This is how cerebral ischemia of the 2nd degree develops in newborns, the consequences depend on the severity of the condition and the quick response of doctors. The prognosis for the baby will also depend on the number of dead cells. If a brain hemorrhage occurs , then the chances of recovery and survival are significantly reduced.
Provocative factors
Associated factors that may push the development of ischemia can be grouped into three groups:
- The course of labor. The risk of pathology increases if:
- bleeding occurred during the bearing of the baby or in the process of labor;
- emergency cesarean section;
- high temperature in the woman in childbirth;
- premature birth;
- small baby weight;
- clouding of amniotic fluid;
- premature detachment of the placenta;
- rapid labor activity.
2. The condition of the mother can cause the development of ischemia in the child, especially when:
- the future mother suffers from neurological problems;
- there are pathologies in the work of the endocrine system;
- pregnancy at a later age;
- the presence of chronic pathologies in the mother.
3. The course of pregnancy is also very important: if preeclampsia or eclampsia was observed, then there is every chance for the development of such a pathology as cerebral ischemia of the 2nd degree in a newborn. The consequences may be different.
These factors are not a 100% guarantee of the development of pathology. Even intrauterine disorders do not always end up with cerebral ischemia developing after birth, the consequences can be eliminated if pathology is detected in time and all measures are taken.
How is the disease manifested?
This pathology has various degrees of manifestation. Grade 2 cerebral ischemia has serious symptoms in newborns, and treatment is required immediately. Here's what should alert the doctors and mommy:
- Decreased muscle tone.
- Big pauses in breathing.
- Tendon reflexes are poorly manifested.
- The lethargy of Moro's reflexes.
The following syndromes are also noted:
- The syndrome of increased excitability, which manifests itself in crying for no reason, restless and shallow sleep, trembling.
- Hydrocephalic syndrome can be recognized by an increase in the size of the head and large fontanel.
- Convulsive syndrome is present.
- If there is cerebral ischemia of the 2nd degree in newborns, inhibition syndrome reduces sucking and swallowing reflexes, muscle tone is weakened, strabismus may occur.
- The most serious syndrome is coma. If it is present, the baby's condition is severe, there are no reflexes, there is no reaction to external stimuli, low pressure, breathing problems appear.
When a lack of oxygen threatens the baby’s life
If this pathology has 1 degree, then this is considered a mild defeat, and doctors evaluate the condition of the newborn on the Apgar scale by 6-7 points. Such a degree is manifested by excitation of the nervous system if the baby was born on time, and depression in premature infants. This condition can be observed for 5-7 days.
Grade 2 cerebral ischemia in newborns has more serious consequences, clinical cramps, respiratory arrest, floating arm movements may appear. If you conduct laboratory tests, then lesions of the brain parenchyma, a violation of the blood flow velocity are detected.
If there are long periods of impaired motor activity, poor appetite, and a violation of the swallowing process, then an urgent consultation of a neurologist is necessary.
A severe degree can result in a coma, which is dangerous for the baby's life. Increasing symptoms increase the risk of developing hydrocephalus.
How is the disease diagnosed?
Almost always, the manifestation of cerebral ischemia begins immediately after childbirth. If the disease has a mild degree, then the symptoms can go away on their own, but a severe form can slightly ease its symptoms, but only for a while, and then flare up again with renewed vigor. Therefore, if there is a suspicion of ischemia, various diagnostic procedures should be carried out, which may include:
- Examination of the child for the presence of reflexes and assessment of the state on the Apgar scale.
- General blood analysis.
- MRI, if moderate or severe is expected. This study helps to examine the structure of the brain and determine the extent of their damage.
- Ultrasound - allows you to detect brain edema or a hemorrhage.
- Electroencephalogram - is mandatory in newborns with a severe degree of disease.
If a diagnosis of cerebral ischemia of the 2nd degree in newborns is expected, treatment will be prescribed after all studies.
The main goals of ischemia therapy
If the diagnosis is confirmed after all studies, then measures begin to maintain normal temperature, humidity, and protection from external stimuli.
Therapy in newborns should be as aggressive as possible. She pursues the following goals:
- Provide adequate ventilation.
- Maintain hemodynamics.
- To constantly monitor the biochemical parameters of the analyzes.
- To prevent seizures.
Where is cerebral ischemia treated?
We have already found out that this disease has several degrees, which differ in the severity of the course. Therapy will depend entirely on the symptoms.
- If a mild degree is observed, then even in the maternity ward, doctors take the necessary measures and discharge the baby. Subsequently, it is recommended to visit a neurologist and get the necessary advice. Most often, massage and daily routine are recommended.
- Grade 2 cerebral ischemia in newborns, what it has already been found out, requires treatment in the hospital and it continues in the hospital, as the symptoms are already more serious.
- In severe cases, the child after birth is immediately placed in intensive care.
Ischemia Treatments
This pathology is characterized by the fact that there is no conservative treatment for it, since dead brain cells cannot be replaced by viable ones. But timely prescribed maintenance therapy allows you to stop the progression of the disease and makes it possible to rehabilitate.
If the pathology is severe, then this is visible immediately after birth. In such cases, the following is undertaken:
- Spend artificial ventilation of the lungs, which will help restore spontaneous breathing. After this, constant monitoring of the condition of the baby is carried out.
- Supportive therapy for the heart is needed in order to prevent cardiac arrhythmias prescribed "Dopamine", "Dobutamine."
- Phenobarbital and Phenytoin will help prevent cramps.
- One of the new methods is hypothermia. It is believed that it reduces the rate of death of brain cells. But it is necessary to carry out it only under the supervision of a doctor. If the temperature is reduced by several degrees, then the child is gradually warmed.
If the disease is mild, it is enough to take drugs that will improve blood circulation in the brain and prevent further damage to neurons.
If there is a threat of hydrocephalus, Furosemide and Manitol are prescribed.
Grades 2 and 3 of the disease have more serious consequences, therefore it is important to take all measures and prescribe therapy that will prevent the development of complications of ischemia. They can be manifested, both to a mild degree, for example, by a lack of attention, and more serious, up to dementia and disability.
Opinion Komarovsky about the disease
If there is cerebral ischemia of the 2nd degree in newborns, Komarovsky believes that drug therapy gives a result, but not the same as everyone expects. It is very important in the acute period, when the effect of a damaging factor on the brain is observed, but, as a rule, pathology is detected much later, when the so-called recovery period begins for the brain. At this time, massage and physiotherapeutic procedures that will help the brain recovery process will be more effective. Dr. Komarovsky believes that all neurological manifestations in newborns are associated with immaturity of the brain, which will gradually disappear if there are no serious chronic pathologies.
The consequences of cerebral ischemia
Currently, medicine is at a level of development that avoids the serious consequences of cerebral ischemia, but provided that the diagnosis has been identified in a timely manner. Many babies who have had this disease experience fatigue, hyperactivity, and memory problems, which can affect school performance. Even when there are consequences (if a diagnosis of cerebral ischemia of degree 2 in newborns is made), the reviews of mothers confirm that they can be dealt with if you go to a doctor and drink the necessary drugs.
With their help, you can significantly affect the excessive activity of the baby, improve his memory and attention, respectively, indicators in the school also improve. It is very important to find a competent specialist who will help to cope with the accompanying symptoms.
The most severe consequences of cerebral ischemia are cerebral palsy and epilepsy. But this most often happens in the most severe cases and with an untimely diagnosis.
What parents can do for their child
Even the 2nd degree of pathology is not a sentence. After passing the course of drug therapy, the recovery period begins. At this time, parents play a big role, it often depends on them how severe the consequences of the pathology will be. For the development of the baby to become normal, parents must:
- Visit your child regularly with a neurologist.
- Give the baby the medicine prescribed by the doctor.
- Closely monitor psychomotor development in order to timely notice abnormalities.
- Strictly follow the recommendations for the regimen of the day.
- If the child has increased excitability, then provide him with a calm environment, eliminate sources of noise.
- Be in the fresh air more often.
- Take massage courses.
- Do exercises with the baby, a set of exercises can be recommended by a doctor.
Any neurological problems can be solved, because the child’s nervous system is not yet fully formed, it is quite flexible and able to recover, so you can’t give up. Even with a diagnosis of cerebral ischemia of the 2nd degree in newborns, the consequences may not be so dire. The care and love of parents, and, of course, the help of doctors, will certainly work a miracle, and the child will not lag behind their peers.