The most common complaint a doctor hears from his patients is a headache. Both adults and children complain about it. It is impossible to ignore this. Especially if there are other symptoms. Particular attention should be paid to parents on headaches in the child and on the behavior of the baby, because he can not say that it hurts. Perhaps these are the consequences of a difficult birth or congenital anomalies, which can be found out at an early age. Maybe these are cerebrospinal fluid disorders. What is it, what are the characteristic signs of this disease in children and adults and how to treat it, we will consider further.
What do liquorodynamic disorders mean?
Cerebrospinal fluid is a cerebrospinal fluid that constantly circulates in the ventricles, cerebrospinal fluid ducts and in the subarachnoid space of the brain and spinal cord. Liquor plays a large role in metabolic processes in the central nervous system, in supporting homeostasis in the brain tissue, and also creates a certain mechanical defense to the brain.
Liquorodynamic disorders are conditions in which the circulation of the cerebrospinal fluid, its secretion and reverse absorption are disturbed . These processes are regulated by glands that are located in the vascular plexuses of the ventricles of the brain that produce fluid.
In the normal state of the body, the composition of the cerebrospinal fluid and its pressure are stable.
What is the mechanism of violations
Consider how cerebrospinal fluid disorders can develop:
- The rate of production and excretion of cerebrospinal fluid by the vascular plexus increases.
- The rate of cerebrospinal fluid absorption from the subarachnoid space slows down due to overlapping narrowing of the cerebrospinal vessels due to transferred subarachnoid hemorrhages or inflammatory diseases of the meninges .
- The rate of CSF production decreases during the normal suction process.
The rate of absorption, production and excretion of cerebrospinal fluid affects:
- On the state of cerebral hemodynamics.
- The state of the blood-brain barrier.
The inflammatory process in the brain increases its volume and increases intracranial pressure. As a result, there is a violation of blood circulation and blockage of the vessels along which the cerebrospinal fluid moves. Due to the accumulation of fluid in the cavities, partial death of intracranial tissues may begin, and this will lead to the development of hydrocephalus.
Classification of violations
Liquorodynamic disorders are classified in the following areas:
- How is the pathological process:
- Chronic course.
- The acute phase.
2. Development stages:
- Progressive. Intracranial pressure increases, and pathological processes progress.
- Compensated. Intracranial pressure is stable, but the ventricles of the brain remain dilated.
- Subcompensated. Great risk of crises. Unstable condition. Pressure can rise sharply at any time.
3. In which cavity of the brain is cerebrospinal fluid localized:
- Intraventricular. Fluid accumulates in the ventricular system of the brain due to obstruction of the cerebrospinal fluid system.
- Subarachnoid. Liquorodynamic disturbances in the external type can lead to destructive lesions of brain tissue.
- Mixed.
4. Depending on the pressure of the cerebrospinal fluid:
- Hypertension Characteristically high intracranial pressure. The outflow of cerebrospinal fluid is impaired.
- Normotensive stage. Intracranial pressure is normal, but the ventricular cavity is enlarged. This condition is characteristic most often in childhood.
- Hypotension. After surgery, excessive outflow of cerebrospinal fluid from the cavities of the ventricles.
Causes are Congenital
There are congenital anomalies that can contribute to the development of cerebrospinal fluid disorders:
- Genetic disorders in the fetal development.
- Agenesis of the corpus callosum.
- Dandy Walker Syndrome.
- Arnold Chiari Syndrome.
- Encephalocele.
- Primary or secondary stenosis of the brain water supply.
- Porencephalic cysts.
Reasons acquired
Liquorodynamic disorders can begin to develop for acquired reasons:
- Injuries to the spinal cord and brain.
- Various infectious diseases and parasitic infections that affect the nervous system.
- Neoplasms inside the skull, which overlap the cerebrospinal fluid paths.
- Thrombosis.
- Intrauterine hypoxia in the first two days after birth.
- Papillomas of the vascular plexus.
Symptoms of cerebrospinal fluid disorders in adults
Liquorodynamic disorders of the brain in adults are accompanied by the following symptoms:
- Severe headaches.
- Nausea and vomiting.
- Fast fatiguability.
- Horizontal involuntary movements of the eyeballs.
- Increased tone, stiffness of muscles.
- Cramps. Myoclonic seizures.
- Speech impairment. Intellectual problems.
Symptoms of disorders in infants
Liquorodynamic disorders in children up to a year have the following symptoms:
- Frequent and profuse regurgitation.
- An unexpected cry for no apparent reason.
- Slow overgrowth of the fontanel.
- Monotonous cry.
- The child is lethargic, sleepy.
- Sleep is disturbed.
- Seam discrepancy.
Over time, the disease progresses more and more, and signs of cerebrospinal fluid disorders become more pronounced:
- Chin tremor.
- Twitching of limbs.
- Involuntary tremors.
- Life support functions are impaired.
- Violations in the work of internal organs for no apparent reason.
- Strabismus is possible.
Visually, you can notice the vascular network in the nose, neck, chest. With crying or muscle tension, it becomes more pronounced.
Also, a neurologist may note such signs:
- Hemiplegia.
- Hypertension of extensors.
- Meningeal signs.
- Paralysis and paresis.
- Paraplegia.
- Symptom Gref.
- The nystagmus is horizontal.
- Lag in psychomotor development.
You should regularly visit a pediatrician. At the appointment, the doctor measures the volume of the head, and in case of pathology development, changes will be noticeable. So, there may be such deviations in the development of the skull:
- The head is rapidly increasing.
- It has an unnaturally elongated shape.
- Large and small fontanelles swell and throb.
- Seams diverge due to high intracranial pressure.
All these are signs that the syndrome of cerebrospinal fluid disturbances in the baby is developing. Hydrocephalus progresses.
It should be noted that in infants it is difficult to determine cerebrospinal fluid crises.
Signs of cerebrospinal fluid disorders in children after a year
The child has already formed a skull after a year. The fontanelles are completely closed, and the seams are ossified. If there are cerebrospinal fluid disorders in a child, signs of increased intracranial pressure appear.
There may be such complaints:
- Headache.
- Apathy.
- Anxiety for no reason.
- Nausea.
- Vomiting, after which there is no relief.
And also such signs are characteristic:
- Disturbed gait, speech.
- There are violations in the coordination of movements.
- Vision is falling.
- Horizontal nystagmus.
- In the neglected case, "the doll’s bobbing head."
And also, if cerebrospinal fluid disorders progress, such abnormalities will be noticeable:
- The child does not speak well.
- Use standard, memorized phrases, not understanding their meaning.
- Always in a good mood.
- Delayed sexual development.
- Convulsive syndrome develops.
- Obesity.
- Violations of the endocrine system.
- Lag in the educational process.
Diagnosis of the disease in children
In children under one year of age, diagnosis begins first with a survey of the mother and collection of information about how the pregnancy and childbirth went. Further, complaints and observations of parents are taken into account. Then it is necessary to examine the child by such specialists:
- Neurologist.
- Ophthalmologist.
To clarify the diagnosis, you will need to undergo the following studies:
- Ultrasound
- CT scan.
- MRI
- Neurosonography
Diagnosis of the disease in adults
With headaches and symptoms described above, you need to contact a neurologist. To clarify the diagnosis and treatment, the following studies can be prescribed:
- Computed tomography.
- Angiography.
- Pneumoencephalography.
- ECHO of the brain.
- NMR
If there is a suspicion of a syndrome of cerebrospinal fluid disturbances, lumbar puncture with a change in cerebrospinal fluid pressure can be prescribed.
When diagnosing in adults, much attention is paid to the underlying disease.
Treatment of cerebrospinal fluid disorders
The earlier the disease is identified, the more likely it is to restore lost brain function. The type of treatment is selected based on the presence of pathological changes in the course of the disease, as well as the age of the patient.
In the presence of increased intracranial pressure, as a rule, diuretics are prescribed: Furosemide, Diakarb. Antibacterial agents are used in the treatment of infectious processes. Normalization of intracranial pressure and its treatment is the main task.
To relieve edema and inflammatory processes, glucocorticoid preparations are used: Prednisolone, Dexamethasone.
Steroids are also used to reduce brain edema. It is necessary to eliminate the cause of the disease.
As soon as cerebrospinal fluid disorders are detected, treatment should be prescribed immediately. After undergoing complex therapy, positive results are noticeable. This is especially important during the period of development of the child. Speech is improving, progress in psychomotor development is noticeable.
Surgical treatment is also possible. It can be prescribed in the following cases:
- Medication is ineffective.
- Liquorodynamic crisis.
- Occlusive hydrocephalus.
Surgical treatment is considered for each case of the disease separately, taking into account the age, characteristics of the body and the course of the disease. In most cases, they try to avoid surgical interventions on the brain so as not to damage healthy brain tissue, and use complex drug treatment.
It is known that if you do not treat the syndrome of cerebrospinal fluid disturbances in a child, mortality is 50% up to 3 years, 20-30% of children survive to adulthood. After surgery, mortality is 5-15% of sick children.
Mortality increases due to untimely diagnosis.
Prevention of cerebrospinal fluid disorders
Preventive measures include:
- Pregnancy monitoring in a antenatal clinic. It is very important to register as early as possible.
- Timely detection of intrauterine infections and their treatment.
On the 18-20th week, an ultrasound scan shows the development of the fetal brain and the condition of the cerebrospinal fluid of the unborn child. At this time, you can determine the presence or absence of pathologies.
- The right choice of delivery.
- Regular monitoring by a pediatrician. Measurement of the circumference of the skull, if there is a need to conduct fundus examination.
- If the fontanel does not close in time, it is necessary to conduct a neurosonography and consult a neurosurgeon.
- Timely removal of tumors that stop the cerebrospinal fluid.
- Regular observation by a doctor and the necessary studies after injuries to the brain and spinal cord.
- Timely treatment of infectious diseases.
- Prevention and therapy of chronic diseases.
- Stop smoking and alcohol.
- It is recommended to play sports, lead an active lifestyle.
Any disease is easier to prevent or take all measures to reduce the risk of developing pathology. If liquorodynamic disorders are diagnosed, then the sooner therapy is started, the more likely it is that the child will develop normally.