The newborn has visible veins on the forehead. Increased intracranial pressure in infants. What symptoms might indicate

Hi all! Today we will talk about the blood vessels of a newborn, or rather, their location directly on the head of a child. After all, if you look closely, you can see a whole network of wreaths and capillaries, which is only slightly covered by the hairline. Although, to be honest, you don’t need to look closely there, the veins in the baby on the head are very visible.

You are probably very worried about this and thoughts like “What if this is some kind of pathology?” sneak in. Today's material is aimed at dispelling all myths and warning about possible diseases. By the way, my son inspired me to write this article, I looked at his head, then the idea arose to look deeper into this issue and publish the material on the site.

Why is this happening

I want to reassure you right away and say that wreaths are visible in most children on their heads and this is not a pathology, but the norm. This is how their still childish organism is arranged. After all, the blood vessels are bright enough, and the skin on the baby’s head is thin, so they shine through it.

Why, then, are the wreaths practically invisible on the body of a child? It's all about the subcutaneous fat, it develops quite well in babies and hides all the blood vessels on the body, with the exception of the head. There is practically no subcutaneous fat on the head and, due to the thin skin (as I already wrote), all vessels are translucent. So don't worry.

When to Worry

Not so long ago, I wrote an article about and in it described the symptoms by which this ailment can be recognized. So, just one of the symptoms of increased intracranial pressure (and, accordingly, headache) is the swollen vessels on the head of a child. I emphasize that it is the swollen, resembling veins on the man's overworked arms.

As soon as you notice that the wreaths are swollen, you should not immediately panic. Perhaps the reason for this was that the baby was pushing or actively playing. The child should be observed for one or more days.

In addition to a swollen wreath on the head, the following symptoms may indicate:

1. Swollen fontanel. Although, again, he, just like the blood vessels, may swell temporarily due to the fact that the baby is overexerted.
2. . I wrote a separate article about this. I advise you to follow the link and read.
3. The child vomits or he often spits up "".
4. The baby cries often.
5. The child is naughty and tries to touch his head with his hands.

Children, of course, have very serious diseases associated with blood vessels, as well as the accumulation of fluid in the head, for example, "", but this is another topic for conversation, so I will not touch on it here.

Young parents rejoice when a newborn baby eats well, sleeps peacefully and cries a little. But sometimes the behavior of the baby begins to disturb - he often cries angrily, does not want to eat, falls asleep hard, burps after feeding. One of the reasons for this, doctors can name increased intracranial pressure (ICP). This is not an independent disease, but only signs of another neurological disease. It is necessary to know the reasons for such a deviation in order to take preventive measures in advance. You also need to be able to detect symptoms in order to start treatment in a timely manner.

A bit of anatomy

In the cranium of both an adult and a small baby there is a brain, blood, cerebrospinal fluid (CSF). It is the cerebrospinal fluid that exerts a certain pressure when it circulates in the space between the brain, the bones of the skull and in other anatomical spaces of the brain and spinal cord. The main tasks of the cerebrospinal fluid:

• Protection of the brain from mechanical damage;
• Maintaining a constant level of intracranial pressure;
• Ensuring metabolic processes between the brain and blood.

Liquor is constantly updated, completely changing about 4 times a day. Under certain loads, the pressure of the fluids in the head of the baby may increase slightly, for example, when the child cried for a long time or pushed hard during a bowel movement. But the condition will stabilize, and the pressure will decrease after a short period of time. Usually attentive parents know how to calm, distract the baby.

But more serious anomalies lead to a pathological increase in ICP. This is a difficult movement of cerebrospinal fluid, its poor absorption, excessive production, accumulation in the channels of the brain. But such violations are rare and have serious causes. It is necessary to be attentive to the behavior of the baby in order to identify signs of a painful condition, and begin treatment.

The main causes of unstable pressure

The main cause of high blood pressure in young children is hydrocephalus. With this pathology, cerebrospinal fluid is produced in excess, accumulates, and moves poorly. Such a disease can be determined immediately after childbirth, which means that treatment should be started on time. Often in infants there is congenital hydrocephalus, which is formed even in the prenatal period.

To provoke the development of congenital hydrocephalus can:

• hereditary, chromosomal anomalies;
• prematurity of a high degree;
• severe pregnancy (severe toxicosis, lack of oxygen in the fetus, poor maturation of the placenta, cord entanglement);
• taking certain medications during pregnancy;
• intrauterine infection;
• trauma during difficult childbirth or during surgery.

If a pregnant woman follows the recommendations of specialists and takes care of her health, these consequences can be avoided. When planning a pregnancy, it is good for the expectant mother to get rid of all infections in the body. This will have a beneficial effect on the health of children, since infection in utero or during childbirth gives rise to many childhood pathologies.

Increased pressure inside the skull is manifested as a result of serious deviations in health, often leading to the disability of the child. This is rare, for example, after a major traumatic brain injury or a neuroinfectious disease (encephalitis or meningitis). Also, a brain tumor is the cause of high ICP.

How does high blood pressure manifest in children?

The main symptoms of high ICP:

• enlargement and protrusion of the fontanel;
• divergence of the sutures of the skull;
• too rapid increase in head circumference.

Such signs may be present in infants of the first year of life. The remaining symptoms characteristic of this period, in the form of prolonged crying, rolling eyes or strabismus, regurgitation and startling, have nothing to do with high ICP.

According to Dr. Komarovsky, this happens in most newborns due to their age, for example, in infants up to a year old, the oculomotor muscles have not yet formed. That is why many parents note strabismus in children, but over time it is treated in this case is not required. Such symptoms may indicate other health problems in the baby, so it is best to consult with specialists. It can be metabolic disorders, encephalitis, abscess or trauma.

Examination methods

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One of the main indicators of proper development is the normal increase in head size in newborns. At birth, it is approximately 34 cm, but the most important thing is that the circumference should increase by an average of 1 cm per month. This means that the increase should be 12 cm per year. It is necessary to trace the increase in head circumference over several months. Each baby grows and develops individually, which is why averages are given.

Head circumference measurement

It is very important to be able to measure the circumference of the head in infants. It is better to take a soft centimeter or a tailor's meter for this. It is necessary to apply a meter above the eyebrows of the baby in front and behind at the most convex point on the back of the head. Often such measurements are made by pediatricians or neurologists during a routine examination, they also note the speed of closing the fontanel, determine the tone of the baby's muscles.

MRI

They can prescribe a tomography (magnetic resonance or computer) to confirm high ICP. It is carried out with an already closed fontanel. But it is rarely prescribed, with severe forms of deviation, since the procedure must be carried out with the calm behavior of the baby, and this is possible only with the introduction of anesthesia.

Neurosonography

Neurosonography is helpful in diagnosing. This ultrasound examination of the brain is performed with an open fontanel. The procedure helps to determine the degree of enlargement of the ventricles. After a certain time, a re-examination is carried out, this helps to trace the dynamics of an increase in the size of the head.

Doctors consultation

For a comprehensive examination, if high blood pressure is detected, an ophthalmologist's consultation is prescribed to examine the fundus of the baby. Edema of the optic nerve and varicose veins in the fundus will be an indirect sign of high ICP.

The well-known pediatrician Komarovsky emphasizes that all examination methods for detecting increased pressure in the skull do not indicate reliably, but only allow for the possibility, suggest such a phenomenon in infants. Only the sum of several signs allows us to speak about the presence of the disease, and it is imperative to monitor the increase in the circumference of the child's head.

The main directions of treatment

Therapeutic actions to reduce increased pressure inside the skull are aimed at eliminating the cause of this condition. In severe cases, for example, with a tumor or brain injury, treatment is carried out in a hospital. But mild forms of hydrocephalus can be treated at home.

An integrated approach to the rehabilitation of infants with such a diagnosis includes medications, vitamins, injections, special massage, and swimming. All this can significantly reduce high blood pressure and improve the condition of the baby.

Magnesia

Magnesia is often prescribed to relieve symptoms, it dilates blood vessels, thereby reducing high intracranial pressure. Magnesia is a solution of magnesium sulfate. Babies are given injections with this medicine. But the well-known pediatrician E. Komarovsky does not support such treatment.

Magnesia is able to calm the nervous system, reduce increased arousal in children, but in case of an overdose it can cause dangerous depression of the respiratory center.

In addition, magnesia when administered intramuscularly (injections) is very painful. And to the poor condition of the babies, magnesia will also add the sick ass of babies.

Glycerol

Helps to remove excess fluid in case of glycerol disease. It allows you to reduce intracranial and intraocular pressure, reduces the volume of cerebrospinal fluid. But glycerol eliminates the symptoms and makes you feel better without affecting the root cause of high blood pressure.

For children, this drug is diluted with unsweetened juices. Compared to other drugs, glycerol gives an effect later, but the result will be more stable, and there will be much fewer side effects.

But there are unpleasant consequences - allergic reactions to the medicine and a violation of the stool. But the general feedback from specialists and parents is positive, as the condition of the children is improving.

In infants, increased ICP is often noted for completely natural reasons. They are sensitive to changes in the weather, may become overexcited while swimming, or anxious due to the accumulation of gases in the tummy. But all this passes on its own after a certain period of time. In order to alleviate the condition of the kids, massage is prescribed and swimming is recommended, and not dubious drugs like magnesia.

Instead of a conclusion

If a pathological increase in ICP is suspected in young children, they are taken under the supervision of a neurologist. Often the symptoms go away on their own. But so that the consequences do not manifest themselves with age in the form of developmental delays, one should consult a doctor.

If the use of certain drugs, for example, magnesia, is not unambiguously perceived by specialists, then the positive effect that massage or swimming gives is recognized by everyone.

Caring for babies requires a lot of strength and patience, especially with unstable ICP. Attention, patience and competent recommendations of specialists will help parents cope with the malaise of newborn babies.

Increased intracranial pressure (ICP) or intracranial hypertension in infants is not an independent disease, but only a symptom of a certain neurological pathology in childhood.

Causes of the development of ICP in infants

The causes of ICP can be diseases that are accompanied by an increased formation of cerebrospinal fluid (CSF), a deterioration in its absorption, the presence of anatomical defects that cause impaired circulation of the cerebrospinal fluid, or a combination of these factors.

The main cause of ICP in young children is hydrocephalus, which occurs due to increased production of cerebrospinal fluid and its accumulation in the ventricles and channels of the brain, which causes disturbances in the circulation of CSF and its absorption. In newborns, the congenital form of hydrocephalus is more common, which develops in the prenatal period of fetal development. Pediatricians and neurologists detect this pathology after childbirth, which makes it possible to prescribe treatment in a timely manner and prevent the baby from lagging behind in development.

To provoke the gradual development of ICP in infants can:

• genetic and chromosomal diseases that provoke the formation of congenital malformations of the brain;
• deep prematurity;
• pathology of pregnancy (placental insufficiency, severe somatic diseases of the pregnant woman);
• intrauterine infection;
• traumatic injuries that occur during childbirth (with complications in childbirth or surgical interventions).

The main diseases in which ICP develops:

• birth trauma, with the development of perinatal lesions (encephalopathy) and hydrocephalus of the brain;
• neuroinfections in young children (meningitis, encephalitis);
• diseases with severe metabolic disorders (diabetes mellitus, hypothyroidism);
• brain tumors.

According to statistical data, the frequency of hydrocephalus is quite high and is growing every year, which indicates overdiagnosis and the groundlessness of a number of criteria for diagnosing ICP.

Signs of ICP in the chest

Signs of ICP in infants that are not typical for babies of other age groups are:

• an increase in size and bulging of a large (central) fontanel;
• divergence of the sutures of the skull;
• protrusion of the veins of the skull with the formation of a venous network on the head;
• trembling of the chin and / or hands;
• frequent regurgitation (up to vomiting);
• lethargy, lag in the physical and psycho-emotional development of the child, reduced weight gain;
• anxiety, tearfulness of the baby (cry (“on one note”), in a monotonous voice).

Additional symptoms of ICP, depending on the severity and progression of the pathological process in infants, are considered to be a significant and steadily progressive increase in head circumference, absence of fontanel pulsation, a symptom of the "setting sun" (when the baby's eyes look down and the lower part of the iris is covered, a wide strip of sclera is visible from above ), convulsions, increased muscle tone.

hydrocephalus in infants

Hydrocephalus in most cases is a congenital pathology, which is accompanied by active production of cerebrospinal fluid, or a violation of its reabsorption on the background of intrauterine infections, chromosomal and genetic defects, or a consequence of severe diseases (birth injuries and neuroinfections), as well as after neurosurgical interventions.

In hydrocephalic syndrome, an excess amount of CSF expands and presses on the ventricles of the brain. Premature babies have a high risk of severe intracranial hemorrhage during childbirth and/or the development of hydrocephalus due to incomplete differentiation of brain structures. At the same time, there is a rapid growth in the size of the baby's head, an increase and bulging of a large fontanel with a divergence of the sutures of the skull.

Types and severity of hydrocephalus in infants

Depending on the cause, type and severity of hydrocephalus, there are various symptoms and the formation of consequences.

Symptoms of this disease appear in the first months of a child's life. The main symptom is a rapid increase in head size - with an increase in head circumference by 6-7 centimeters per month, it is considered a reason for careful monthly monitoring and further instrumental diagnostics - NSG (neurosonography) - ultrasound of brain structures through a large fontanel.

With a compensated form, all symptoms are moderately expressed, the physical and mental development of the baby does not suffer, and the treatment is carried out conservatively - with medications that activate the outflow of cerebrospinal fluid and reduce its production. In severe cases, surgical (neurosurgical) intervention is required - shunting.

Less often, ICP in infants is a symptom of infectious and inflammatory diseases of the brain (neuroinfections) - encephalitis and meningitis. Infection of a child can occur in utero, if there is a focus of herpetic, chlamydial or other infection in the mother (herpetic meningitis is most common) or when infections are generalized in a baby due to purulent skin diseases, an umbilical wound, pneumonia with a significant decrease in the immune reactivity of the baby's body.

Methods for diagnosing ICP in infants

The main methods for diagnosing ICP in infants are based on the presence of clinical symptoms and the identification of indirect signs of intracranial hydrocephalus.

With the manifestation of any of the main symptoms of ICP, it is necessary to contact the local pediatrician, who subsequently prescribes (if necessary) further examination:

• examination by a pediatric neurologist, who determines the condition of the fontanel, assesses muscle tone and measures the head circumference of the child in dynamics;
• examination by an ophthalmologist of the fundus;
• neurosonography;
• computed or magnetic resonance imaging with a closed large fontanel.

Neurosonography for the diagnosis of ICP

NSG (ultrasound of the brain) is prescribed for infants, since this study can only be carried out with an open large fontanel, which can miss ultrasonic waves. With this method of examining the brain, the size of the ventricles is assessed, and their increase is a sign of intracranial hypertension with its repeated conduct after a certain period of time. As well as the progression of clinical symptoms - a significant monthly increase in head size, the formation of a venous network and the divergence of cranial sutures with the addition of clinical symptoms (frequent regurgitation, anxiety, chin tremor, progressive lethargy, baby's weakness, weight loss).

Ophthalmologist examination

Also to establish the presence of increased ICP in children is an examination of the fundus by an ophthalmologist.

Indirect signs of the presence of intracranial hypertension are:

• edema of the optic discs;
• expansion of the veins of the fundus.

Computed or magnetic nuclear tomography

The most accurate methods for clarifying the diagnosis are computed tomography or magnetic nuclear tomography. These techniques are considered quite expensive, and the child must also be in a state of complete rest, so various types of anesthesia are used.

Tomography is not often used, only with serious suspicions of severe forms of intracranial pathology.

Echoencephalography with increased ICP in infants

The method of encephalography (Echo-EG) is widely used today in our country, although it is quite outdated and cannot serve as a reliable sign of hypertensive-hydrocephalic syndrome.

ICP in infants treatment

Intracranial hydrocephalus, which has a benign course, in most cases resolves on its own with adequate complex conservative treatment, which consists in prescribing drugs (diuretic and vascular drugs, neuroprotectors and vitamins), courses of physiotherapy, exercise therapy, massage, swimming, which helps to significantly slow down the progression of the increase ICP and improve the general condition of the child. In the future, constant monitoring and courses of drug therapy and other conservative methods lead to a complete cure for the child. An important factor is the timely seeking medical help and the dynamic monitoring of specialists - if the treatment is not carried out in time, the baby will not be able to develop normally, which will lead to severe violations of the physical and mental development of the child. And with a severe course of this pathological condition and lack of treatment, it can lead to disability and the development of persistent neurological disorders - cerebral palsy.

In severe (decompensated) hydrocephalus, conservative treatment does not give positive results, especially with organic disorders (adhesions, additional vessels, malformations of the meninges).

The main method of treating a child with severe hydrocephalus requires surgical intervention - brain bypass, when, when a special shunt (temporary or lifelong) is placed, excess fluid is removed from the canals and the ventricle of the brain.

Visiting a city clinic is not the most pleasant event that parents have to go through with their children.

In addition to kilometer-long queues, noise and confusion, which for many years has been “blooming in riotous color” within the walls of most children's medical institutions in the country, we often also encounter doctors who make terrible diagnoses out of the blue, without appropriate diagnostics and research.

One of these is a statement of increased intracranial pressure in a newborn (ICP).

What do these words mean and what is the essence of such a condition, which is interpreted as painful, and which is determined in almost every baby who has visited a local neuropathologist - we will analyze all this right now.

From this article you will learn:

Not a single modern, qualified and adequate doctor will make a diagnosis of "increased intracranial pressure in a newborn", based only on a face-to-face examination of a small patient. The reason for this is more than valid - such a condition is always associated with severe diseases, often leading children to disability, so the banal complaints of parents about prolonged sobbing, tantrums and sleep disturbances in a child in no way indicate this ailment.

As a rule, he has the same relation to the baby as Buenos Aires has to the North Pole.

The popularity of the diagnosis of ICP is a peculiar phenomenon of domestic medicine. In no country in the world, the topic of increased intracranial pressure in infants is not exaggerated with such zeal as we do.

It’s worth the mother at the pediatrician’s appointment to hint that she noticed a twitch of limbs in her crumbs, a trembling of her chin, or she witnessed heart-rending crying or, God forbid, rolling her eyes - an examination by a picky neuropathologist is guaranteed for the baby.

He, in turn, after performing a few simple manipulations, will announce the verdict - intracranial pressure is above normal. Next will be a prescription for pills, often glycine, and diuretics, which parents will have to shove into the child for several weeks, or even more.

Most likely, the described scenario is familiar to many of our readers. Thousands of mothers go through it every day, who, like you, do not know what to think about and where to run after the next visit to an overdiagnosis specialist.

In order to immediately dot the “I”, it is necessary to understand the essence of the concept of intracranial pressure. To do this, you will have to make a brief excursion into the forgotten school subject "Human Anatomy".

How is our head?

Every adult and small representative of humanity has a cavity in the head called the cranium. It contains three vital components:

• brain;
• blood circulating through the blood vessels;
• cerebrospinal fluid, which is called a buzzword - liquor.

This one liquor produce vascular plexuses. It enters the cranium through the spinal canal, bathes the brain, bringing oxygen, nutrients and moving hormones to it. For some time, the cerebrospinal fluid lingers in the cranial cavity, after which it leaves it through the venous sinuses.

• 85% is occupied by the brain;
• 8% - blood;
• 7% - with liquor.

In total, 100% is obtained, which is the norm of intracranial pressure.

If more blood comes to the child's head, as in the case of prolonged tantrums or diligence during the act of defecation, the pressure in the head rises. As soon as the baby calms down or stops "sulking", it gradually returns to normal.

When the pressure returns to normal without problems and outside help, the child does not need any methods of therapy.

If fluctuations in ICP occur, which are caused by disturbances in the activity of the brain, specific medical diagnostics (ultrasound or opening of the skull) is necessary. Only in this case can we talk about a real pathological increase in intracranial pressure, including in newborns.

Once, the famous pediatrician E.O. Komarovsky said: “If a child eats well, sleeps more or less well, is active and develops within the normal range, he does not have any pathologically increased ICP!” If the pressure had been increased, then such a child would have been in the hospital, or even in the intensive care unit.

When is ICP a pathology?

Serious health problems for the baby, which are indicated by high ICP, arise:

• If there are tumors in the brain;
• In the inflammatory process in the brain (meningitis, encephalitis);
• With craniocerebral injuries that provoke the development of hematomas;
• When there is a failure of the outflow of CSF through the venous sinuses (hydroencephaly).

In these conditions, simple pills will not help: the tumor will have to be cut out, the fluid will be pumped out, and hematomas will need to be removed surgically. As you can see, ICP indicates much more serious problems than those with which you most often go to the doctor.

How to measure?

How to recognize increased ICP in an infant?

The causes of a slight increase in intracranial pressure in infants are:

• prolonged labor with complications;
• cord entanglement;
• birth trauma of the child (asphyxia, hypoxia).

After a certain time, the baby recovers, and his pressure returns to normal.

True, in some children there is a persistent increase in ICP - with congenital and acquired hydrocephalus. The first occurs with hemorrhages in the cranial cavity, and it is also caused by genetic abnormalities. The acquired form of hydrocephalus develops after a child suffers from neuroinfectious diseases or if there are tumors in his brain.

Since any enemy needs to be known by sight, we bring to your attention that the signs of an abnormal increase in ICP in newborns are:

• lethargy, drowsiness, tearfulness, anxiety and restlessness;
• exceeding the norms of the head circumference of the child, its disproportion;
• pronounced venous network on the head;
• "Convex" fontanel;
• Pain in the eyes;
• divergence of the bones of the skull.

The manifestation of these symptoms, as a rule, several at the same time, requires a thorough medical investigation: from ultrasound of the brain to neurosurgical intervention.

They do not talk about pathological intracranial pressure in a newborn:

• nosebleeds;
• hyperactivity;
• disturbance of appetite and sleep;
• tiptoe walking;
• developmental delays;
• tremor of the limbs;
• vomit
• slow tightening of the fontanel;
• frequent shudders;
• rolled eyes, etc.

We hope that now you understand the difference between a pathological and physiological increase in intracranial pressure in newborns and, if it is diagnosed, you will require detailed explanations from the doctor and justification for the diagnosis.

Pathology or norm?

Such a diagnosis is often made in children. After all, this condition requires constant monitoring. Intracranial pressure is not a single disease, but a symptom of various disorders.
If the child is capricious, constantly spitting up, and the fontanel protrudes above the surface of the skull, then this may indicate the presence of the following pathologies in the child: hydrocephalus, tumors, hemorrhages and other pathological conditions.
Such serious diseases require timely treatment. Otherwise, it will lead to developmental delay, and in some cases to death.