The fluid in the head of an adult is a rather dangerous disease called hydrocephalus or dropsy of the brain. This ailment is considered a pathological condition, which is characterized by the accumulation of excess fluid in the so-called cerebrospinal fluid spaces. It is noteworthy that hydrocephalus can act as an independent nosological unit, and can be a consequence of all kinds of brain diseases. The exact cause can only be determined by a doctor as a result of thorough diagnostic tests. This disease necessarily requires specialized treatment. If this is not done, then the patient may become disabled and even die.
Varieties
It must be understood that when excess fluid appears in the head of an adult, this is a serious disease that requires immediate treatment. Hydrocephalus itself can be acquired or congenital. Congenital in most cases is diagnosed in the first years of life.
Depending on the mechanism of the appearance of this ailment, several varieties of it are distinguished:
- Open hydrocephalus. This type is based on disturbances in the absorption into the venous system of our brain, which occurs at the level of cells, arachnoid villi, pachyon granulation, venous sinuses.
- Closed hydrocephalus occurs due to disruption of cerebrospinal fluid flow. As a rule, this is due to overlapping or blocking of the cerebrospinal fluid paths. At the same time, a commissure, a blood clot, or a tumor resists the steady flow of cerebrospinal fluid.
- Hypersecretory hydrocephalus occurs with a large amount of excess cerebrospinal fluid production.
- The external type of this disease is noted by a high content of cerebrospinal fluid in the subarachnoid space, and not only in the ventricles of the brain. It is noteworthy that earlier this form was not attributed to hydrocephalus, becoming to do this relatively recently. This decision was made on the basis that the reason for increasing cerebrospinal fluid is to destroy brain tissue and reduce its size. At the same time, interruptions in the circulation of cerebrospinal fluid practically do not affect these processes.
There are several types of diseases when fluid accumulates in the head of an adult. They are distinguished by comparing the level of intracranial pressure. In this case, hydrocephalus can be:
- normotensive, if the pressure is stable and normal;
- hypertensive if the pressure is significantly increased;
- antihypertensive if cerebrospinal fluid pressure is lowered.
According to the time of the onset of the disease, they distinguish: subacute progressive hydrocephalus (develops in three to four weeks), acute (develops in several days, a maximum of three), chronic (development period is from three weeks to six months or more).
How does the brain work?
To cure this disease, it is important to establish the causes of fluid accumulation in the adult's head. Each person in the brain has special spaces containing a special fluid. It is called cerebrospinal fluid. In the brain itself is a complex system of ventricles that communicate with each other. The so-called subarachnoid space with tanks is located outside the brain.
The cerebrospinal fluid in the human brain performs an important function, protecting it from strokes, infectious agents, as it contains antibodies, as well as from sudden shocks that can damage it.
In addition, cerebrospinal fluid nourishes the brain, is directly involved in the regulation of blood circulation in the skull and in the confined space of the brain itself, and guarantees self-regulation by controlling intracranial pressure.
In an adult, the total volume of cerebrospinal fluid varies from 120 to 150 ml. It is updated repeatedly in one day. In this case, the production of cerebrospinal fluid comes from the vascular plexuses of the ventricles of the human brain. For example, from the lateral ventricles, which contain up to 25 ml of cerebrospinal fluid, it enters through the holes of Monroe into the next ventricle, with a volume of not more than five ml. From the third ventricle, it moves into the fourth, also 5 ml in volume, and then follows the Sylvian water supply (this is an organ that, in fact, performs the functions of the water supply to the brain).
At the bottom of the fourth ventricle several holes are located at once. Through them, cerebrospinal fluid enters the subarachnoid space, which is located between the arachnoid and soft membranes of the brain. Moreover, on the basal surface, the subarachnoid space expands to the maximum, forming several tanks at the same time. So it is customary to call cavities filled with cerebrospinal fluid. From tanks it enters the outer surface, as if enveloping it from all sides.
Through the cerebrospinal fluid, absorption occurs in the venous system of the brain, which is carried out through the villi and arachnoid cells. The accumulations of such villi are called pachyon granulations. At the same time, part of the cerebrospinal fluid is actively absorbed into the lymphatic system, which occurs at the level of the nerve membranes in the brain.
Based on the information received, we can conclude that cerebrospinal fluid, which is produced in the vascular plexuses of the brain, thoroughly washes it from all sides, and then is absorbed into the venous system. Of great importance is the fact that this process is continuous. This is how cerebrospinal fluid circulation is carried out, if a person’s state of health is stable, no violations are observed. In this case, the amount of fluid that is produced per day should be equal to the absorbed fluid. When problems arise at one of these stages, doctors say that fluid accumulates in the adult's head. In this case, the diagnosis of hydrocephalus.
Causes
With the formation of fluid in the head in an adult, the causes can be very different. One of the most common is infectious diseases that affect the lining of the brain, as well as the brain itself. These include encephalitis, meningitis, ventriculitis.
With the appearance of fluid in the head in an adult, brain tumors that have a bore or stem localization can become the cause.
Vascular pathology leads to such an ailment. In particular, intraventricular, subarachnoid hemorrhages. These conditions are caused by arteriovenous malformations and aneurysms.
Finally, a lot of fluid in the adult's head appears due to toxic or alcoholic encephalopathy. Causes may include post-traumatic conditions and brain injuries, various defects of the nervous system. For example, they include Dandy-Walker syndrome, stenosis of sylvian aqueduct. This is why fluid builds up in an adult's head.
Symptoms
The symptoms of this disease should be familiar to everyone, so that at their first manifestations, the patient should consult a doctor for emergency care. Hydrocephalus is a serious and dangerous disease that should not be neglected. It should always be remembered that when fluid is collected in an adult's head, his health and even his life are in serious danger.
The clinical picture of the development of this disease largely depends on many factors. This is the period of hydrocephalus formation, the level of cerebrospinal fluid pressure, and the mechanisms of its development.
If, in the presence of fluid in the head, an adult is diagnosed with hydrocephalus, then the doctor was able to come to this conclusion on the basis of specific symptoms. Severe headache, most pronounced in the morning, which is accompanied by vomiting and constant nausea, indicates subacute or acute occlusal hydrocephalus. In this case, morning pain should be regular, and after vomiting, relief should come. Also, the signs of this disease in this form are a sensation of specks in the eye, a characteristic burning sensation, from severe pain the patient simply can not sit still. In this case, an injection of vascular sclera is likely.
With increasing pressure, drowsiness becomes an additional symptom. This is a bad sign, since it indicates that the symptoms are intensifying, a person may begin to lose consciousness. Among other symptoms, loss of orientation, blurred consciousness, blurred vision, and stagnant discs appear on the fundus.
If in this condition, when the fluid in the adult’s head doesn’t seek medical help on time, the cerebrospinal fluid content will increase, and the increase in pressure will provoke a life-threatening dislocation syndrome. This state manifests itself by oppression of consciousness and reflexes, strabismus, a person can fall into a coma. These symptoms indicate that the midbrain is constricted.
If compression of the medulla oblongata is impaired, signs arise associated with difficulty in swallowing, breathing, cardiac activity is inhibited, voice changes. All this leads to the death of a person.
In some cases, an adult develops chronic hydrocephalus due to fluid in the frontal part of the head. It happens in combination with slightly increased intracranial or normal pressure. This disease develops gradually over several months. In this case, the sleep cycle will be disturbed first, then drowsiness or insomnia occurs. Lethargy appears, memory worsens, a person begins to tire quickly. As the disease progresses, cognitive impairment occurs, in advanced cases dementia develops. At the same time, patients cannot serve themselves, their consciousness may be impaired.
Signs of a chronic condition
The next typical symptom is a violation of walking. At first, the gait becomes unstable and as if slowed down, and then uncertainty appears in it, it becomes difficult to start any movement. The patient may begin to imitate walking while sitting or lying down, while in the upright position he is immediately lost. Another sign is the so-called "magnetic" gait. There is a feeling that the person is as if glued to the floor. As soon as he moves, he begins to make small shuffling steps, to stagnate.
Muscle strength sometimes decreases, paresis in the legs occurs. Loss of balance is progressing. As a result, a person may even lose the ability to stand independently or even sit.
In chronic hydrocephalus, urination becomes more frequent at night. Imperative urges are added to this symptom, requiring immediate emptying. Everything can end and incontinence at all. In this case, the fluid in the head of an adult, the diagnosis is obvious - this is hydrocephalus.
Diagnostics
In the diagnosis of this disease, the main role belongs to computer research. It is important that CT and MRI show fluid in the adult's head. They also help establish the shape and size of the ventricles, subarachnoid space and tanks.
A radiography of the tanks is carried out separately to establish the direction of movement of the cerebrospinal fluid, to clarify the type of disease.
In some cases, lumbar puncture is done, removing from 30 to 50 ml of cerebrospinal fluid, which allows you to temporarily improve the patient's condition. This is due to the restoration of blood supply amid a significant decrease in intracranial pressure.
When making forecasts for the treatment of hydrocephalus, this is considered a favorable sign. Puncture is contraindicated in acute hydrocephalus, as it is associated with a risk of wedging into the brain stem. Fear is worth the development of a dislocation syndrome.
Treatment methods
At the initial stage of the disease, with fluid in the head in an adult, treatment is carried out with medication. Two types of drugs are used. The first reduce intracranial pressure, contribute to the withdrawal of excess fluid. It is important to maintain the outflow of cerebrospinal fluid. To do this, use drugs such as Mannitol, Diacarb, Mannitol, they are combined with Lasix and Furosemide.
An important factor in conservative treatment is the stabilization of the amount of potassium in the body. The Asparkam drug will effectively help with this.
Drugs that increase brain tissue nutrition are also required. In particular, these are Actovegin, Cavinton, Choline, Gliatilin, Cerebrolysin, Cortexin, Memoplant, Semax.
Acute conditions
In the neglected state, medical methods can only briefly improve the patient's condition. In this case, surgical intervention is required.
Acute hydrocephalus is considered a life-threatening condition. Urgent neurosurgical treatment is needed. It consists in the application of external drainages and craniotomy to ensure the outflow of excess fluid. In surgery, this method is called external ventricular drainage.
In addition, it becomes possible to introduce drugs through the drainage system that dilute blood clots. This is important to do, since intraventricular hemorrhage is a very common cause of acute hydrocephalus.
Chronic Stage Surgery
At the chronic stage of the disease, liquor-assisting surgery is necessary. In this case, the surgeon removes excess cerebrospinal fluid through a complex system of valves and catheters. In particular, cerebrospinal fluid is sent to the pelvic cavity and abdominal cavity.
In these areas, the rapid absorption of excess cerebrospinal fluid begins. This is how liquid is pumped out of the head of an adult. These operations are considered quite dangerous and traumatic, but when correctly performed by an experienced specialist, they really help the patient get rid of hydrocephalus.
Currently, the most effective method of treating this condition is considered to be a more gentle procedure, which is called a neuroendoscopic technique. This is an invasive surgery. The duration of the operation is about a quarter of an hour. Moreover, it is very expensive, so it is not very common both in Russia and abroad. This method of treatment involves the introduction of a surgical instrument with a camera into the ventricles of the brain. At the bottom of the third ventricle, the surgeon creates a special hole that can eliminate the cause of hydrocephalus. Thus, between the ventricles and cisterns, natural blood flow is restored.
Effects
This disease is extremely dangerous. If you ignore its symptoms, you can remain disabled and even die. In addition, changes in the brain during hydrocephalus are irreversible.
With untimely treatment, the patient runs the risk of remaining incapacitated. Serious problems with movement and mental development can occur, hearing and vision are reduced, urination is impaired, and epileptic seizures are likely.
All these are the consequences of untreated hydrocephalus.