Dilatation of the lateral ventricles of the brain in newborns. Enlargement of the ventricles of the brain in newborns

Ventricles of the brain

The ventricles of the brain is a system of anastomizing cavities that communicate with the subarachnoid space and the spinal canal. They contain cerebrospinal fluid. The ependyma covers the inner surface of the walls of the ventricles.

Types of cerebral ventricles

The lateral ventricles are cavities in the brain that contain CSF. Such ventricles are the largest in the ventricular system. The left ventricle is called the first, and the right - the second. It is worth noting that the lateral ventricles communicate with the third ventricle using the interventricular or Monroe foramina. Their location is below the corpus callosum, on both sides of the midline, symmetrically. Each lateral ventricle has an anterior horn, posterior horn, body, and inferior horn.
The third ventricle is located between the visual tubercles. It has an annular shape, since intermediate visual tubercles grow into it. The walls of the ventricle are filled with central gray medulla. It contains subcortical vegetative centers. The third ventricle communicates with the aqueduct of the midbrain. Behind the nasal commissure, it communicates through the interventricular foramen with the lateral ventricles of the brain.
The fourth ventricle is located between the medulla oblongata and the cerebellum. The arch of this ventricle is the cerebral sails and the worm, and the bottom is the bridge and the medulla oblongata.

This disease is manifested by certain symptoms - signs of deterioration in well-being, which should definitely be paid attention to. They directly depend on the age group to which the patient belongs, as well as on the degree of progression of the disease. For example, cerebral hydrocephalus in newborns is accompanied by a number of features. First of all, those children who have been diagnosed with this disease have an overly large head circumference, which continues to increase in the future. At the same time, a convex fontanel is noticeable on the parietal part of the child's head. Other manifestations of this disease in young children include vomiting, poor sleep, irritability, eye rolling, and convulsions. Most often, the development of such children occurs with a delay, complicated by poor perception of information, slow thinking process, learning difficulties, etc.

Hydrocephalus of the brain in children can appear even during the mother's pregnancy. This kind of this disease is called congenital. Intrauterine infections, fetal malformations, hemorrhages in the ventricles of the brain in an unborn child lead to its occurrence. Another type of this disease is acquired hydrocephalus. It develops after the baby is born. Its causes can be traumatic brain injuries received during childbirth, as well as various infectious diseases.

All of the above types of hydrocephalus are in an active progressive form, in which intracranial pressure increases, brain tissue atrophies and the ventricles of the brain expand. But the expansion of the ventricles of the brain can be passive, this form is called moderate external hydrocephalus. Doctors believe that moderate external hydrocephalus is a rather dangerous disease, since in most cases there are no symptoms characteristic of hydrocephalus. It is worth noting that moderate external hydrocephalus leads to a violation of the blood circulation of the brain and the patient begins to suffer from disorders of the nervous system, lethargy, migraine.

Symptoms of the manifestation of hydrocephalus of the brain

The most basic signs of hydrocephalus are advanced head growth and a greatly enlarged skull.

Symptoms of hydrocephalus in newborns

frequent tilting of the head;
tense fontanel;
eyeballs, shifted to the bottom;
strabismus;
pulsating round protrusions, in places where the bones of the skull have not fused normally.

Closed and open hydrocephalus

The immediate cause of excessive fluid accumulation will always be some kind of disruption in its production and circulation. Sometimes there is a violation of the circulation of the fluid, caused, for example, by a tumor. This is occlusive hydrocephalus, in its treatment, circulation is restored by removing the obstruction. Closed, or occlusive, hydrocephalus is divided into:

monoventricular - in this case, communication with one of the ventricles of the brain is disrupted,
biventicular hydrocephalus occurs if both interventricular openings of the anterior and middle sections of the 3rd ventricle are clogged. The lateral ventricles are always enlarged.
triventricular hydrocephalus is accompanied by blockade of the aqueduct of the brain or 4 ventricles, while all the ventricles, aqueduct and interventricular openings are dilated,
tetraventricular hydrocephalus is also manifested by the expansion of all components of the ventricular system, it is characterized by blockage of the median and lateral aperture of the 4th ventricle.

Gomel (

A big request, please tell us, in our NSG conclusion it is written: microcalcifications in both caudal-thalamic sulci; single microcalcifications in both thalamus. Signs of external hydrocephalus. Border dimensions of the anterior horns, lateral ventricles and 3rd ventricle. What does it mean? This is dangerous? Is it curable? Thank you.

Dear Elena, microcalcifications in the basal ganglia may be a sign of Farah's disease or, more likely, the child does not have any calcifications. Sometimes doctors perceive hyperechoic ischemic formations in this area and misinterpret. Calcifications are confirmed by CT of the brain. The remaining changes in the NSG correspond to the transferred fetal hypoxia. Perform an NSG with another doctor or have an NSG follow-up after 3 months.

Kaliningrad region, Ozyorsk (

Dear Oleg Igorevich! My son is 4 years 11 months old. From the age of 3.5, the boy has recurrent neuropathy of the facial nerve on the right. On May 16, 2011, an MRI was performed with a resolution of 1.0 Tesla. The results are:

A series of MR tomograms weighted by T1 and T2 in three projections visualized sub- and supratentorial structures. An arachnoid cyst of the pellucid septum is visualized with dimensions of 4.8x1.3x2.3 cm. The lateral ventricles of the brain are not dilated, the 3rd and 5th ventricles are not changed, the basal cisterns are not dilated. The chiasmatic area is without features, the pituitary tissue has a normal signal. Subarachnoid convexital spaces and sulci are locally enlarged, predominantly in the area of the frontal and parietal lobes. Median structures are not displaced. Cerebellar tonsils are usually located. Changes of focal and diffuse nature in the substance of the brain were not revealed. On a series of MR angiograms performed in the TOR mode, the internal carotid, basilar, and intracranial segments of the vertebral arteries and their branchings are visualized in the axial projection. The circle of Willis is closed. There is a narrowing of the lumen and a decrease in blood flow in the intracranial section of the right VA (hypoplasia?). The lumens of other vessels were uniform, the blood flow was symmetrical, no areas with pathological blood flow were found.

Conclusion: MR picture of arachnoid changes of cerebrospinal fluid character. The circle of Willis is closed. Reduced blood flow in the intracranial segment of the right VA (hypoplasia?).

Dear doctor, tell me, what is the dangerous situation, is surgical intervention necessary? What are the treatments? Sincerely, Julia.

Dear Julia, recurrent neuropathy of the facial nerve is not associated with those small changes on the MRI. You need to see a pediatric neurologist and start therapy in a timely manner. Perhaps the child has a hereditary nature of this pathology.

Vladivostok (

Oleg Igorevich! We are very lucky to have such a wonderful specialist like you in our city! Thank you for your advice and even moral support. But let me, please, turn to you once again with my meticulous questions! I can not calm down about the future health of my child. I already wrote to you that the size of the large cistern of the fetal brain at 31 weeks was 9 mm. You said that there is still some increase. I've looked all over the internet for reference values, but I haven't found anything. I am still concerned about how this may affect the psychological and physiological health of the child after birth. At the ultrasound, I asked - they said that the cerebellar vermis is normal, the lateral ventricles, too, the cerebellum is also normal. BUT they did not say anything about the fact that the dimensions of the large tank are somewhat larger than the norm (according to you). And is it normal that in almost 2 months the dimensions of this tank have not changed in any way? Is all this a pathology or a norm? Of course, I understand that a more accurate answer and result can only be obtained after the birth of a child. But still, presumably, what should we hope for? Maybe you need another ultrasound?

Particularly interested in what are the normal values at this time? Of course, one should hope for the best. But I think that you need to be ready for anything. What can be with such sizes with a child? Thank you very much for your understanding!

Dear Ekaterina, do not panic and forget about these changes. Normal sizes are an approximate calculation that most people have. But everything in the human body is individual, and perhaps this is also the norm for your child. I repeat once again, at such sizes, there may not be any neurological symptoms.

Velsk (

Hello Oleg Igorevich! The child is 2 months old. After birth, a cyst was found in her: on the right - 82 * 59 mm, and now: on the right, subependymal cysts up to 5 mm, in the parenchyma in the parietotemporal region, a cyst: 75 * 56 * 84 mm of a homogeneous internal structure. Frontal horn 3.8 mm; body 9.5 mm, occipital horn 12 mm, (left lateral ventricle), and right lateral ventricle: frontal horn 3.7 mm, body 9.3 mm, third ventricle 7 mm. Echogenicity on the left is heterogeneous, the choroid plexus on the right is not clearly distinguished. The interhemispheric fissure was expanded in the frontal regions up to 5.5 mm. There is a shift in the middle structures. Legs of the brain of the correct form. This is serious? Is it worth worrying? We are very worried!! Thank you in advance!!

Dear Lisa, you need to perform an MRI to clarify the cyst. You can then send MRI images to me by email. We will discuss further tactics in more detail.

Hello, dear Oleg Igorevich! Please advise us! The child is 2 months old. NSG results (at 1.5 months): the brain was examined in standard sections. Side. In p / sag. square right: 2-2-12 mm, left: 3-2-9 mm. Oblique incision of the anterior horns: right 2 mm, left: 3 mm. Vascular plexus: heterogeneous right - closer to the body anechoic formation 4.3 mm. 3rd ventricle - 3.6 mm. Monroe d=s=2 mm. Interhemispheric fissure - 3 mm. Posterior cranial fossa: bcc - 6.3 mm. Additionally: the thalamocaudal notch is clearly visualized; in CLC, the blood flow is not depleted. Conclusion: moderate dilatation of the interhemispheric fissure and BCC, cyst of the right choroid plexus, asymmetry of the lateral ventricles without dilatation. Now we drink Asparkam, Cavinton, Diakarb. Tell me, please, what is it? What threatens, the consequences? How to treat?

Dear Irina, I see no reason to take Diakarb and Asparkam. As for Cavinton, it is probably necessary if there are neurological symptoms. See a neurologist. NSG control after 2-3 months is shown.

Vladivostok (

Dear Oleg Igorevich. At terms of 23-24 weeks, the second ultrasound revealed cysts of the posterior cranial fossa and an expansion of the large cistern up to 11 mm. But at the subsequent ultrasound at 25 weeks, they didn’t tell me anything about the cysts and the size of the large cistern was 9 mm. The results of cordocentesis are the norm of 46 chromosomes. I was with you for a consultation. You said that you need to watch in dynamics. Now my term is 31 weeks - I went through the 3rd scheduled ultrasound - the results say that there are no deviations, but the size of the large cistern, 9 mm, remained the same, the cerebellum is the norm. Tell me, please, at the moment is everything in order with the fetal brain and is it possible to accurately exclude such a disease as Dandy-Walker? Do the dimensions (9 mm) of the large cisternae correspond to this gestational age, can the cysts of the posterior cranial fossa resolve on their own? Thanks in advance for your reply!!!

Dear Ekaterina, calmly go into childbirth. After birth, it will be necessary to perform an NSG and appear. I think that your child has nothing to worry about, since a slight increase in the large cistern of the brain can pass without neurological symptoms.

Zaporozhye (

Good afternoon, Oleg Igorevich! I am now at 24 weeks of pregnancy, on ultrasound we found a cyst of "Blake's pocket" 14×12 mm. The doctor says there is nothing to worry about. And I want to know how this threatens our baby and what needs to be done in this situation. Thank you.

Dear Svetlana, according to ultrasound data, it is very difficult to determine the type of cyst: Blake, Dandy-Walker, retrocerebellar cyst, enlarged large cistern of the brain, etc. Such dimensions are not threatening for a neurological deficit. However, for a more detailed examination, you can perform an MRI of the fetus and dot all the points.

Velsk (

Good evening, Oleg Igorevich! We are 2 months old. We have a diagnosis: posthemorrhagic cyst of the right parietotemporal region. Is it dangerous, will it pass with time, can it be treated without surgery, and is it possible to refuse an MRI of the brain? Thanks in advance!!!

Dear Nadezhda, at 2 months you can do without MRI by performing NSG. If it is definitely posthemorrhagic, then it does not require surgical treatment, and its regression depends on the size of the lesion. There is a risk of developing cerebral palsy, in the form of a hemiparetic form.

St. Petersburg (

We are 9 months old. The head is larger than the chest. Head 46 cm, chest 44 cm. Sent for ultrasound of the brain: V3–3 mm, MS - 52 mm, MD - 52 mm, VLD - 16.5 mm, VLS - 15.2 mm, temporal horns of the lateral ventricles: s - 26/2 mm, D - 26/2 mm, interhemispheric fissure - 1 mm, subrachnoid spaces - 1.5/1.5 mm. The patient was diagnosed with dilatation of the right lateral ventricle. Isn't it dangerous? And what should we do? Thank you.

Dear Natalia, judging by the description, your child has dilatation of both ventricles. Whether it is associated with hydrocephalus or not (that is, whether there are signs of increased intracranial pressure), a neurologist or neurosurgeon can establish.

Arkhangelsk (

Good afternoon! CIS results:

echogenicity of the brain parenchyma: slightly increased in the parieto-occipital region;
left lateral ventricle: frontal horn - 5.5 mm, body - 5.5 mm, occipital horn - 13.3 mm;
right lateral ventricle: frontal horn - 5.0 mm, body - 4.6 mm, occipital horn - 12.6 mm;
third ventricle: 3.5 mm;
ventricular ependyma: not thickened;
choroid plexuses of the ventricles: contours are even, echogenicity is homogeneous, cysts are not detected;
interhemispheric fissure: not expanded;
the cavity of the transparent septum is not expanded;
displacement of median structures - no;
legs of the brain - the correct form, symmetrical;

The patient was diagnosed with an increase in echogenicity in the air defense system, ventriculomegaly, left LVF. My son is now 2 months old, was born at 36 weeks, had an entanglement of the umbilical cord and was without water for 6 hours. Decipher, please, the diagnosis. THANK YOU IN ADVANCE!

Dear Anna, this is not a diagnosis, but simply the conclusion of the NSG. A neurologist will establish a diagnosis for you after an objective examination, taking into account this conclusion and anamnesis. It is likely that your child has a perinatal CNS lesion of hypoxic origin. Syndromic details will be specified after examination.

Abovyan (

Dear Oleg Igorevich, I am 25 and I have a pineal cyst. On a series of MR-tomography of the brain in three projections, the interhemispheric fissure runs along the midline. The membranes of the brain are not thickened. Ventricles - the shape, size and location of the lateral ventricles are normal, the cavity of the fourth ventricle is free, the Sylvius aqueduct is passable. The furrows of both hemispheres are not changed, the architectonics is not broken. The subarachnoid spaces of the convexital surfaces of the brain are not dilated. An enlarged gland is visualized, in size:

on sagittal slices up to 14 mm
on coronal up to 12 mm
on axial up to 14 mm

The parenchyma of the gland is represented by a cystically transformed structure, the contents of which in all scanning modes have an MR signal intensity corresponding to a dense fluid. When examined at DWI, no evidence of diffusion disturbance. On a series of post-contrast MR-tomograms, the accumulation of contrast by the contour of this structure is observed. The anterior contour of the structure is intimately adjacent to the posterior surface of the posterior commissure (commisura posterior), the upper contour reaches the corpus callosum ridge.

There were no signs of liquorodynamic disturbances at the time of the study. The corpus callosum, basal ganglia, optic tubercle, stem structures of the brain and cerebellum are usually formed. The pituitary gland is located in the center of the Turkish saddle, without structural changes. Differentiation into adeno and neurohypophysis is not changed. The funnel is located centrally, not thickened. The structures of the cerebellopontine angles are unchanged. Cranio - vertebral transition without visible pathology.

Conclusion: MR picture of the main changes in the brain leaves the impression of a cyst of the pineal gland, without signs of impaired liquorodynamics. It is recommended to dynamically monitor the size of the cyst.

This MRI was done on 02/07/2011. I have two questions:

Will this cyst be able to dissolve with the help of drugs or other means? Please tell me if you know any way...
And can massages help dissolve the cyst?

Thanks for your reply.

Good afternoon, it is enough to observe this cyst in dynamics. It is not necessary to “dissolve” it, especially since it is impossible to do this with any drugs and massage. Observation at the endocrinologist and MRT - 1 time a year is shown to you.

Karaganda (

Oleg Igorevich, please tell us how terrible our diagnosis is, whether shunting is necessary. At 7.5 months, an ultrasound scan was performed: the parenchyma was of medium echogenicity, the interhemispheric fissure was not deformed, expanded to 5.0 mm, the lateral ventricles were symmetrical, the anterior horns D=S - 9.7 mm, the body D=S-12 mm, the occipital horns D =S - 16 mm, choroid plexus contours are clear, even D=S - 11 mm, 3 ventricle 7.1 mm, 4 ventricle 4.9 mm, subarachnoid space D=S - 4.7 mm. Conclusion: moderate ventriculomegaly, moderate expansion of the interhemispheric fissure and subarachnoid space in the frontal region. Hypoxic-ischemic lesion of the central nervous system, hydrocephalic syndrome. We drank diakarb, asparkam for 1 month. An ultrasound was done at 8.5 months - an increase in the ventricles anterior horns D=S - 10 mm, body D=S - 13 mm, occipital horns D=S - 17.3 mm and blood flow through the vein of Galen 17 cmsec. The diagnosis is the same, it is recommended: we do not need medical treatment, the course of dehydration is at the end of May, diacarb and asparkam are 2 weeks. Prior to that, we were observed by another doctor for 4 months and also drank a diuretic. The child develops with age. The fontanel is 6.0 by 6.0 cm, the head at 7.5 months was 47 cm, at 8.5 months - 48 cm. We have no more complaints, the child is like a child. The doctor says that if it were not for the ultrasound results, he would never have thought that the child had hydrocephalus. Oleg Igorevich, thanks in advance.

Dear Irina, your child does not have hydrocephalus. These changes in NSG are due to perinatal hypoxia of the brain. Diacarb with asparkam are not shown. See a neurologist and get a massage.

Kazakhstan, Pavlodar (

Dear Oleg Igorevich! Daughters 2 and 10 had another examination - a computer EEG. Conclusion: against the background of moderately pronounced general cerebral changes in the activity of the brain, signs of irritation of the mesodiencephalic structures are recorded. Decipher, please, the diagnosis. Should we be worried? Is treatment necessary? Since the year my daughter has been diagnosed with mild compensated hydrocephalus. Is the diagnosis correct? Thank you.

Dear Julia, the conclusion of the EEG is not a diagnosis, and it does not say anything specific. Perform a brain MRI to remove or confirm the diagnosis of Hydrocephalus. In my opinion, there is nothing to worry about.

Odintsovo (

Hello Oleg Igorevich! My daughter is 7 months old. 2 months ago, a bump grew out of the seam between the frontal and temporal bones on the head. On ultrasound: the connective tissue of the suture has grown, there are no additional vessels. The doctors don't know what it is, I'm a paramedic myself. Maybe this manifestation of rickets is atypical? I hope you can help us decide on our next strategy.

Dear Elena, usually a dermoid cyst is localized in this place. You can operate on it after a year or earlier if it increases rapidly.

Diagnosis of hydrocephalus is based on the clinical picture, examination of the fundus, as well as additional research methods, such as neurosonography (NSG), ultrasound of the brain (in infants up to 2 years), computed tomography (CT) or magnetic resonance imaging (MRI) of the head brain. The primary diagnosis can be made by a neonatologist, pediatrician, neuropathologist or neurosurgeon.

The most common operation is the ventriculo-peritoneal shunt (VPSH).

Neurosonography is an effective method for diagnosing the state of the substance of the brain and ventricular system in children under 1.5-2 years old, until the large fontanel and other "ultrasonic windows" have closed - areas of the skull where the bones are very thin (for example, the temporal bone) and pass ultrasound. It allows you to detect the expansion of the ventricular system, intracranial volumetric formations (tumors, hematomas, cysts), some malformations of the brain. However, it should be remembered that the NSG method is not entirely accurate. The image of the brain is obtained with a much lower resolution (less clear) than with CT and MRI.

If any pathology of the brain is detected, CT or MRI is necessary. Without them, it is impossible to make an accurate diagnosis, identify the cause of hydrocephalus, and even more so carry out treatment. This equipment is expensive and is still not installed in all hospitals. In this case, parents should insist on CT or MRI at other centers or perform them themselves on a commercial basis. It should be borne in mind that a clinic that undertakes the treatment of children with hydrocephalus must have this equipment. Otherwise, parents can be advised to choose another, more equipped hospital, even in another city.

At 1.5 months, development corresponds to age. We did an ultrasound (it would be better if I didn’t do it, this nightmare began again) and received the following conclusion:

"lateral ventricles are dilated, asymmetrical edges are rounded

Left anterior horn 15.2 mm body 5.3 mm (Left ventriculomegaly)

Right anterior horn 11mm body 3.6mm

The echogenicity of the brain parenchyma is moderately increased

displacement of middle structures was not revealed

periventricular area of increased echogenicity

No focal changes

Vascular plexuses are homogeneous

Width of the 3rd ventricle 2.6 mm

Interhemispheric fissure up to 3.2 mm wide in the frontal and parietal parts

The subarachnoid space along the contour of the frontal, parietal lobes is slightly expanded to 2.3 mm.

I am in a panic and do not understand anything. We were prescribed to drink encephobol, but we couldn’t really drink it, the child doesn’t take a bottle, and we choke on a spoon.

Other questions from the section "ENT": cryosurgery of the tonsils

The most common disease of the cerebral ventricles is hydrocephalus. It is a disease in which the volume of the cerebral ventricles increases, sometimes to an impressive size. Symptoms of this disease are manifested due to excessive production of cerebrospinal fluid and the accumulation of this substance in the area of \u200b\u200bthe brain cavities. Most often, this disease is diagnosed in newborns, but sometimes it occurs in people of other age categories.

To diagnose various pathologies of the brain ventricles, magnetic resonance or computed tomography is used. With the help of these research methods, it is possible to identify the disease in a timely manner and prescribe adequate therapy.

Ventricles of the brain have a complex structure, in their work they are associated with various organs and systems. It is worth noting that their expansion may indicate developing hydrocephalus - in this case, consultation of a competent specialist is required.

The human brain is a complex and amazing structure, all the secrets of which scientists have not yet unraveled. One of the most interesting mechanisms of the functioning of the nervous system is the process of formation and circulation of CSF (cerebrospinal fluid), which is carried out with the help of the 3rd ventricle of the brain.

3 ventricle of the brain: anatomy and physiology

The third ventricle of the brain is a thin slit-like cavity bounded by the visual tubercles of the thalamus and located in the diencephalon. Inside the third ventricle of the brain is lined with a pia mater, branched choroid plexus and filled with cerebrospinal fluid.

The physiological significance of the 3rd ventricle is very large. It provides an unhindered flow of CSF from the lateral ventricles to the subarachnoid space for washing the brain and spinal cord. Simply put, it provides circulation of cerebrospinal fluid, which is necessary for:

regulation of intracranial pressure;
mechanical protection of the brain from damage and injury;
transportation of substances from the brain to the spinal cord and vice versa;
protect the brain from infection.

3 ventricle of the brain: the norm in children and adults

A normally functioning liquor system is an uninterrupted and well-coordinated process. But even a small “breakdown” in the processes of formation and circulation of cerebrospinal fluid should happen - this will definitely affect the condition of a child or an adult.

Particularly important in this regard is the 3rd ventricle of the brain, the norm of which is indicated below:

Newborns -3-5 mm.
Children 1-3 months -3-5 mm.
Children 3 months - 6 years -3-6 mm.
Adults -4-6 mm.

Common diseases of the third ventricle of the brain

Most often, the problem of violation of the outflow of cerebrospinal fluid occurs in children - newborns and babies up to a year. One of the most common diseases at this age is ICH () and its complication is hydrocephalus.

During pregnancy, the expectant mother undergoes obligatory ultrasound of the fetus, which makes it possible to detect congenital malformations of the central nervous system of the child in the early stages. If during the examination the doctor notes that the 3rd ventricle of the brain is enlarged, additional diagnostic tests and careful medical supervision will be required.

If the cavity of the 3rd ventricle in the fetus expands more and more, in the future such a baby may need a bypass operation to restore the normal outflow of cerebrospinal fluid.

Also, all born babies at the age of two months (according to indications - earlier) undergo a mandatory medical examination by a neurologist, who may suspect an expansion of the 3rd ventricle and the presence of ICH. Such children are sent for a special examination of brain structures - (neurosonography).

What is NSG?

Neurosonography is a special type of ultrasound examination of the brain. It can be carried out in infants, because they have a small physiological opening in the skull - a fontanelle.

Using a special sensor, the doctor receives an image of all the internal structures of the brain, determines their size and location. If the 3rd ventricle is enlarged by NSG, more detailed tests are performed - computed tomography (CT) or magnetic resonance imaging (MRI) to obtain a more accurate picture of the disease and confirm the diagnosis.

Which doctors should be contacted when making a diagnosis of ICH?

If the 3rd ventricle of the baby's brain is slightly enlarged and the mother has no serious complaints, regular monitoring by the district pediatrician is sufficient. Consultation of a neuropathologist and a neurosurgeon is necessary if there is a significant expansion of the ventricles on ultrasound or symptoms of ICH:

the child began to suck worse at the breast;
the fontanel is tense, protrudes above the surface of the skull;
saphenous veins of the scalp are dilated;
Graefe's symptom - a section of white sclera between the iris and eyelid when looking down;
loud, sharp cry;
vomit;
divergence of the sutures of the skull;
rapid increase in head size.

Doctors determine the further tactics of treating a baby with: conservative means the appointment of vascular drugs, massage, physiotherapy; surgical - performing an operation. After therapy, children quickly recover, the activity of the nervous system is restored.

Colloidal cyst of the 3rd ventricle is a disease common among adults 20-40 years old. It is characterized by the appearance of a benign rounded formation in the cavity of the 3rd ventricle, not prone to rapid growth and metastasis.

By itself, a colloid cyst does not pose any danger to human health. Problems begin if it reaches a large size and prevents the outflow of cerebrospinal fluid. In this case, the patient has neurological symptoms associated with an increase in intracranial pressure:

severe headache;
vomit;
visual impairment;
convulsions.

A neuropathologist and a neurosurgeon are jointly engaged in the diagnosis and treatment of a colloid cyst of the third ventricle. With a pronounced size of the formation, determined by CT or, surgical treatment of the cyst is prescribed. After the operation, the normal flow of cerebrospinal fluid is quickly restored, and all symptoms of the disease disappear.

Summing up

Thus, the third ventricle is an important element of the CSF system, the diseases of which can lead to serious consequences. Attentive attitude to health and timely access to doctors will help to quickly and permanently cope with the disease.

The ventricles of the brain are considered an anatomically important structure. They are presented in the form of peculiar voids lined with ependyma and communicating with each other. In the process of development, the brain vesicles form from the neural tube, which subsequently transform into the ventricular system.

Tasks

The main function of the ventricles of the brain is the production and circulation of CSF. It protects the main parts of the nervous system from a variety of mechanical damage, maintaining a normal level. The cerebrospinal fluid takes part in the delivery of nutrients to neurons from the circulating blood.

Structure

All ventricles of the brain have special vascular plexuses. They produce liquor. The ventricles of the brain are interconnected by the subarachnoid space. Thanks to this, the movement of liquor is carried out. First, from the lateral ones, it penetrates into the 3rd ventricle of the brain, and then into the fourth. At the final stage of circulation, the outflow of CSF into the venous sinuses occurs through granulations in the arachnoid membrane. All parts of the ventricular system communicate with each other through channels and openings.

Kinds

The lateral parts of the system are located in the cerebral hemispheres. Each lateral ventricle of the brain communicates with the cavity of the third through a special foramen of Monroe. In the center is the third section. Its walls form the hypothalamus and thalamus. The third and fourth ventricles are connected to each other through a long canal. It is called the Sylvius Passage. It circulates cerebrospinal fluid between the spinal cord and the brain.

Lateral departments

Conventionally, they are called the first and second. Each lateral ventricle of the brain includes three horns and a central region. The latter is located in the parietal lobe. The anterior horn is located in the frontal, the lower - in the temporal, and the posterior - in the occipital zone. In their perimeter there is a vascular plexus, which is dispersed rather unevenly. So, for example, it is absent in the posterior and anterior horns. The choroid plexus begins directly in the central zone, descending gradually into the lower horn. It is in this region that the size of the plexus reaches its maximum value. For this, this area is called a tangle. The asymmetry of the lateral ventricles of the brain is caused by a violation in the stroma of the tangles. Also often this area undergoes degenerative changes. Such pathologies are quite easily detected on conventional radiographs and carry a special diagnostic value.

The third cavity of the system

This ventricle is located in the diencephalon. It connects the lateral divisions with the fourth. As in other ventricles, the choroid plexuses are present in the third. They are distributed along its roof. The ventricle is filled with cerebrospinal fluid. In this department, the hypothalamic groove is of particular importance. Anatomically, it is the border between the thalamus and hypothalamus. The third and fourth ventricles of the brain are connected by the aqueduct of Sylvius. This element is considered one of the important components of the midbrain.

fourth cavity

This department is located between the bridge, the cerebellum and the medulla oblongata. The shape of the cavity is similar to a pyramid. The floor of the ventricle is called the rhomboid fossa. This is due to the fact that anatomically it is a depression that looks like a rhombus. It is lined with gray matter with a large number of tubercles and depressions. The roof of the cavity is formed by the lower and upper medullary sails. She seems to be hanging over the hole. The choroid plexus is relatively autonomous. It includes two lateral and medial sections. The choroid plexus is attached to the lateral lower surfaces of the cavity, spreading to its lateral inversions. Through the medial foramen of Magendie and the symmetrical lateral foramina of Luschka, the ventricular system communicates with the subarachnoid and subarachnoid spaces.

Structure changes

The expansion of the ventricles of the brain negatively affects the activity of the nervous system. Their condition can be assessed using diagnostic methods. So, for example, in the process of computed tomography, it is revealed whether the ventricles of the brain are enlarged or not. MRI is also used for diagnostic purposes. Asymmetry of the lateral ventricles of the brain or other disorders can be triggered by various reasons. Among the most popular provoking factors, experts call the increased formation of cerebrospinal fluid. This phenomenon accompanies inflammation in the choroid plexus or papilloma. Asymmetry of the ventricles of the brain or a change in the size of the cavities may be the result of a violation of the outflow of CSF. This happens when the openings of Luschka and Magendie become impassable due to the appearance of inflammation in the membranes - meningitis. The cause of obstruction may also be metabolic reactions against the background of vein thrombosis or subarachnoid hemorrhage. Often, asymmetry of the ventricles of the brain is detected in the presence of volumetric neoplasms in the cranial cavity. It can be an abscess, hematoma, cyst or tumor.

The general mechanism for the development of disorders of the cavities

At the first stage, there is difficulty in the outflow of cerebral fluid into the subarachnoid space from the ventricles. This provokes the expansion of the cavities. At the same time, there is compression of the surrounding tissue. In connection with the primary blockade of the outflow of fluid, a number of complications arise. One of the main is the occurrence of hydrocephalus. Patients complain of headaches that occur suddenly, nausea, and in some cases vomiting. Violations of vegetative functions are also found. These symptoms are caused by an increase in pressure inside the ventricles of an acute nature, which is characteristic of some pathologies of the cerebrospinal fluid system.

cerebral fluid

The spinal cord, like the brain, is located inside the bone elements in a suspended state. Both are washed by liquor from all sides. Cerebrospinal fluid is produced in the choroid plexuses of all ventricles. CSF circulation is carried out due to the connections between the cavities in the subarachnoid space. In children, it also passes through the central spinal canal (in adults, it overgrows in some areas).

The ventricles of the brain are a system of interconnected cavities where cerebrospinal fluid circulates. The ventricles provide:

Mechanical protection of the brain, creating a soft "buffer" on impact.
The production of cerebrospinal fluid - a fluid that nourishes the brain tissue.
Liquor circulation. The ventricles ensure the removal of toxic metabolic products from the brain.
Filtration of substances that enter the cavities of the nervous system.

Dilation or expansion of the ventricles of the brain leads to dysfunction, which develops neurological and psychological symptoms.

Dilation develops in two types:

An increase in the volume of all ventricles.
An increase in the volume of individual ventricles, which leads to their asymmetry.

The expansion or asymmetry of the cavities leads to a change in the intracranial pressure. Rising, it compresses parts of the brain, forming a clinical picture, which is determined mainly by cerebral symptoms, since the entire ventricular system is affected. A separate brain area is not affected.

Dilatation is not an independent disease, but is included in the symptom complex of other, major leading diseases or defects. For example, dilatation can be thought of as an anatomical change in infectious and inflammatory diseases.

Dilation is considered a pathology only when it manifests itself: it worsens the quality of a person’s life, gives rise to symptoms. When the expansion of the ventricles proceeds latently, asymptomatically, this is considered an anatomical feature of the nervous system.

Dilatation may or may not manifest as a syndrome. The severity of specific signs depends on the degree of expansion of the cerebral cavities.

Cavity expansion also occurs in newborns. In this case, the pathology is a defect in the intrauterine development of the fetus.

The reasons

Dilation in adults occurs for the following reasons:

Inflammatory diseases of the central nervous system:, poliomyelitis, rabies.
Congenital features: an excess of synthesis of cerebrospinal fluid.
Insufficient absorption of CSF in the walls of the ventricles.
Mechanical blockage of the CSF pathways of the spinal cord due to a hernia or tumor.
Traumatic brain injury: brain contusion, concussion.
Tumors.

Factors that impede the outflow of cerebrospinal fluid:

cysts, tumors;
transferred intracerebral hemorrhage;
blood diseases accompanied by excessive clotting;
vascular pathology, for example.

Breast expansion may be due to:

Hydrocephalus is a disease that is accompanied by excessive accumulation of cerebrospinal fluid in the ventricles. Acquired hydrocephalus is formed in the first month of life against the background of a head injury and intoxication syndromes.
Birth traumatic brain injury, if the mother has been ill with infectious diseases, for example, toxoplasmosis or cytomegalovirus.
Oxygen starvation of the fetus. It occurs if the mother smoked, drank or took drugs.
Hereditary factor: the peculiarity of the volume of the ventricles arose due to the fact that this was the case with parents and grandparents.
Violation of pregnancy.
Chronic diseases in the mother: diabetes mellitus, heart failure, coronary heart disease.

How does it manifest

Ventriculomegaly is determined by how much intracranial pressure is increased and how the patient's adaptive mechanisms are struggling with this change. Mild dilatation manifests itself:

Frequent headache and dizziness. May be worse at bedtime or upon waking.
Nausea.
Apathy, lethargy.

Strong dilatation is manifested:

Headache and dizziness.
Nausea and vomiting.
Drowsiness, loss of strength, lack of desire to study the world around.
Sleep disturbance.
The appearance of a vein on the forehead due to obstructed venous outflow.
Change in muscle tone: the tone may weaken or increase.
Trembling of hands and feet.
Large head, disproportionate to the body.

Ventriculomegaly in a child may present with common symptoms, such as:

head circumference grows too fast;
the fontanel bulges and pulsates;
a symptom of the "setting sun": when the eyelids are raised, the pupils of the child are lowered down;
the head is often thrown back;
in places of the skull where the bones did not meet at the seams, pulsating protrusions of a round shape are observed;
nystagmus - synchronous and rhythmic eye movement in one direction (up to 200 movements per minute).

In children, a strong expansion of the ventricles of the brain causes hypertensive-hydrocephalic syndrome. The essence of the pathology is a gross increase in intracranial pressure and an increase in the volume of cerebrospinal fluid. Symptoms of the syndrome:

Lack of appetite, apathy, no interest in toys.
Decreased muscle tone.
Weakness of the main congenital reflexes of swallowing, sucking and grasping.
The child spits up a fountain.
Strabismus and nystagmus.
The sutures of the skull are not connected, pulsating protrusions protrude between them.
Child lagging behind in psychosomatic age.
Decreased intelligence and all mental faculties.

Hypertensive-hydrocephalic syndrome, which has not been treated, leads to the following consequences:

paresis or paralysis;
mental retardation;
speech disorders;
deterioration or loss of vision.

Diagnosis and treatment

Dilation can be diagnosed with:

(ultrasound for the brain). It is used for adults and children after the first month.
. Examines the location and degree of expansion.
Fetal ultrasound. Allows you to identify pathology at the stage of formation of the child's body.

The essence of the treatment:

Therapy of the underlying disease.
Prevention of complications and stabilization of the course of the disease.

Appointed:

antihypoxants - drugs that improve oxygen metabolism in the brain;
diuretics - to correct water balance and prevent cerebral edema;
nootropics - to improve the microcirculation of the nervous tissue.
B vitamins;
Therapeutic gymnastics, massage and physiotherapy.

In the first days of a newborn's life, various tests are taken, vaccinations are given, and examinations are carried out in order to obtain complete information about the general condition of the child. One of the main procedures is an ultrasound of the brain. It allows you to learn not only about any deviations and the degree of development of the brain, but also to check the overall dimensions of the ventricles of the brain in a newborn, the norm of which is a certain value. Examination of a baby is an important stage in his life, since violations and pathologies that are not immediately identified can adversely affect the future life and development of the baby.

What to do if suddenly an ultrasound showed an increase in the ventricles of the brain in a newborn? If newborns with enlarged ventricles of the brain are in a normal condition and there are no serious neuropathological abnormalities, then a specialist can prescribe regular visits to a neurologist to monitor and monitor the condition. But if the deviations from the norm are quite serious, and the neuropathological symptoms are pronounced, then the child needs special treatment, which is prescribed by a neuropathologist.

At the moment, it is known about many factors that affect the appearance of pathologies of the ventricles of the brain in children. All of them can be divided into two categories: acquired and congenital. Acquired include those causes that could arise during the pregnancy of the mother of the child:

Infectious diseases that a woman suffers from during pregnancy.
Infections and sepsis inside the womb.
Penetration of foreign bodies into the brain.
Chronic diseases of the mother that affect the normal course of pregnancy.
Birth before the due date.
Hypoxia of the fetus inside the womb (insufficient or, conversely, increased blood supply to the placenta).
Abnormal duration of the anhydrous period.
Injury to the infant during childbirth (suffocation by the umbilical cord or deformation of the skull).
Stormy childbirth.

Congenital causes include a genetic predisposition to an increase in the ventricles; anomalies occurring in the chromosomes, as well as various neoplasms (cysts, malignant or benign tumors, hematomas). Along with the above reasons, characteristic changes in the size of the ventricles of the brain can be triggered by traumatic brain injury, cerebral hemorrhage, and stroke.

Anatomy of the ventricles of the brain

The human brain is a very complex structure, in which each substructure and each component is responsible for the fulfillment of certain goals. In humans, there is a special structure in the brain that contains cerebrospinal fluid (CSF). The purpose of this structure is the circulation and production of CSF. Each child and adult has 3 types of brain ventricles, and their total number is 4. They are interconnected through channels and openings, valves. So, distinguish the ventricles:

Side.
Third.
Fourth.

The lateral ventricles are located symmetrically with respect to each other. The left is designated first, the right - second, they are connected to the third. The third ventricle is anterior, it contains the centers of the autonomic nervous system. The fourth is the back, it is similar in shape to a pyramid and is connected to the spinal cord. A change in the size of the ventricles entails a disorder in the production and circulation of cerebrospinal fluid, which can lead to an increase in the volume of fluid in the spinal cord and a violation of the working condition of a vital organ.

Enlarged ventricles: manifestation

As you know, one of the functions of the ventricles is the secretion of cerebrospinal fluid into the cavity between the meninges and spinal membranes (subarachnoid space). Therefore, disturbances in the secretion and outflow of fluid lead to an increase in the volume of the ventricles.

But not any increase and change in size is considered a pathology. If both lateral ventricles symmetrically become larger, then you should not worry. If the increase occurs asymmetrically, that is, the horn of one of the lateral ventricles increases, and the horn of the other does not, then pathological development is detected.

Enlargement of the head ventricles is called ventriculomegaly. It exists in 3 types:

Lateral (expansion of the right or left ventricles, an increase in the posterior).
Cerebellar (changing the size of the cerebellum and medulla oblongata).
Pathological discharge of cerebrospinal fluid in the frontal region.

There are 3 degrees of the course of the disease:

Light.
Average.
Heavy.

Sometimes the disease accompanies a malfunction of the central nervous system. An increase in the ventricles in large children with a non-standard skull shape is considered normal.

Interpretation of the appearance of dilated ventricles

Deviation from the normal size of the ventricles does not always indicate the course of pathological processes. Most often, these changes are a consequence of the anthropological characteristics of the baby. Virtually all newborns under one year of age have ventriculomegaly. It appears as a result of a violation of the outflow of fluid or excessive accumulation of cerebrospinal fluid.

According to statistics, enlargement of the lateral ventricles is more common in children born prematurely. In them, unlike babies born at the right time, the sizes of the first and second cavities are more enlarged. If there are suspicions of asymmetry, measurements, diagnostics and a qualitative characteristic should be carried out.

Symptoms of venticulomegaly

With venticulomegaly, due to the large amount of cerebrospinal fluid, the pressure inside the skull rises in the baby; swelling of the cortex, gray matter, tissues appear. Pressure disrupts the blood supply to the brain, and deterioration and malfunctions of the central nervous system are also observed.

Symptoms with an increase in the ventricles are the following:

Increase in muscle activity.
Deterioration of vision (defocusing, strabismus, downcast gaze).
Trembling of limbs.
Strange gait (moving on tiptoe).
Inactive reflective manifestations.
Sluggish, apathetic behavior.
Increased moodiness and irritability.
Insomnia, sleepwalking.
Lack of appetite.

An obvious symptom of venticulomegaly is regurgitation and vomiting, the number of which exceeds the norm. This happens due to irritation of the vomiting center in the fourth ventricle, which is located at the bottom of the fossa in the form of a diamond.

Diagnosis of the disease

Diagnosis is carried out to clarify the diagnosis. The doctor can notice the chronic form of venticulomegaly already at the age of three months with the help of ultrasound. The survey includes the following procedures:

Examination by an ophthalmologist (this way puffiness of the eyes, hydrocephalus is detected).
Magnetic resonance imaging (the MRI procedure helps to monitor the growth of the ventricles after the fusion of the cranial bone. For the examination, which takes from 20 to 40 minutes in time, the baby is put to sleep with the help of drugs).
CT scan. AT this case no medication sleep is required because the procedure does not take much time. So CT is the best option for children who cannot tolerate anesthesia.

Ultrasound is prescribed for children born after pregnancy, during which there were complications. It is done in the first year of life, and if there are no neurological abnormalities, then it is repeated after three months.

Indicators of normal sizes

Each ventricle has a certain size, which is considered normal. Deviation from them is a pathology. So, the normal depth of the third ventricle - no more than 5 mm, the fourth ventricle - does not exceed 4 mm. When measuring the side, the following values are taken into account:

Side cavities - the depth should not exceed 4 mm.
Horns in the back of the head - 10 - 15 mm.
Horns in front - 2 - 4 mm.

The depth of a large tank is no more than 3 - 6 mm. All cavities and structures of the brain must have a gradual development, coordinated and linearly dependent on the size of the skull.

Treatment of the disease

Treatment can only be prescribed by a neurosurgeon or a neuropathologist. Usually drug therapy is used. Not all episodes require treatment, but it is used in case of pronounced neuropathological abnormalities. The main medicines are:

Diuretics are used to reduce cerebral edema, normalize and accelerate the excretion of fluid.
Potassium-containing drugs make up for the deficiency of the required amount of potassium while accelerating the process of urination.
Vitamin complexes are used to replenish lost vitamins, as well as to restore the patient's body.
Nootropics improve blood supply to the brain, microtissue circulation and vascular elasticity.
Sedative drugs have a sedative effect, reduce neurological signs such as tearfulness, moodiness, irritability.

If the cause of the appearance of deviations in the size of the cavities of the brain is mechanical damage to the head, then surgical intervention is required.