Moderate hypertension syndrome in osteochondrosis. Hypertensive syndrome: signs, treatment, causes, prognosis

Hypertension syndrome is characterized by a set of signs that accompany abnormal processes in the brain. Symptomatic disease causes high blood pressure in cranium associated with a neoplasm, a tumor that fills the intracranial space. common cause anomalies is the accumulation of cerebrospinal fluid, which caused edema. Excess secretion is formed in the spinal trunk, localized in the ventricles of the brain. Pathological phenomena lead to the expansion of arteries with blood and an increase in the diameter of crowded cavities.

Causes of hypertension syndrome

The skeletal system of the skull creates a constant internal volume. The growth of foreign tissue and the accumulation of fluid lead to filling the space, while pushing and squeezing the brain.

In adults

Increased production of cerebrospinal secretions, insufficient circulation and excretion form cerebrospinal fluid hypertension syndrome in adults. A number of factors that can cause a malfunction in the production and dynamics of the spinal fluid are determined:

edema, hydrocephalus;
insufficient outflow of blood;
prolonged hypoxia;
hemorrhage in the brain;
neoplasms of a malignant and benign nature;
fragments of the skull, hematomas resulting from head injuries;
a sharp increase in blood pressure;
hypotension of the vascular walls;
a consequence of a stroke;
dysfunction endocrine system;
infectious lesions (encephalitis, meningitis).

AT rare cases the etiology of the anomaly is hereditary predisposition. There is a form with an unknown cause (idiopathic), it affects mainly women with excess body weight and problems of the endocrine system. Reception contraceptives worsens the clinical picture.

In children

Pathology is defined as acquired or congenital, the latter type being infancy. For older children, an acquired genesis is characteristic, occurring in a mild or moderate form. Hypertension syndrome in infants develops for the following reasons:

prematurity of the fetus;
hypoxia in the perinatal period;
prolonged labor complicated by a head injury;
infections during pregnancy (toxoplasmosis);
defects in the development of the central nervous system;
anhydrous periods before childbirth (more than 10 hours);
intrauterine underdevelopment of the brain, cranial bones.

The disease belongs to the category of neurological, in the process of growth of the baby there is an increase in the fontanel and skull, non-union of the sutures between the bones in the region of the crown.

AT adolescence the causes of the syndrome are also associated with an excess and accumulation of cerebrospinal fluid:

craniocerebral damage;
infectious diseases;
neoplasms and edema;
renal and heart failure;
convulsive syndrome;
intra-abdominal pressure;
hormonal disorders.

Hypertension syndrome in children preschool age can manifest itself as a result of the formation of pathologies associated with early fusion of the parietal bones, hypervitaminosis, heavy metal intoxication. Less commonly, development is due to chromosomal abnormalities (Turner's disease).

Classification and signs

By the nature of the flow hypertensive syndrome divided into acute and chronic form. The first type of pathology begins with a sharp increase in pressure and a rapid intensity of symptoms, there is big risk loss of consciousness, in the worst case - coma, displacement of brain areas. Chronic form occurs against the background of insufficient venous outflow and anomalies in the structures of the spinal column. The pressure rises gradually, does not reach high rate does not pose a threat to life.

Signs of hypertension syndrome depend on the age of the patient. In adults, the anomaly is determined by a number of symptoms, the main of which is a strong headache. The condition is pronounced in a horizontal position. Secondary symptoms include:

blue circles above the zygomatic arches;
visually defined capillary "network" on the eyelids;
frequent drops in blood pressure;
tachycardia, intense sweating;
decline erectile function in men, libido in women;
weakening of the tone skeletal muscles spine;
a quick change of nervousness and irritability with apathy, a feeling of fatigue;
nausea, possible vomiting;
fainting state without visible reasons especially before changing weather conditions;
decreased vision.

The manifestation of the disease in children primarily affects their behavior and is expressed:

anxiety;
bad sleep;
causeless crying;
refusal of food;
frequent profuse regurgitation.

With a moderate manifestation of the disease, lethargy, lack of activity, drowsiness, lethargy are observed.

In a newborn, visual signs are added to the symptoms:

opening of a small and protrusion of a large fontanel;
the areas between the cranial bones are not closed;
bulge of the arteries at the temples;
the head is larger than the generally accepted norms;
in the eyes, a line of protein above the iris is clearly defined.

AT severe cases characterized by weak muscle tone, lack of a swallowing reflex, vomiting, hyperthermia.

Diagnostics

To determine the syndrome and causes in infants under 12 months of age, pediatrics use laboratory research urine and blood on biochemical composition. An instrumental diagnostic method is neurosonography, performed with ultrasound beams through a large fontanelle. Adult patients and older children are examined using:

computer, magnetic resonance imaging (CT, MRI);
echoencephalography;
ophthalmoscopy;
neurosonography;
transcranial Doppler ultrasound;
Ultrasound of the peritoneum;
radiography.

To make a diagnosis, the vessels of the fundus are examined. The most informative method for determining hypertension is puncture (ventricular, lumbar), which measures the pressure of the cerebrospinal fluid in the lumbar region of the spine or the lateral ventricles of the brain. The technique is traumatic, there are contraindications.

Therapy chronic type hypertension syndrome is carried out at home, the acute form requires hospitalization. Treatment of adult patients is carried out with the aim of:

Restoring the dynamics of cerebrospinal fluid with the help of diuretics ("Hypothiazid", "Furosemide", "Diakarb", "Acetazolamide", "Veroshpiron").
Normalization of the secretion outflow ("Eufillin", "Rigematin").
Improving the blood supply to the brain ("Cavinton", "Detralex").
Elimination of blood pressure (Nimotop, Enalapril, Labetalol).
Relief of pain with sedative and anesthetic medicines ("Midazolam", "Droperidol", "Analgin").
Improving the condition of the walls of blood vessels ("Aescusan").
Reduced tissue compression ("Sermion", "Phezam", "Cerebrolysin").

Manifestation acute form the child requires urgent medical intervention. little patient subject to immediate hospitalization for first aid:

normalization and synchronization respiratory function, ventilation of the lungs, the use of sedatives;
cupping pain syndrome;
stimulation of peristalsis with an intestinal probe to relieve pressure inside the peritoneum.

Dehydration therapy is carried out with Furosemide, Mannitol, Diacarb. To reduce intracranial compression, Magnesium sulfate, Magnesia, Glycerin, solutions of Eufillin, Sorbitol, Rigematin, preparations nootropic action("Anvifen", "Fenibut").

In adults and children with acute course syndrome with the risk of displacement of the brain areas for decompression resort to surgical intervention. Surgically neoplasms and a foreign body are removed.

For mild manifestations of the disease, diuretics are prescribed, compliance with drinking regime(minimum fluid intake). Physical therapy, massage, herbal medicine are shown.

Folk methods

Therapy is carried out in order to prevent squeezing the brain with an excess of accumulated cerebrospinal fluid. That's why Alternative medicine offers recipes with herbal ingredients that have diuretic properties.

A decoction of parsley root (grind 100 g of the component, place in a container, add 0.5 liters of water, boil for 10 minutes, let it brew for 2 hours, filter). Take during the day (from the year of life).
Celery seeds (1 teaspoon), pour 0.2 liters of boiling water, infuse in a thermos for 5 hours, give the baby 1 tbsp before meals. l., infants - 1 tsp each;
Herbal collection, which in equal parts includes wild rosemary, cumin seeds, motherwort, catnip, knotweed. For its preparation 1 tbsp. l. ingredients, 0.25 l of water is poured, aged in a steam bath for 20 minutes. Then the infusion is filtered. It is recommended to drink for children over two years old, a teaspoon five times a day.

Recipes for adults:

Powdered dry hop cones (2 tablespoons per glass of water) are boiled over low heat for 15 minutes, infused for 2 hours. ½ tsp is added to the composition. turmeric. It should be taken 100 g in two visits in the morning and before lunch.
Dry lavender leaves (40 g), pre-crushed, mixed with 0.5 cup mustard oil placed in a dark place for 14 days. In the finished tincture is added Kalanchoe juice(50 g). Keep the potion in the refrigerator. Drink 1 tbsp. spoon on an empty stomach.
Mix in equal parts tricolor violet, burdock leaves, peppermint and cat, mistletoe, wild rosemary root. 100 g of grass pour 1 liter of boiling water. The mixture is infused in a thermos for one night. Finished product strained, divided into 5 equal parts, is drunk during the day.

Application folk recipes allowed if there is no individual intolerance to the components.

Possible complications and prognosis

violations of memory, thinking, attention;
an increase in the fontanel in infants;
hypotension of muscle mass;
paresis of the limbs;
epileptic syndrome;
developmental delays (risk of imbecility);
incontinence of feces and urine.

The prognosis depends on the intensity and genesis of the disease. If a child has birth defects in the development of the brain, a cure is hardly possible. With a moderate degree of anomaly therapeutic measures able to completely get rid of the cause and symptoms.

Prevention

To prevent the manifestation of hypertension syndrome, a number of preventive measures, which includes:

limitation of physical, mental, visual stress;
exclusion of emotional overstrain;
salt-free diet, compliance with the drinking regime;
timely treatment infectious diseases.

Not last place in prevention in adults takes weight correction. If symptoms appear, a complete examination should be performed.

Hypertensive syndrome is understood as a condition that appears against the background of pathological processes accompanied by an increase in intracranial pressure. Other names this disease- Liquor-hypertensive or hypertensive-hydrocephalic syndrome.

Description of the disease

Hypertensive syndrome explains most cases of headache. An increase in intracranial pressure occurs against the background of stagnation of blood in the veins. The latter, in turn, often occurs as a result of the development of spinal pathologies in the cervical region, such as osteochondrosis.

Surplus cerebrospinal fluid, or liquor, appear in the trunk spinal cord disrupting circulation. Liquor as a result stagnates in the ventricles of the brain and inside its membranes, which leads to an excess of blood in the veins with a further expansion of the cavities occupied by the liquid.

Kinds

Hypertension syndrome is divided into several varieties, taking into account the age of the patient:

syndrome in newborns.
Pathology in older children.
hydrocephalus in adults.

AT infancy the appearance of increased intracranial pressure due to congenital diseases. In the case of more senior group patients pathology is acquired.

The reasons

Hypertension syndrome can affect patients of any age. If we talk about adults, then men are most susceptible to it. In the case of a child, both boys and girls can suffer from this pathology.

As mentioned above, there is a congenital and acquired variety of hydrocephalus. The causes that provoke the appearance of a congenital syndrome can be:

Complications accompanying pregnancy.
Difficult birth.
Hypoxia in the fetus.
The birth of a child prematurely, up to 34 weeks.
Walking and late labor after 42 weeks.
Head injury during childbirth.
Intrauterine infectious diseases.
Congenital brain defects.
Long waterless period of more than twelve hours.

In neurological practice, hypertension syndrome in children is diagnosed as a consequence of encephalopathy of the perinatal period, that is, as brain pathologists of unknown origin.

Provoking factors

acquired species this syndrome may develop due to factors such as:

Tumor formations, cysts, hematomas, abscesses.
Availability foreign body in the region of the brain.
Traumatic brain injury. Especially if fragments of the bones of the skull remained in the brain.
Sharp rises pressure of unknown origin.
Infectious diseases.
Stroke and complications after it.
Disorders in the endocrine system.

An infectious disease often accompanies hypertension. Along with the causes, the clinical manifestations of the disease in children and adults also differ.

Symptoms in adults

The main symptom of the onset of hypertension in an adult patient is a headache. Its manifestations are most noticeable in the mornings and evenings, when the human body is in a horizontal position. It is under such conditions that the activation of fluid secretion occurs, and the rate of its absorption also decreases.

Another sign of hypertension syndrome is nausea, periodically turning into vomiting. These symptoms most often appear in morning time.

Other signs

In addition, there are a number of other signs:

Great nervousness and irritability.
Fatigue both after physical and after mental load.
Decreased libido.
A state close to fainting. With hypertension in adults, this happens quite often.
Drops in blood pressure.
The dependence of the human condition on weather conditions.
Cardiopalmus.
Increased sweating.
Dark circles in the eye area and a network of small veins.

Similar symptoms are also typical for other brain diseases, so the diagnosis may require a thorough examination and collection of a detailed anamnesis.

How does hypertension manifest itself in children?

Symptoms in children

A newborn child with this disease is characterized by restless behavior and sleep problems. The child often cries for no apparent reason. In some cases, sweating, changes in body temperature and nausea, accompanied by vomiting, were noted. A neuropathologist during an examination can diagnose hydrocephalus by the following signs:

Enlargement of a large fontanelle.
The small spring is open.
The sutures between the bones of the skull are also open.
A convex network of saphenous veins is visualized in the forehead and temples.
Abnormal growth of head circumference.
Above the iris of the eye there is a strip of protein.

In addition, for newborns with hypertension syndrome, a decrease in muscle tone is characteristic. Sometimes the baby refuses to feed and reacts badly to the breast. The child also lacks a pronounced swallowing reflex.

Patients at an older age have a severe headache in the morning. There is nausea and the urge to vomit. It is difficult for the child to raise his eyes and delivers pain simple head turn. Children feel weakness, as well as dizziness, the skin turns pale, appears hypersensitivity to the light and loud sounds. Symptoms of hypertension syndrome are very unpleasant.

Diagnostics

Identification of pathology occurs on the basis of complex diagnostics, which should include both instrumental techniques research as well as clinical. The patient needs to go through several specialists to clarify the diagnosis. As a rule, first of all, the neurologist, psychiatrist, ophthalmologist and neurosurgeon perform the examination, and in the case of newborn children, also a neonatologist.

In order to find out the exact cause of the pathological process and make a diagnosis of "hypertensive syndrome", the following medical manipulations are carried out:

X-ray examination skulls. In the case of children, the procedure is performed only after the child reaches one year old.
Echoencephalography reveals possible lesions brain.
Rheoencephalogram. Performed to assess the outflow of blood from the veins.
Electroencephalography is used to determine the level brain activity through electrical impulses.
Examination of the fundus to detect hemorrhages, edema and vasospasm.
Cerebrospinal puncture to detect pressure under the influence of CSF.
Magnetic resonance or computed tomography.

In children under the age of one year, the fontanel has not yet overgrown, therefore, neurosonography is performed in newborns using ultrasound scanning.

Treatment in adults

Therapy is selected on the basis of a complete examination. As a rule, the treatment regimen is prescribed by a neurologist. Treatment can be both conservative and radical with the use of surgical methods.

Hypertension syndrome is a danger to human life, therefore suitable treatment should be started as soon as possible after diagnosis. An important stage of treatment is the intake of diuretics. They make it possible to quickly remove the cerebrospinal fluid and accelerate the process of its absorption. If the disease is recurrent, such therapy should be carried out continuously.

With a mild degree of hydrocephalus, the doctor gives several important recommendations to be followed:

Normalization of the drinking regime.
Performing special gymnastic exercises that can reduce intracranial pressure.
Holding manual therapy and osteopathy to unload the bed of the veins.

To normalize the dynamics of cerebrospinal fluid and eliminate congestion, diuretics are prescribed, for example, Furosemide, Diakarb, Acetazolamide, etc. Cinnarizine and Cavinton contribute to the normalization of brain blood circulation. If the fact of an infectious lesion of the brain is established, then the therapeutic scheme is added antibacterial drugs. The dosage and regimen of the latter are selected taking into account the age of the patient and the nature of the disease.

In addition, physiotherapeutic methods of treatment are used. This can be acupuncture, circular shower, electrophoresis, etc. Physiotherapy also has importance in the treatment of hydrocephalus. Swimming and regular walks positive result. Physical exercise should not be overly intense.

Consider below the treatment of hypertension in children.

Therapy in children

If the disease is congenital in nature, its treatment must be carried out during the first year of the child's life. This condition due to the need to prevent the development of complications and developmental delay.

Therapy in childhood aimed at reducing the amount of liquor produced. In addition, it is necessary to accelerate the process of outflow from the veins. To achieve these goals, the following appointments are made:

Furosemide.
"Diacarb".
Magnesium sulphate in the form of a 25% solution.
Glycerin in 50% solution.
"Eufillin", "Rigematin" and "Sorbitol" in the form of a solution.

This therapeutic regimen helps to reduce intracranial pressure. When the hypertension syndrome is not caused by a neoplasm in the brain, it is permissible to use physiotherapeutic methods of treatment, as well as massage.

The treatment is supplemented by the intake of vitamins of group B, "Aminalon", various nootropic drugs, "Lipocerebrin" and glutamic acid. Sometimes medicines are used sedative effect.

If the symptoms worsen, then the treatment is transferred to the conditions of inpatient observation. For children, it is necessary to create conditions that reduce the amount of crying to a minimum. It is very important to establish a regimen, walk regularly and avoid infection.

Most often it is possible to establish intracranial pressure after 6-12 months of therapy. However, the disease itself can remain and periodically make itself felt. You need to visit a neurologist twice a year.

Concerning surgical treatment, then the need for it appears if the hypertension syndrome is due to the presence of a tumor, abscess or hematoma. Most often, shunting of the brain cavities is performed, which allows you to restore the outflow of cerebrospinal fluid. Also surgical intervention may be required in case of blockage of blood vessels.

Complications

What are the consequences of hypertension syndrome?

Hydrocephalus poses a risk to patients of any age group. Most complex consequences of this disease are:

Bulging fontanel.
Lag in physical development.
Incontinence of feces and urine.
Blindness and deafness.
epileptic seizures.
Paralysis.
Coma.

Full recovery is possible at any age. But the treatment of the disease must begin on initial stage disease, while it is not yet accompanied by various complications.

Hypertensive syndrome is a condition resulting from an increase in intracranial pressure, which is distributed evenly in the skull and affects all areas of the brain. This pathology can be associated with various disorders in the brain - tumors, craniocerebral injuries, hemorrhage, encephalomeningitis. According to statistics, men intracranial hypertension occurs more frequently than in women.

SYMPTOMS OF HYPERTENSION SYNDROME: Regular headaches, feeling of heaviness in the head. These conditions are especially pronounced in the morning and at night. This is due to the fact that in a horizontal position, cerebrospinal fluid is released more actively, but its absorption slows down, which leads to an increase in intracranial pressure, as well as its symptoms.

Nausea and vomiting. These signs are most pronounced in the morning.

Increased nervousness.

Rapid fatigue, which appears even with small physical or mental stress.

Signs of vegetative-vascular dystonia. These include pre-syncope, fluctuations in blood pressure, palpitations, sweating.

Other objective signs are used to determine the diagnosis:

The expansion and tortuosity of the veins of the fundus is quite reliable symptom increased pressure inside the skull.

Ultrasound examination of the vessels allows you to determine the violation of the outflow of venous blood from the skull.

With the help of magnetic resonance or computed tomography, it is possible to determine the rarefaction along the edge of the ventricles of the medulla and the expansion of the fluid cavities in the brain.

Echoencephalography allows you to assess the state of the brain with an increase in intracranial pressure.

After identifying such a syndrome, treatment of intracranial hypertension should begin. Most often, diuretics are used to normalize intracranial pressure, which help to increase the rate of CSF release and contribute to its better absorption. Such therapy is carried out in courses. If relapses often occur, then the drugs should be taken constantly - for example, once a week. In mild cases, hypertension syndrome is treated without the use of medications. In such a situation, the following actions are prescribed:

Normalization of the drinking regime.

Manual therapy, osteopathy, which allow you to unload the venous bed of the head.

Gymnastic exercises to reduce intracranial pressure.

In difficult cases, when the signs of intracranial hypertension are threatening, surgical intervention may be necessary, which involves the implantation of shunts to drain the CSF.

19.Agnosia and aproxia-

agnosia- disorder of recognition of objects (objects, persons) with the preservation of elementary forms of sensitivity, vision, hearing.

sensitive agnosia - the impossibility of recognizing and understanding objects and phenomena on the basis of individual sensations (auditory, gustatory, tactile, visual agnosia, etc.) or their synthesis. Such forms of agnosia are usually associated with damage to the associative areas of the cortex located in the vicinity of the corresponding projection zones.

Spatial agnosia - disorientation in space or ignoring part of the surrounding space, usually its left half with a pathological focus in the right parietal lobe.

Auditory, or acoustic, agnosia - a variant of sensitive agnosia, in which a disorder of recognition of audible sounds is manifested. In cases of damage to the associative fields in the zone of localization of the cortical end of the auditory analyzer in the dominant hemisphere, more often on the left, phonemic hearing is impaired, and in connection with this, the understanding of audible speech. The defeat of similar cortical fields on the right leads to a violation of the ability to recognize non-speech object sounds (the rustle of leaves, the murmur of a stream, etc.).

visual agnosia - a disorder in the synthesis of individual visual sensations and, in connection with this, the impossibility or difficulty of recognizing objects and their images with intact vision.

Visuo-spatial agnosia, or spatial apractagnosia - visual agnosia, in which the patient has difficulty compiling ideas about the spatial relationships between objects. This leads to a violation of the ability to differentiate between left and right, to a violation of the possibility of orientation in the area, drawing up a plan of a room, etc. It occurs when the tertiary associative zones of the parieto-occipital cortex are affected, usually in the right hemisphere of the brain.

Facial agnosia (prosopagnosia) ) - visual agnosia, manifested by unrecognition of faces or portrait images (drawing, photograph, etc.) of acquaintances, relatives or well-known people. This is a sign of damage to the cortex of the secondary associative zone in the right occipital-parietal region.

Treatment. Agnosia has no specific treatment. Rehabilitation with the assistance of a speech therapist or occupational therapist can help the patient achieve compensation for the disease. The degree of recovery depends on the size and location of the lesions, the degree of damage and the age of the patient. Recovery mostly occurs within the first three months, but generally lasts up to one year.

Apraxia- the process of violation of purposeful movements and actions in which the components of its elementary movements are preserved. Given pathological condition can occur in the presence of focal lesions of the pathways of the plexus of nerve fibers (corpus callosum), as well as the cortex of the cerebral hemispheres.

Apraxia may result from the following conditions:

Stroke (apoplexy);

Tumor processes of the brain;

brain injury;

infectious diseases;

The hypertension syndrome is intracranial elevation pressure that may arise from different reasons– from infectious diseases to hormonal disorders. Most bright sign of this disorder is a headache. Diagnosis of the syndrome is difficult, most exact method is a puncture of the spinal cord or ventricles of the brain. The danger of the disease lies in a significant deterioration in the quality of life, a decrease in vision, up to blindness, in severe cases - hypoxia and brain death. Treatment is medical, and if it is ineffective, surgical.

Description of the disease

The space inside the human skull is filled with three main components - medulla (85%), cerebrospinal fluid (or cerebrospinal fluid, 10%) and blood (5%). Intracranial pressure in all people is excessive in relation to atmospheric pressure and is 7.5 -15 mm Hg. in the supine position in adults and adolescents. With a vertical position of the body, the pressure decreases to 5 mm Hg. and less. In full-term newborns, it is 1.5-6 mm Hg, in older children it is 3-7 mm Hg, and in some cases it can be equal to atmospheric. A persistent excess of this parameter in adults and children is more than 20 mm Hg. called hypertension syndrome.

When the 3 components of the intracranial space are in balance, a constant pressure value is maintained by creating a buffer volume while reducing the amount of CSF or blood. If there is an increase in the volume of one of the components (with cerebral edema, hyperemia and other pathologies) or an additional component appears (trauma, hemorrhage, tumor), then the compensatory abilities of this system are quickly exhausted and intracranial hypertension appears.

With a significant increase in intracranial pressure, the blood supply to the brain deteriorates, vision is impaired (up to complete blindness), brain ischemia occurs, edema develops, and dislocation of its parts occurs with a violation vital functions organs, vegetative abnormalities appear (arterial hypertension, respiratory failure, bradycardia, and others). There are several stages of hypertension, the last of which poses a threat to human life.

Hypertension Syndrome is clinical manifestation increased intracranial pressure. The latter may be due various reasons: diseases and injuries. For staging accurate diagnosis detailed examinations of the brain and other systems are required. As the well-known pediatrician Komarovsky notes, in Russia there is a practice of “hyperdiagnosis” of this syndrome, especially in newborns, when the diagnosis is established in cases not confirmed by clinical studies.

Hypothalamic Syndrome - Causes, Symptoms and Treatments

Symptoms

In infants of the first year of life, there are the following symptoms pathologies:

an increase in head circumference in each month by more than 1 cm in full-term babies and more than 2 cm in premature babies;
anxiety, increased excitability;
divergence of the sutures of the cranium;
bulging of a large fontanel;
plentiful and frequent regurgitation, especially in the morning hours;
poor, light sleep or increased sleepiness;
Graefe's symptom - when the child looks down and he has a visible top part squirrel ("bulging" eyes);
excessive motor activity.

In older children, the following symptoms are noted:

frequent headache, which does not have a specific localization, aggravated in the morning, when coughing, sneezing, motion sickness;
dizziness;
nausea and vomiting not associated with eating, after vomiting the child has a slight relief;
instability in the Romberg position (legs together, arms extended forward, eyes closed);
blurred vision (blurring, darkening, double vision, loss of visual fields);
increased tactile, auditory and visual sensitivity;
irritability, psycho-emotional instability and sleep disturbances;
increased secretion salivary glands not associated with eating;
cognitive decline, memory impairment.

For adolescents and adults, the following symptoms of the syndrome are characteristic:

The leading symptom is a headache (in 90% of cases) of varying strength, with pronounced intensity in the morning, accompanied by nausea and vomiting (in 30% of cases), increased severity when tilting the head down and coughing. Pain in the morning due to biological rhythm production of liquor (40% of this fluid is produced between 4 and 6 hours) and is bursting in nature with a sensation of squeezing out the eyes.
Vertigo.
Temporary visual disturbances (darkening, blurring in the central part, bifurcation, loss of visual fields) are noted in 70% of cases, precede headache or occur at the onset of the disease.
Noise in the head (in 60% of patients).
False sensation of light in the eyes (more than 50% of cases).
Movement restriction eyeballs towards the outside.

In critical cases, the following symptoms appear:

respiratory disorders;
disturbance of consciousness;
convulsive seizures;
change in pupil size, lack of reaction to light, blindness;
movement disorders;
lethargy.

Visual changes in the absence timely treatment in 10% of cases lead to irreversible deterioration of vision.

Diagnostics

When diagnosing the syndrome and identifying its causes, it is necessary to pass a general, hormonal and biochemical analyzes blood. The main diagnostic method in newborns and children under 1 year old is neurosonography - ultrasound procedure brain through a large fontanel. In older children and adults, the following instrumental examinations are performed:

magnetic resonance or computed tomography(MRI or CT);
electroencephalogram;
ophthalmoscopy;
Ultrasound of the abdominal cavity;
ultrasound dopplerography (USDG) of the vessels of the head.

Signs of hypertension

The following symptoms are present on x-rays:

enlarged lower horns lateral ventricles;
lack of visualization of subarachnoid spaces, interhemispheric and lateral fissures of the brain;
tortuosity of the optic nerve;
expansion of the anterior horns of the lateral ventricles;
reduced tissue density;
"empty Turkish saddle";
flattening of the posterior surface of the eyeball.

X-ray examination of the brain (MRI and CT) is also carried out in order to exclude other pathologies - the presence of volumetric processes, vein thrombosis. In difficult cases, an x-ray is taken. The most informative is the method of lumbar or ventricular puncture, in which in the lumbar region or in lateral ventricles brain, a needle is inserted into the space filled with cerebrospinal fluid. Pressure is measured using sensors. This procedure is contraindicated in the presence of structural displacements and severe cerebral edema, as it may end lethal outcome for the patient. The puncture has complications - intracranial infections and hemorrhages, infection of the spinal cord, damage to the functional areas of the brain and blood vessels.

During ophthalmoscopy, the following signs are revealed:

swelling of the optic nerve;
expansion of the blind spot, leading to loss of visual field;
hemorrhages in the fundus;
narrowing of the arteries and dilation of the veins;
decrease in visual acuity.

Since direct measurement of intracranial pressure is a traumatic and invasive method, in medical science searching for more safe ways diagnostics. These include:

Transcranial dopplerography - ultrasound scan cerebral vessels, which assess the difference in blood flow in the average cerebral artery and during contraction and relaxation of the heart muscle. Exceeding the value of 0.8-0.9 is a sign of intracranial hypertension.
Measurement of pressure through the labyrinth of the inner ear.

The reasons

The main factors in the appearance of hypertension syndrome are violations of the production and circulation of cerebrospinal fluid, stagnation of blood inside the skull and an increase in brain volume. The reasons may be:

infectious diseases of the brain (inflammation of the brain and arachnoid membranes);
viral diseases (measles, influenza, chicken pox, parotitis and others);
kidney failure;
convulsive syndrome;
concussions and craniocerebral injuries;
hemorrhages;
arterial hypo- or hypertension;
vein thrombosis;
brain development anomalies (hydrocephalus, microcephaly, craniocerebral hernia, vascular aneurysms, premature bone fusion in newborns);
increased intra-abdominal or intrathoracic pressure;
brain tumors and abscesses;
polycystic ovary syndrome;
swelling of the brain;
endocrine and hormonal disorders accompanied by obesity;
systemic diseases (lupus erythematosus, sarcoidosis, thrombocytopenic purpura);
heavy metal poisoning;
taking certain medications (tetracycline antibiotics, hormones, Retinol, Cimetidine, Amiodarone, products containing lithium salts, nalidixic acid, and others);
hypervitaminosis;
Turner syndrome (chromosomal disorder).

There is also an idiopathic form of hypertension syndrome, which manifests itself mainly in women 30-50 years old, suffering from obesity and endocrine disorders. The exact pathogenesis of this form of the disease has not been established. Deterioration of the condition can begin during pregnancy, after childbirth, or when taking hormonal and contraceptive drugs.

Treatment

Patients with hypertension syndrome are shown to rest during the entire period of treatment, since excessive activity aggravates the condition. basis conservative therapy comprise the following activities:

1. Improving the outflow of blood from the cranial cavity. To do this, the head end of the bed should be raised by 30-40 degrees, and a small pillow should be placed under the head to prevent the head from tipping over. These simple measures can reduce intracranial pressure and alleviate the patient's condition.
2. The use of sedatives and painkillers (Propofol, Midazolam, Diazepam, Droperidol and others). Psychoemotional arousal and pain lead to an increase in arterial and intracranial pressure. Pain impulses contribute to the emergence of foci of excitation in the structures of the brain, which can provoke convulsions and the expansion of the zone of brain damage. In a hospital setting, intravenous or intramuscular injection painkillers (Fentanyl, Promedol, Nalbuphine, Butorphanol).
3. If the patient's condition is accompanied by fever, then it is necessary to use antipyretic drugs (Analgin, Diphenhydramine, Ketorolac) and physical methods cooling: putting an ice pack on the neck, rubbing cool water cooling the body with a fan. Elevated temperature leads to an increase in blood supply to the brain and an increase in intracranial pressure. A decrease in brain temperature from 39.5 to 38.5 degrees helps to reduce pressure from 17 mm Hg. up to 13 mm Hg
4. Main medicine for hypertension is Acetazolamide (Diacarb). In adults, the initial dose is 500 mg twice a day, the dosage is gradually increased to 2-2.5 g / day. Treatment should be carried out for a long time, for several months. This drug not only contributes to the normalization of intracranial pressure, but is also effective in patients with visual disorders.
5. In patients with hypertension syndrome, it is necessary to constantly monitor the level of blood pressure, since if the self-regulation of cerebral blood flow is disturbed, it leads to an increase in intracranial pressure. To reduce arterial pressure, Labetalol, Nitroglycerin, Enalapril, Nimotop and other drugs are used.

Emergency treatment in a hospital setting includes the following measures:

1. Elimination of respiratory disorders with the help artificial ventilation lungs (IVL), application sedatives to synchronize breathing and ventilation in order to prevent an increase in intrathoracic pressure.
2. Reducing pain syndrome with the help of analgesics.
3. Decrease intra-abdominal pressure with drugs that stimulate peristalsis digestive tract, installation of a gastric or intestinal probe.
4. The use of hypothermic and antihypertensive drugs.
5. The use of hyperosmolar solutions of Mannitol, sodium chloride and combinations of the latter with colloid preparations.
6. The use of barbiturates (Phenobarbital, sodium thiopental, Surital, Brevital and others), which depress metabolic processes and reduce blood flow to the brain. In high doses, they help reduce intracranial blood volume.

For the treatment of children use the following means:

diuretics for dehydration therapy (Mannitol, Furosemide, Diakarb);
sedatives (magnesium sulfate);
nootropic (Fenibut, Anvifen);
B vitamins;
symptomatic remedies according to the indications of narrow specialists.

As a prevention of the disease in children, it is necessary:

1. compliance with the regime;
2. balanced diet with limited salt and liquid;
3. regular performance of physiotherapy (exercise therapy, massage);
4. moderate physical activity;
5. limitation of visual and psycho-emotional stress;
6. prevention of infectious diseases, obesity and injuries.

In adults good result shows a diet to reduce body weight. If conservative therapy fails and sharp deterioration vision, surgical interventions are used:

serial lumbar punctures;
decompression of the optic nerve sheath;
shunting of the veins of the brain;
decompressive craniotomy (craniotomy).

The last method is the most aggressive and has pronounced positive effects, but is not used in wide clinical practice due to the lack of sufficient evidence and possible complications.

Hypertensive syndrome is a disease that can lead to complications or death. This disease occurs against the background of increased intracranial pressure due to the formation excess cerebrospinal fluid.

The reasons

Hypertensive syndrome occurs due to:

cerebral edema;
traumatic brain injury;
hemorrhages in the brain;
malignant formations;
encephalitis;
infectious diseases of the brain or its membranes;
vascular hypotension.

The syndrome can be congenital or acquired. In newborns, this pathology most often occurs due to the following conditions:

intrauterine infections;
the occurrence of complications during pregnancy;
difficult childbirth;
prematurity;
hypoxia;
the formation of brain defects;
anhydrous period lasting more than 12 hours.

Acquired pathology is formed due to:

infections;
stroke
brain injuries;
diseases of the endocrine system;
presence in the brain of foreign bodies;
development in the brain of tumors, hematomas or abscesses.

Symptoms

Hypertensive syndrome is important to identify at the initial stage, so you need to have an idea about its signs.

The following symptoms signal the presence of hypertension in adults:

Spontaneous sharp or often manifested headaches. Most often, discomfort manifests itself in the morning or evening. This fact is explained by the horizontal position of the body, which contributes to the active release of cerebrospinal fluid and its slow absorption. Feelings of heaviness and pain in the head can be so strong that a person is able to wake up in the middle of the night. It is impossible to determine where the pain occurs, because. discomfort spread throughout the head.
Sudden or persistent bouts of nausea, usually manifested in the morning after eating. Vomiting may also occur.
unstable arterial pressure accompanied by palpitations. On the skin while sweat comes out.
Backache. It can manifest itself in all parts of the spine.
excitability and fast fatiguability occurring for no reason.
Deterioration in the quality of vision. A foggy veil appears, and sensitivity to bright light decreases.
Dependence on the variability of weather conditions, when a person's well-being can deteriorate sharply due to changes in atmospheric pressure.
Feelings of unpleasant subcutaneous itching, against which it manifests itself severe irritability and excitability.
Availability dark circles under the eyes, regardless of what lifestyle a person adheres to.

Such clinical picture may indicate not only the development of hypertensive syndrome, but also other no less dangerous diseases brain. In these cases, a comprehensive diagnosis is important.

Diagnostics

It is possible to identify a hypertensive syndrome when conducting appropriate clinical and instrumental research. The patient is examined by the following specialists:

ophthalmologist;
psychiatrist;
neurologist;
neurosurgeon;
neonatologist (for newborns).

To detect pathology, the following studies are carried out:

Echoencephalography and rheoencephalogram. The use of these diagnostic methods allows you to get an accurate picture of the work of the brain. The first method uses ultrasound. A rheoencephalogram helps to assess the condition of the vessels.
X-ray of the skull. This procedure used to determine the disease in children older than 1 year. Basically, these are patients in whom the disease lasts for a long time. In children, thinning of the cranial bones or changes in their shape are detected.
CT scan. Using this method, specialists receive a virtual section of tissues and organs. In addition, the existing dimensions of the brain cavities are displayed. An increase in their size may be a sign of increased intracranial pressure.
Electroencephalography. With the help of this procedure, the level of activity of processes in the brain is studied, the localization of the pathology of the vessels and their condition are specified.
Neurosonography, which allows you to explore the anatomy of the brain. This is an informative and safe method that detects the disease even in newborns. Pathological changes detected by ultrasonic penetration into soft tissues.
Cerebrospinal puncture. With the help of this method, not only the disease is detected, but also the path of treatment is determined. The procedure for extracting cerebrospinal fluid is carried out using a special needle. The operation is not easy, so only professionals are allowed to carry it out.

Treatment

Syndrome arterial hypertension requires proper treatment, and here can be applied as conservative methods as well as surgical intervention.

The main therapy is to take diuretics, which accelerate the release of cerebrospinal fluid and improve its absorption. If relapse occurs, the patient should take such drugs regularly.

If the attacks of the syndrome are mild, then the patient must adhere to the following recommendations:

normalize the drinking regime;
perform exercises that help reduce pressure;
use manual therapy.

To improve the general condition, diuretics may be prescribed by a doctor:

Diacarb;
Furosemide.

It will be possible to normalize the blood circulation of the brain with the help of:

Cinnarizine;
Cavinton.

Some physical therapy measures may also be helpful, including:

acupuncture;
circular shower;
electrophoresis.

Positive results are provided by daily walking, swimming, gymnastic exercises. However, the load should be moderate.

Before using any therapeutic method a doctor's consultation is necessary, tk. herbal preparations and alternative medicine can harm health.

Surgical intervention will be required in the presence of tumors, abscesses, hematomas or blockage of blood vessels.

Possible Complications

Possible complications of pathology include:

blindness;
deafness;
paralysis;
delay in mental or physical development;
urinary or fecal incontinence;
coma.

Intracranial hypertension is a pathology that requires constant monitoring by a specialist. Such a disease threatens not only the health of the patient, but also his life. However timely diagnosis and correct treatment will help to normalize the patient's condition and make his life easier.