External hydrocephalus. Diagnosis of external hydrocephalus. How is external cerebral hydrocephalus diagnosed?

Hydrocephalus of the brain is a fairly serious disease associated with an excess amount of cerebrospinal fluid (CSF). That is why the people. The cerebrospinal fluid itself does not cause any harm, on the contrary, its presence is mandatory for the brain, but only if its level is within the normal range. Liquor usually fills the space under the meninges.

The disease is very difficult to tolerate in both adults and children. Moreover, at first the symptoms are almost imperceptible, and the person often does not even feel the onset of pathology. But a little later, hydrocephalus makes itself felt through external manifestations: stability when walking is lost, memory and vision deteriorate.

Usually, the circulation of cerebrospinal fluid is disturbed due to craniocerebral trauma, vascular damage. Slightly less often, the reasons may be past infections or a stroke.

Hydrocephalus of the brain is not only an acquired disease, it can also affect newborns ( congenital disease develops due to intrauterine infections).

Depending on the form of the pathology and its causes, experts distinguish several types of hydrocephalus of the brain:

1. open external hydrocephalus. With this type of disease, the structure and tissues of the brain are so destroyed that they can no longer absorb cerebrospinal fluid, although the process of its production takes place without changes;
2. hypersecretory hydrocephalus. This type is characterized increased amount produced liquor. Raising the level of cerebrospinal fluid above normal means the impossibility of absorption by the brain of its entire amount. Thus, fluid fills the cranial cavity;
3. closed hydrocephalus. With the closed form of the disease, the liquor-bearing spaces are blocked, thus, the circulation of the fluid is disturbed, its level often fluctuates. Usually, the causes of closed hydrocephalus of the brain are the formation of blood clots and tumors that interfere with the normal movement of CSF;
4. outdoor replacement hydrocephalus. This type of disease is the most dangerous for the body, because with it the volume of cerebral gray matter decreases, and the vacated cavities are occupied by cerebrospinal fluid. Human can for a long time not to feel the appearance of pathology, because due to the replacement of gray matter with cerebrospinal fluid, there are no jumps in intracranial pressure. Therefore, the patient goes to the doctor already at the severe stage of the disease, when it manifests itself outwardly;
5. moderate external hydrocephalus. With this type of disease, cerebrospinal fluid accumulates in the subarachnoid space.

The reasons

The reasons that can provoke the development of hydrocephalus can be very different, but in in general terms they come down to one denominator - to neurological internal disorders or mechanical damage. So, there are several reasons that cause this disease:

1. traumatic brain injury, concussion. With head injuries, the structure of the brain tissue is disrupted, as a result, the brain becomes unable to completely absorb the CSF. The fluid continues to accumulate, fill the spaces, that is, the disease will progress if you do not consult a doctor and do not heal the injury, because its consequences, even after a while, can be deplorable;
2. stroke. The stroke is also the destruction of its tissues and structures. The functionality of the brain is impaired, despite the fact that the CSF spaces continue to communicate with each other;
3. development of inflammation in the central nervous system. These inflammations can cause severe infections - tuberculosis, encephalitis, meningitis;
4. oncological diseases.

Symptoms of the development of the disease

Symptoms of external hydrocephalus differ in their dependence on the stages of the disease. On first, mild stage hydrocephalus, a person may not notice any external manifestations for a long time. Moreover, if the violation of the circulation of cerebrospinal fluid is not so global, then the body itself will try to restore it. Identified at the first stage, the disease is easily treatable, which in this case has a very positive outlook.

If you delay contacting a doctor, the disease will imperceptibly for the whole body flow into the second stage, which is characterized by severe symptoms:

1. nausea, vomiting;
2. head pressing pains, migraine;
3. deterioration of vision and hearing;
4. deterioration of memory and intellectual abilities;
5. a very high degree of drowsiness - a person can literally fall asleep on the go;
6. speech defects.

With even more severe forms illnesses are possible mental disorders, depression and depression. The patient may begin to confuse day and night, not responding to questions from others. Given the neurological impairment, a person has problems with movement, he cannot fully control musculoskeletal system, staggers while walking.

In infants, the disease manifests itself even more clearly - the skull grows right before our eyes due to excessive pressure in the cranial box, which is created by an excessive level of cerebrospinal fluid. Due to the fact that the cranial sutures in newborns are not yet strong at all, the head increases in size, becomes disproportionate to the rest of the body.

If we touch on such a variety of external hydrocephalus as replacement, then its symptoms will be somewhat different, since this species pathology is very difficult for the human body, constantly progressing:

1. more pronounced violations memory (a person can forget his name for a short period, always answers questions slowly and sluggishly, not reacting to strangers);
2. arbitrary urination, not only at night, but also during the day;
3. impaired coordination of movements, gait;
4. development of dementia.

Diagnosis of external hydrocephalus

Despite the variety of all diagnostic methods for detecting the presence of too much fluid in the brain, leading role the examination is usually played by MRI (magnetic resonance imaging) or CT ( CT scan). These procedures can help to quickly make an accurate diagnosis.

With the help of MRI and CT, the signs and causes of the disease, the stage at which it is now located, and, accordingly, the degree of its neglect are revealed. Through procedures, specialists examine the cranial cavity, the contours of the brain and possible cysts and tumors. A contrast agent is not required when examining the brain for hydrocephalus, however, many doctors advise nevertheless to introduce it into the body, and at the same time the condition blood vessels in the brain. It is clear that the influence of the circulatory system on the excess of cerebrospinal fluid is not great, but MRI or sometimes other diseases can be detected if they suddenly exist.

Also, specialists can record a patient for a cisternography procedure - one of latest methods diagnostics of the brain, aimed just at the study of the circulation of cerebrospinal fluid.

In addition to these outpatient methods for diagnosing hydrocephalus, the following procedures are also commonly used:

1. angiography - used to check the condition of blood vessels, the absence or presence of tumors, cysts, blood clots;
2. radiography of the brain;
3. ultrasound of the brain;
4. examinations for viruses and infections.

It is also mandatory for a specialist to question the patient for complaints. The patient should describe those symptoms that have clearly manifested themselves, and as accurately as possible. This will help doctors make an accurate diagnosis and prescribe proper treatment, which will weaken the outward expression of symptoms.

Treatment

A person should not panic if he was diagnosed with “external hydrocephalus of the brain”. Timely diagnosed disease can be treated with various medicines. According to statistics, about 80% of patients observe positive effect, the disease usually goes away forever. However, neglected hydrocephalus triggers negative processes in the body, as a result, a person may remain disabled. Sometimes the treatment of a disease requires surgical intervention.

With drug treatment, it is important not only to alleviate the symptoms, but also to restore fluid balance in the body. The doctor can prescribe three at once:

1. diuretic drugs;
2. non-steroidal anti-inflammatory drugs (Ketoprofen, Nimesil);

Medicines containing magnesium (Asparkam, Panangin) are excellent in restoring fluid balance.

Surgical intervention is required if there is no beneficial effect from medications for a long time. Also, the patient may be warned about the operation immediately after the MRI or CT procedures, if the specialist determines that the disease develops into a very serious stage, that the level of cerebrospinal fluid is too high.

In 20-30% of operations, the so-called CSF shunting is performed. In other words, cerebrospinal fluid is pumped from the cranial cavity and delivered to the places where it should be, that is, to natural areas.

Much more often during surgery, the method of endoscopic treatment is used, which implies that the fluid will leave by artificial means. This option is considered more successful than shunting.

Video

Hydroencephalopathy of the brain is also known as dropsy. Any head injuries, infections, strokes (), tumors, etc. can provoke replacement hydrocephalus. This disease is considered very difficult to tolerate in adults, and in childhood especially.

Risk factors for the formation of hydrocephalus are associated with the fact that too much a large number of liquor. In general, this liquid has many useful features, however, its volume should be within the normal range. If its quantity begins to increase, then it accumulates in the cavities of the skull. And this provokes serious violations in the work of the brain.

External hydrocephalus can be provoked various reasons. Usually these are violations that affect certain areas. nervous system.

However, a clear diagnosis has not yet been developed. There are times when doctors send their patients to a psychiatric ward and try to treat, but this is the wrong therapy.

The main causes of hydrocephalus in adults are head injuries. The disease can cause a stroke. This applies to both ischemic and hemorrhagic form. The cause may be a psychoorganic syndrome.

Increase the risk of developing external dropsy of the brain inflammatory processes in the central nervous system, especially if they are caused by infections (, ventriculitis, tuberculosis, meningitis, etc.).

Provoke hydrocephalus can not only encephalitis caused by infection, but also post-traumatic. The risk of its development increases in people who suffer from cancer. And this also applies to the intraventricular, stem and parastem location.

Hydrocephalus of the brain can be acute and chronic. In both cases, the symptoms will be slightly different. If the disease develops in a child who is not more than 2 years old, then his head circumference will begin to increase sharply.

This is due to the fact that the fluid creates pressure, and the sutures of the skull have not yet strengthened, so they begin to diverge. As a result, the child's head becomes disproportionate, the forehead begins to protrude strongly, the veins on the head are visible. The child becomes very lethargic, it is difficult for him to keep his head straight.

Symptoms

In adults, the symptoms of hydrocephalus will be slightly different. A person complains about constant nausea. There are vomiting episodes. Most often, this symptom torments a person in morning time. There is constant pain in the head, especially after sleep.

The first sign of hydrocephalus, which indicates that the condition is getting worse, is drowsiness. Consciousness can be oppressed, which will develop into a coma. stagnant processes sometimes affect optic nerves and the sick getting worse vision.

Sometimes hydrocephalus in adults develops into a chronic form. In this case, all violations will be systemic, and some of them cannot be corrected. Usually, the disease manifests itself about a couple of weeks after a stroke, meningitis, or injury.

At chronic form, the memory of a person begins to deteriorate sharply. This is especially true for short-term numbers - age, date, etc. The patient begins to confuse day and night.

If you ask the victim questions, then he thinks for a long time and gives monosyllabic answers, speaks slowly. Sometimes speech becomes completely inadequate.

Diagnostics

The main place in the diagnosis of cerebral hydrocephalus is given to magnetic resonance imaging (MRI) and computed tomography. Physicians should evaluate the size, position and condition of the ventricles, the space in the skull, and the degree of deformity. Only then does the treatment begin.

Computed tomography helps to examine the contours of the brain, the space in it, and so on. Thanks to this technique, you can accurately determine the shape and size of the ventricles, as well as find cysts, tumors and other neoplasms.

• Angiography involves insertion through an artery contrast medium after which an x-ray can be taken. circulatory system. Any, even the smallest, violations will be identified.

Cisternography allows you to determine how the cerebrospinal fluid circulates. A neuropsychological examination is also carried out. An anamnesis is collected and the patient is interviewed. So you can identify primary disorders in the brain.

Medical treatment

Treatment of hydrocephalus should be started only after the diagnosis has been accurately confirmed. Treatment is carried out using drug therapy.

The therapy used for hydrocephalus in adults is determined solely by qualified specialist based on survey results.

If diagnostics are early stage and start therapy on time, then complications will not arise. A set of measures has been developed that allows you to restore the balance of fluid in the human body, so that this will to some extent eliminate hydrocephalus.

However, these measures do not always help, so treatment is carried out not only with medicines. Must be observed correct mode activity and recreation. In addition, you need to monitor your own nutrition, and this applies not only to the diet, but also to the regimen. It is necessary to complete the complex therapeutic exercises. They improve blood circulation and metabolism.

As for medications in the treatment of external hydrocephalus, your doctor will prescribe drugs that have a diuretic effect. Anti-inflammatory drugs are essential. You will also need vasodilators.

These funds help at an early stage in the development of hydroencephalopathy. Usually Panangin or Asparkam is prescribed by a doctor. These are drugs that include magnesium and potassium.

Choline Alfoscerate-cerepro or Gliatilin is prescribed. Mannitol or Mannitol is used. Sometimes Actovegin or Solcoseryl is used.

A separate group consists of:

1. Telektol;
2. Vinpocetine or Korsavin;
3. Acetazolamil;

At severe pain you can use painkillers. For example, non-steroidal anti-inflammatory drugs - Nimesulide, Ketoprofen, Ketonal, Nimesil and others will go.

Treximed helps with migraine. Barbiturates such as Amital, Nembutal, or Phenobarbital are sometimes used.

Surgical intervention

If a drug treatment hydrocephalus does not help, then surgery will be required. If a acute form disease is caused by hemorrhage inside the ventricle, then this severe complication can only be eliminated with a neurosurgical operation.

First, a CSF shunt can be performed. The desired effect is achieved in 90% of all operations. This will help eliminate the accumulated fluid and pump it into the natural areas of the body for it. A system of valves and tubes is used.

However, it must be remembered that unpleasant complications operations are also possible, and in 50% of all cases. For example, a patient may become infected with a shunt, which means that microorganisms will also pass to the membranes of the brain. There is a risk of blockage in the ventricles. Sometimes the shunt leads to mechanical damage. There are others side effects. In addition, the outflow of fluid is very slow.

Secondly, you can make endoscopic treatment hydrocephalus. This option is considered more successful and is used much more often than CSF shunting. Here, the outflow of fluid will take place artificially. The advantage of the operation is that the level of its trauma is very low.

After the operation, the patient's quality of life begins to improve. There will be no foreign bodies in the body. CSF flow will gradually recover, so that the patient recovers.

Hydrocephalus of the brain is very complex and serious illness. Adults and children are difficult to tolerate this disease. Identify hydrocephalus of the brain by symptoms difficult. It is also necessary to carry out serious diagnostic procedures.

Most often, this disease appears in newborns. In this case, the right treatment will help fix everything. However, drug therapy does not always help, so surgery is required.

In order not to cause hydrocephalus, you need to avoid head injuries, eat right and at least once a year undergo a complete diagnostic examination. These rules will help prevent such unpleasant illness like a dropsy.

Symptoms and treatment of cerebral hydrocephalus in adults updated: February 8, 2017 by: author

It was classified exclusively as an infantile disease.

Over time, doctors were forced to admit that no age group is immune from such a diagnosis.

When external cerebral hydrocephalus is diagnosed in adults, treatment is prescribed according to one of the clinical programs.

External hydrocephalus is neurological disease dangerous complications. Normally, the intracerebral fluid cerebrospinal fluid circulates continuously, providing nutrition to soft tissues and protecting them from damage.

Neoplasms, adhesions and any other obstacles create a threat of outflow disturbance. An excess of accumulated fluid creates pressure, leading to a decrease in brain volume or rupture of the ventricles.

Drug treatment is recognized as not the most effective, at the same time, the most sparing method. Conservative treatment assigned based on general condition, age and nature of hydrocephalus.

The emphasis is on vasodilators, diuretics and potent saluretics that increase the outflow of CSF. Appointed at the same time pharmacological agents slowing down its production.

Concomitant medications are also prescribed to alleviate the patient's condition, these are the means that the standard prescription includes:

1. acetazolamide- a means of lowering intraocular pressure;
2. attracts, diacarb, glimarite- diuretics;
3. painkillers and barbiturates;
4. furosemide and ethacrynic acid- preparations that remove salts and excess water;
5. 20% albumin solution to correct the composition of blood and plasma;
6. 25% magnesium sulfate solution, glivenol, troxevasin- drugs that improve blood circulation;
7. betamethasone, dexamethasone, methylprednisolone, prednisolone- hormonal steroids that have an anti-inflammatory effect.

Conservative therapy leads to complete recovery only in some cases, its primary task is to slow down the development of external hydrocephalus and alleviate the patient's condition.

If within 2-3 months it is not possible to achieve steady state requiring surgical intervention. Medical treatment is unacceptable in acute clinical forms diseases.

Brain shunt

Brain shunting is one of the effective methods treatment of external hydrocephalus in adults, 85% of the operations performed give a satisfactory result. With the help of a system of tubes and valves, excess cerebrospinal fluid is removed by natural and forced methods into the body cavity, where fluid accumulation is not so critical.

Brain shunting for hydrocephalus

Complete recovery is the main advantage of the technique, at the same time, there is a possibility of complications and inconvenience for the patient, the most common of which are:

• periodic need for partial or complete replacement of the shunt;
• dependence on system performance;
• the risk of hematoma formation due to intense outflow;
• too slow outflow;
• the likelihood of inflammation, bedsores,.

There are a number of contraindications for shunting:

1. chronic form of hydrocephalus;
2. neurological diseases;
3. mental disorders;
4. epilepsy;
5. blindness.

Endoscopy

In most cases, the indication for endoscopy in adults is the presence of a tumor or a formation of traumatic origin. Thanks to this technology, it is possible to remove an obstacle that impedes the circulation of CSF without trepanation and opening cranium.

Through the endoscope, neurosurgical instruments are introduced into the liquor accumulation foci, which ensure the suction of excess fluid to the normal limits.

Comparing shunting and endoscopy, the advantages endoscopic method obvious:

1. the initial goal of endoscopy is the normalization of natural CSF flow;
2. minimal trauma during surgery;
3. absence foreign body in the body;
4. high chance of complete recovery.

With the help of an endoscope, it is possible to completely remove neoplasms that caused the blockage of CSF circulation, as a result, the patient's condition improves almost immediately after the operation is completed.

Folk remedies

Folk methods of helping a person suffering from dropsy have been known since ancient times and continue to be used today. Experts say that none of them guarantees complete cure however, their beneficial effects are noted.

Decoctions and tinctures medicinal plants improve blood circulation, accelerate metabolism in soft tissues, are recognized as effective diuretics and salt-removing agents, below are some of them.

In his writings, Avicenna insists on the use of spices: cinnamon, fennel, suneli hops, ginger and parsley.

According to him, these plants not only improve taste qualities a very limited patient menu, but also help to eliminate any blockages in the body.

There is an opinion that due to age features or prolonged inactivity, the volume of the brain decreases and the empty space is filled with fluid.

However, this is a reversible process: intellectual activity helps to return the brain to its former dimensions and displace excess moisture.

In medicine, there is no official confirmation or refutation of this theory, however, in any case, reading, mastering new material, solving crossword puzzles and solving problems will not cause harm.

Diet

The diet includes products that do not contain salts and sugar:

• steamed lean meat;
• boiled eggs or steamed scrambled eggs;
• vegetables and greens;
• stale bread;
• porridge.

Dishes that promote fluid accumulation should be excluded from the patient's menu:

• confectionery and freshly baked flour products;
• fried, smoked, fatty meat, sausages;
• mushroom and fish soups;
• carbonated drinks;
• onion, garlic, radish.

When the cerebrospinal fluid fills the subarachnoid space and the ventricles of the brain. Lead to this disease could be for a variety of reasons, from congenital disorders to inflammatory processes.

Vivid and especially severe symptoms are characterized by moderate hydrocephalus in adults. And how this brain disease is treated is described in detail.

Related videos

About the causes and treatment of hydrocephalus (dropsy) of the brain:

The prognosis of external cerebral hydrocephalus in adults is not always predictable. This is enough serious illness, the launched form of which can lead to lethal outcome. Even a successful and timely operation does not guarantee the absence of complications and some restrictions in the future.

Experts note not only physiological, but also psychoneurological disorders. To relieve stress, the patient will help moderate physical exercise, regular walks. Practice shows that in most cases it is possible full recovery after surgical treatment and return to a full life.

Hydrocephalus is a pathology associated with excessive accumulation of cerebral fluid in the ventricles of the brain. The disease can occur at any age, but most often doctors diagnose it in a newborn or infant in the first months of life. Dropsy causes the ventricles, greatly enlarged, to put pressure on other parts of the brain, causing neurological damage.

Classification of pathology

Exist different kinds pathologies associated with the cause and form of the disorder:

1. Open external hydrocephalus. In this case, there is a destruction of brain tissues, which become unable to absorb cerebrospinal fluid, the production of which is not disturbed.
2. Hypersecretory hydrocephalus. Occurs due to excessive synthesis of cerebrospinal fluid. Its quantity becomes such that the brain tissues cannot absorb it, so the volume begins to fill the cranial cavity.
3. Hypotrophic hydrocephalus is associated with malnutrition of brain tissues.

1. Closed hydrocephalus is associated with blockage of the CSF space and impaired fluid movement, so its level begins to fluctuate. The main reason for this condition is the development of a tumor or the formation of blood clots, which become an obstacle to the movement of cerebrospinal fluid.

1. External replacement or non-occlusive hydrocephalus is considered the most dangerous, as it leads to a decrease in the amount of gray matter in the brain, which is replaced by cerebrospinal fluid. In this case abrupt change intracranial pressure does not occur. Therefore, the patient may not pay attention to the ongoing changes for a long time and seeks medical care already when the pathology acquires external manifestations.
2. Moderate external hydrocephalus of the brain. In this case, the cerebrospinal fluid begins to fill the subarachnoid space.

Causes of external hydrocephalus

Dropsy of the brain in an adult or child may appear on different reasons, which are always associated with mechanical damage or neurological disorder. Most often, external hydrocephalus occurs due to:

• Inflammatory processes that have affected the central nervous system, which can be provoked by some infections (encephalitis, tuberculosis, etc.).
• Violations in the cervical vertebrae.
• Violations of the functioning of blood vessels in the brain.

• Traumatic brain injuries. As a result of mechanical impact on the head, there is a violation of the structure of the brain tissues, so they cannot fully absorb the cerebrospinal fluid. Gradually, the cerebrospinal fluid fills the free spaces. If you do not seek medical help in time and do not start competent treatment, then soon, slightly pronounced external hydrocephalus of the brain will begin to progress, causing dangerous consequences.

• Neoplasms, including malignant.
• Disturbances in the development of the central nervous system.
• Surgical intervention on the brain.

Symptoms

External hydrocephalus manifests itself sharp rise pressure and headache. This is due to a decrease in the volume of the brain and the filling of free space with cerebrospinal fluid. As a result of its accumulation, the liquid causes. The patient constantly feels severe fatigue and drowsiness, nausea and vomiting occur.

The danger of pathology lies in the fact that long time(sometimes even for several years) she does not give herself away in any way. And because of hypertension and atherosclerosis, other symptoms characteristic of external hydrocephalus develop. Over time, cerebral circulation is disturbed, which ultimately leads to sharp deterioration the patient's condition. Only then can one pay attention to danger signs illness.

Moderate external hydrocephalus except common features manifests itself:

1. Constant migraines.
2. Urinary incontinence.
3. Patients may experience double vision.

The neurosurgeon Fayyad Akhmedovich Farhat tells about the symptoms and treatment of the disease:

1. Change in gait.
2. Violation of coordination of movement.
3. Constant fatigue provokes a violation mental state patient who develops depression and increased irritability. A person stops responding to others, can confuse the name of things.

If at least a few symptoms of a pathology are detected, it is important to immediately consult a doctor, since many of them can be characteristic of other equally dangerous diseases. If he confirms the diagnosis of mild external hydrocephalus, then the patient will be prescribed a medical course of treatment. Sometimes, surgery is needed to correct external hydrocephalus.

In an infant, the symptoms of internal or external forms of hydrocephalus are more pronounced. They begin to actively increase the volume of the cranium, which is associated with high pressure liquor. Since the bones of the skull in babies are still very fragile and not fully fused, the size of the head increases, from the outside it can be seen even with the naked eye.

In the case of replacement hydrocephalus, the symptoms will be slightly different, since this type of brain pathology is considered the most complex and actively progressing. In this case, the patient is concerned about:

• Severe memory loss. The victim speaks very slowly and inappropriately, does not remember his name and does not react to others.
• There is a violation of coordination of movement. The gait becomes unsteady.

More details about the violation of coordination of movements and its treatment are described by the neurologist Mikhail Moiseevich Shperling:

• A person is not able to control the process of urination.
• Dementia develops.

Diagnostics

Physicians have great amount diagnostic methods that help to identify the accumulation of cerebrospinal fluid in the brain. However, the most informative of them are computed (CT) and magnetic resonance imaging (MRI).

Thanks to these diagnostic methods, the doctor can not only establish the fact of hydrocephalus, but also identify the causes of its occurrence, stage and degree of development. MRI allows you to explore the cranial cavity, the brain, to detect possible neoplasms and liquorodynamic changes.

MRI image of hydrocephalus

To detect hydrocephalus, it is not necessary to inject a contrast agent into the body. However, doctors often recommend doing this in order to determine the state of the vessels located in the brain.

One of the new methods for examining the state of the brain is cisternography, which allows you to evaluate the process of CSF circulation. In addition, for the diagnosis of external hydrocephalus, the following can be used:

1. (conducted for children of the first year of life).
2. Angiography - assessment of the condition of blood vessels, blood clots and aneurysms. The examination reveals the presence of cysts and tumors in the brain.
3. Examination of the body for the presence of viruses and other infections in it.

Ultrasound examination of the brain

For staging accurate diagnosis(external hydrocephalus) the doctor should find out specific complaints from the patient. Therefore, it is important to clearly describe all violations that have occurred recently.

Treatment

Therapy should be based on a set of measures aimed at improving cerebral circulation and functionality of the central nervous system. With moderate external hydrocephalus, drug treatment is effective. For this, the patient is assigned:

• Drugs with a diuretic property ("Diakarb"), which help to remove from the body excess liquid.
• Saluretics.
• Solutions of plasma substitutes.

The average price in pharmacies for 30 tablets of the diuretic drug "Diacarb" is 250 rubles

• Drugs that strengthen the vascular walls.
• Barbiturates.
• Glucocorticosteroids.
• Painkillers.

The patient is prescribed physiotherapy and a course of exercise therapy. During treatment, it is important for the patient to adhere to a special diet with low quantity fatty foods and reduce the amount of fluid consumed so as not to provoke the development of puffiness. In addition to taking medication, he can use folk remedies which have a diuretic effect. But, it is worth remembering that they independent use will not cure external hydrocephalus.

If such treatment does not bring the desired result, the doctor will decide on an operation. Also, surgery becomes the only treatment option for hydrocephalus caused by cerebral hemorrhage, or if a replacement pathology is diagnosed.

Today, minimally invasive techniques are used for the surgical treatment of any form of hydrocephalus. During the operation, the surgeon performs a shunt, which allows the CSF to drain into other cavities. For this, a microscopic incision is made and a neuroendoscope is used. According to patient reviews, such an operation is well tolerated and contributes to a significant improvement in the general condition of a person.

The prognosis for the patient will depend on the timeliness of the visit to the doctor and the start of competent treatment. It is important to identify and eliminate the underlying cause of external hydrocephalus. If external hydrocephalus in adults is accompanied by atrophy, then the patient may develop serious neurological disorders. The danger is also represented by substitutive hydrocephalus, which requires timely, qualified medical care.

Neurosurgeon Alexander Vyacheslavovich Pechiborsch talks about surgery diseases:

Prevention

External hydrocephalus is considered a dangerous disease that can cause serious problems with health. To avoid its development, you must adhere to some rules:

1. Avoid head injury.
2. Timely treatment of hypertension and vascular pathologies.
3. prevent development infectious processes in the body.
4. Monitor weight and, if necessary, take measures to reduce it.

Rheumatologist Pavel Valeryevich Evdokimenko talks about ways to treat hypertension:

1. To refuse from bad habits.
2. Eat properly.
3. Do sport.

When the first signs of the disease appear, it is important to immediately consult a doctor to start timely treatment which will help to avoid serious consequences.

External hydrocephalus of the brain in adults is pathological disease, in which there is an excessive formation of cerebrospinal fluid (CSF). At healthy person fluid circulates, washing the brain tissue. It also performs protective and nutritional functions. As soon as the normal outflow of fluid is disturbed, it begins to form excess amount. So there is hydrocephalus, or dropsy of the brain. result pathological changes become atrophy and expansion of brain tissue. Treatment of pathology is carried out by neuropathologists and neurosurgeons.

The disease can be both congenital (infection of the fetus during prenatal development), and acquired (injuries, tumors, infectious diseases).

Hydrocephalus is classified into several types:

1. External, or non-occlusive, - fluid accumulates in the subarachnoid space, but in the cerebral ventricles its level remains normal;
2. Internal - the level of cerebrospinal fluid rises in the ventricles of the brain;
3. Mixed - an increase in the amount of liquor occurs everywhere;
4. Hypertensive;
5. Normotensive.

According to the mechanism of formation, pathology is divided into 3 forms: open, closed and ex vacuo. If there is a violation of the processes of formation of cerebrospinal fluid and its further absorption, then external hydrocephalus is formed. At the same time, normal circulation between the liquor-bearing spaces is maintained. When the pathways between these spaces are blocked and fluid no longer has an outlet, closed hydrocephalus occurs. The ex vacuo form occurs when brain tissue atrophies and shrinks significantly. It also develops as a result age-related changes or various violations CNS.

Depending on how intensely the disease proceeds in adults, moderate and severe forms are distinguished. moderate hydrocephalus characterized by mild symptoms, since the accumulation of fluid in the brain tissues is insignificant. The pronounced form is always accompanied by acute neurological seizures. With this type of disease, a large amount of cerebrospinal fluid accumulates in the brain tissues.

The most common moderate external hydrocephalus occurs in open form. The cerebrospinal fluid ceases to circulate normally, despite the fact that there are no neoplasms (cysts, tumors, etc.) that can prevent its outflow.

Depending on the cause of the pathology, hydrocephalus is congenital, acquired or atrophic. Doctors also choose methods of treatment depending on the type and form of hydrocephalus in adults.

Causes of the disease

Doctors allocate the following reasons development of moderate external hydrocephalus:

1. Concussion, traumatic brain injury;
2. Fractures and injuries of the bones of the spine;
3. Surgical operations on brain tissues;
4. Tumors in the head of various etiologies;
5. Strokes, extensive cerebral hemorrhages, hematomas;
6. Various diseases caused by infection or inflammatory processes(tuberculosis, meningitis, encephalitis, etc.);
7. Pathological disorders of the vertebrae in the cervical region;
8. Diseases of the blood vessels in the tissues of the brain;
9. Oncological diseases bone tissue in the spine;
10. Age-related changes in brain tissues;
11. Serious deviations in the development of the central nervous system.

One of the reasons for the development of external hydrocephalus can be prolonged intoxication organism. Yes, alcohol abuse nerve cells the brain begins to die rapidly. The result of such violations is a strong deterioration in the absorption, production and circulation of cerebrospinal fluid. The accumulated fluid begins to stretch the ventricles of the brain. This leads to impregnation of the medulla cerebrospinal fluid, which significantly reduces its density and narrows the subarachnoid spaces. As a result, a person develops external hydrocephalus of the brain of an atrophic nature.

Most often, moderately severe external hydrocephalus affects the elderly. This disease should not be left without adequate medical therapy under the supervision of a physician. Practice shows what it is dangerous disease and if left untreated, it can be fatal.

Main symptoms

Pathology manifests itself as severe headache attacks and a sharp increase blood pressure. This is due to a decrease in the total volume of the brain. The remaining free space is filled with cerebrospinal fluid. Having no way out and continuing to accumulate, it creates an increased intracranial pressure. The person begins to experience nausea, the urge to vomit, a chronic feeling of fatigue and constant desire sleep.

The disease is especially dangerous because for a long period of time (several months or even years) it may not have any manifestations. Already against the background of atherosclerosis or high blood pressure, other signs of external hydrocephalus begin to appear. But there comes a time when the patient's condition deteriorates sharply, because the blood circulation process is disturbed in the brain. Then the first dangerous symptoms begin to appear.

As for the moderate form of the disease, it is most often external symptoms manifest as urinary incontinence, nausea and vomiting, severe attacks migraine. Patients often experience a split in the eyes, they can roll them up involuntarily. Coordination of movements and gait are disturbed. Prolonged fatigue leads to the fact that such a state is strongly reflected in the psyche of the victim. He begins to experience constant irritation, depression.

Upon detection of one or more similar symptoms need to see a neurologist for clinical examination and making a diagnosis. If the diagnosis of minor external hydrocephalus is confirmed by several methods of research, then the patient will be required to undergo full course medical treatment. In some cases, surgery is required to eliminate this pathology. In no case should you engage in self-diagnosis, since many symptoms and signs of external hydrocephalus can be characteristic of other dangerous diseases.

Diagnostic methods

External hydrocephalus of the brain in an adult is diagnosed using following methods clinical study:

1. A complete neuropsychological examination, during which the patient is interviewed about his condition. Information is collected about the presence of all kinds of abnormalities and violations of the functionality of the brain. Based on the data obtained, the doctor makes an anamnesis, decides on the diagnosis or additional methods research;
2. CT (computed tomography). This method is one of the most accurate and reliable diagnostic methods. With the help of CT, the contours of the brain and cranium, the location of the ventricles, their shape and size are determined; detect abnormal neoplasms (tumors, cysts, hematomas, blood clots, etc.);
3. MRI (magnetic resonance imaging). MRI picture allows you to accurately determine the form and severity of any type of hydrocephalus. Thanks to MRI, a correct diagnosis of dropsy of the brain is possible;
4. Angiography (examination of blood vessels in the brain using x-ray exposure). The study is carried out using a contrast agent, which allows you to identify the slightest violations of the vessels of the circulatory system in the human brain;
5. Cisternography. X-rays cisterns at the base of the skull help to get ahead of the type of hydrocephalus. Also, using this method, the doctor can determine the direction of movement of the cerebrospinal fluid in the brain tissues.

Medical therapy

First of all, the treatment of pathology is aimed at restoring the functionality of the blood vessels of the brain and the central nervous system. Moderate external cerebral hydrocephalus responds well to medical therapy. The attending physician prescribes a course of diuretic medications, which help to remove excess fluid from the body. Solutions of plasma substitutes, saluretics, drugs that help strengthen venous tone, glucocorticosteroids, barbiturates are used. For elimination pain syndrome prescribed pain medication. During treatment, patients are prescribed to follow a special diet with low content fat. Complex therapy provides for the regular implementation of therapeutic gymnastic exercises.

If drug treatment does not give positive results for certain period time, a decision is made on the need for urgent surgical intervention.

Today, hydrocephalus of any form is treated with minimally invasive surgical technician. Many clinics have everything at their disposal necessary equipment for neuroendoscopic operations. During this intervention, the neurosurgeon performs various types of shunting in the brain tissues, which allows the drainage of cerebrospinal fluid into other cavities. All manipulations are performed through small incisions using miniature surgical instruments and neuroendoscope. Such manipulations last only a few hours and are carried out in a hospital under general anesthesia. The procedure is quite safe for the patient's life.

Treatment of hydrocephalus is always an individual process that has its own prognosis depending on the characteristics of the patient's body. However, in most cases timely diagnosis and give treatment positive results, what in short time allows the patient to return to normal life.