External hydrocephalus of the brain is a rather serious disease, which is caused by an excess of cerebrospinal fluid, that is, cerebrospinal fluid. It is for this reason that the people call this pathology dropsy. Cerebrospinal fluid in itself does not do any harm, its presence is mandatory for the brain, but only when its level is within normal limits. Most often, a violation of fluid circulation occurs due to vascular injuries and traumatic brain injuries. A bit more rare causes are a stroke or a patient’s infection.
External hydrocephalus is not only an acquired pathology, it can also occur in newborns (the cause of its development is intrauterine infections).
Types
Depending on what are the causes of disorders and their forms, the following types of this disease are distinguished:
- Hydrocephalus is open. Cerebrospinal fluid is produced, but brain cells do not absorb it.
- Hydrocephalus is closed. It is characterized by blockage or difficulty in fluid movement, as well as its accumulation in brain tissue. In the form of obstacles that block the cerebrospinal fluid channels, blood clots, tumors, and tumors appear due to the patient’s inflammation and hematoma.
- External hydrocephalus of the brain is non-occlusive (or substitutional). The liquid fills the spaces in the brain structures, which turned out to be free due to a decrease in the amount of gray matter, that is, brain atrophy. This pathological form is dangerous if there is no timely therapy, because it is characterized by the appearance of symptoms at a late stage of development.
- Hydrocephalus is moderate. Liquor fluid due to defects in its circulation directly accumulates in the subarachnoid space.
- Hydrocephalus is hypotrophic. Appears with malnutrition of brain tissue and is accompanied by a number of acute symptoms, including vomiting, decreased vestibular functioning, nausea, intense headaches.
- Hypersecretory hydrocephalus is a consequence of too high production of cerebrospinal fluid, brain tissue is not able to absorb a large amount of it, and in this case, the fluid fills the cavity inside the skull.
External hydrocephalus, by its origin, is either acquired or congenital. An acquired disease occurs after ailments of the vertebral and vascular systems, intracranial injuries, an increase in tumors, inflammatory and infectious processes that affect the brain.
Mild illness
External hydrocephalus in adults in the first stage may not manifest itself. This is characteristic of a mild degree of the disease. With an insignificant degree of disorders of the brain system, the body is able to restore fluid circulation on its own. Thus, mild external hydrocephalus of the brain of the head is characterized by very optimistic forecasts in terms of the features of therapy and consequences.
Symptoms in an Adult
In an adult patient, in the absence of diagnosis, pressure on the brain system increases, external hydrocephalus of the brain of the head of a pronounced type appears, characterized by a number of specific symptoms:
- migraine and headaches;
- drowsiness;
- nausea;
- impaired functioning of vision (double vision);
- excessive fatigue;
- weakness.
If signs of external hydrocephalus occur after an injury or an illness, you should immediately consult a specialist.
Hydrocephalus replacement
In the absence of timely implementation of the necessary treatment, an external replacement hydrocephalus of the brain of the head may appear, characterized by worse symptoms:
- impaired gait and coordination;
- traits of dementia;
- voluntary urination.
Often, such symptoms are characteristic of age-related changes, and thus the consequences of the disease are even more complicated.
Diagnostics
Although there are quite a few diagnostic methods for determining excessive amounts of fluid in the brain of the head, the main importance in the examination is given to CT, that is, computed tomography, and MRI, that is, magnetic resonance imaging. Such procedures help quickly make the correct diagnosis.
Thanks to CT and MRI, the causes and symptoms of the pathology, its stage and, naturally, the level of its neglect are determined. Using procedures, experts examine the cranial cavity, the contours of the brain of the head and possible tumors and cysts.
When examining the brain for the presence of external hydrocephalus, a contrast agent is not required, but many doctors still advise injecting it into the body to simultaneously check the state of the blood vessels. Of course, the effect of the circulatory system on the excess amount of cerebrospinal fluid is not too large, however, CT or MRI with contrast in some cases can also diagnose other diseases, if any, in the patient’s body.
In addition, specialists can record a patient for a procedure such as cisternography. This is one of the newest diagnostic methods for studying the brain of the head, which is aimed at analyzing the turnover of cerebrospinal fluid.
Other treatments
In addition to the listed outpatient research methods for determining hydrocephalus, in some cases, procedures such as:
- angiography - used to diagnose the condition of blood vessels, the presence or absence of cysts, tumors, blood clots and aneurysms;
- Ultrasound of the brain of the head;
- radiography;
- screening for infections and viruses.
A specialist is also required to interview the patient for any complaints. The patient should characterize the symptoms that he manifests. Thanks to this, doctors will be able to make the correct diagnosis and choose the right therapeutic course, which will reduce the external manifestation of pathological signs.
Consider how to treat external hydrocephalus.
Medication Therapy
Despite the fact that drug therapy is not the most effective, it is at the same time more sparing. Conservative treatment can be prescribed based on the patient's age, general condition and type of hydrocephalus. The main attention is paid to diuretic, vasodilator drugs and potent saluretics that increase the outflow of cerebrospinal fluid. At the same time, such pharmacological preparations are prescribed that slow down its production. Concomitant medications are prescribed to the patient, allowing to treat external hydrocephalus.
The following remedies are included in the standard recipe:
- "Acetazolamide" - a drug that lowers pressure inside the eye;
- "Glimarite", "Diacarb", "Mannit" - diuretics;
- barbiturates and painkillers;
- ethacrylic acid and Furosemide - means that remove salts and excess water from the body;
- an albumin solution in a concentration of 20% to adjust the composition of plasma and blood;
- a solution of magnesium sulfate 25%, "Troxevasin" and "Glivenol" - drugs that improve blood circulation;
- "Prednisolone", "Methylprednisolone", "Dexamethasone", "Betamethasone" are hormone-type steroids that have an anti-inflammatory effect.
Conservative treatment only in some cases leads to recovery, its primary task is to alleviate the patient's condition and the development of external hydrocephalus. If it is impossible to achieve a stable state within two to three months, surgical intervention is necessary. Drug therapy is also not allowed for diseases in an acute clinical form.
Bypass surgery
In adult patients, brain bypass surgery is one of the most effective treatments for external hydrocephalus in the brain. In 85% of cases of operations performed, a satisfactory result is achieved. Thanks to the system of valves and tubes, the excess amount of cerebrospinal fluid is eliminated by forced and natural methods in those body cavities in which the accumulation of fluid is not so critical.
Complete recovery is the main advantage of this technique, however, along with this there is a likelihood of inconvenience and complications in the patient, among which the most common are:
- from time to time there is a need for a full or partial replacement of the shunt;
- the risk of hematomas due to intense fluid outflow;
- dependence on the functioning of the system;
- outflow too low;
- the possibility of epilepsy, pressure sores, inflammation.
There are also contraindications for bypass surgery:
- neurological diseases;
- chronic hydrocephalus;
- blindness;
- epilepsy;
- mental disorders.
Endoscopy
Most often, the indication for adult endoscopy is a tumor or traumatic lesions. Thanks to this technology, it is possible to eliminate an obstacle that impedes cerebrospinal fluid circulation, without opening and trepanation of the cranium. With the help of an endoscope, instruments are inserted into the places where cerebrospinal fluid accumulates, by which excess fluid is sucked up to normal limits. Compared to this method, the advantages of endoscopy are obvious: its initial goal is to normalize the natural flow of cerebrospinal fluid, minimize injuries during surgery, and increase the likelihood of recovery. In addition, there is no foreign body in the body. Thanks to the endoscope, it becomes possible to completely eliminate the neoplasms that became the reason for blockage of the cerebrospinal fluid circulation, as a result of which the patient's condition improves almost immediately after the operation is completed. Often, this is the only method to eliminate a malignant or benign tumor. The attending physician decides on the use of endoscopic intervention for external hydrocephalus of the brain in an adult.
Diet
Dietary instructions for adults with external hydrocephalus of the brain are aimed at stabilizing the water balance in the body. The diet includes products that do not contain salts and sugar:
- steamed lean meat;
- boiled eggs or steamed omelet;
- vegetables and greens;
- stale bread;
- porridge.
From the patient menu, dishes that contribute to the accumulation of fluid should be excluded:
- confectionery and freshly baked flour products;
- fried, smoked, fatty meat, sausages;
- mushroom and fish soups;
- carbonated drinks;
- onions, garlic, radish.
Forecast
The prognosis of external cerebral hydrocephalus in adults is not always predictable. This is a fairly serious disease, the neglected form of which can lead to death. Even a successful and timely operation does not guarantee the absence of complications and some restrictions in the future. Specialists note not only physiological, but also neuropsychiatric disorders. Moderate physical activity, regular walks will help the patient relieve stress. Practice shows that in most cases a complete recovery after surgical treatment and a return to a full life is possible.