External hydrocephalus replacement nature of the brain symptoms. Minor external replacement hydrocephalus. Replacement hydrocephalus: causes, signs, treatment. What is dangerous hydrocephalus for humans

Shoshina Vera Nikolaevna

Therapist, education: Northern Medical University. Work experience 10 years.

Articles written

Hydrocephalus of the brain is called a pathology, which is characterized by the accumulation of cerebrospinal fluid in the cerebrospinal fluid spaces. This problem can be an independent disease or arises as a result of injuries, tumors, infections and under the influence of other causes. The disease is also known under the name "dropsy of the brain."

Classification of hydrocephalus

People have:

1. External hydrocephalus of the brain. The problem occurs if the CSF is not absorbed into the bloodstream. It is malabsorption that leads to the accumulation of cerebrospinal fluid, increased pressure in the skull and expansion of spaces in the brain. Open hydrocephalus often occurs due to infections.
2. Internal hydrocephalus of the brain. It is characterized by the accumulation of fluid inside the ventricles and cisterns of the brain. Most often, this form is congenital hydrocephalus.
3. Mixed hydrocephalus of the brain. In this case, CSF accumulates not only inside the ventricles and cisterns, but also in the space around them. It can be compensated, when the work of the organ is not disturbed, and decompensated, in which brain tissues are compressed and malfunctions of the organ occur.
4. Replacement hydrocephalus of the brain in adults. In this pathological process, the substance of the brain decreases in size and is replaced by cerebrospinal fluid. Mixed replacement hydrocephalus develops when the cerebrospinal fluid fills the internal cavities of the organ and the spaces between them.
5. Occlusive hydrocephalus. The pathological process occurs when the ducts are clogged and the outflow of cerebrospinal fluid is disturbed. Based on how severely the outflow is blocked, there are triventricular hydrocephalus, biventricular hydrocephalus, tetra- and monoventricular forms.
6. Nonocclusive hydrocephalus. This form differs in that it does not develop intracranial hypertension. The causes of the violations are not clear, the current of the liquor and its circulation remain within the normal range.
7. Normotensive hydrocephalus. With this syndrome, a violation of motor function is combined as a result of a significant expansion of the ventricles. The pressure in the skull is normal.
8. Moderate hydrocephalus may not manifest itself in any way, but it leads to impaired blood circulation in the brain, which can subsequently cause complications, so treatment is necessary.
9. Obstructive hydrocephalus. In this case, the accumulation of fluid occurs due to the fact that the outflow of cerebrospinal fluid is blocked. This can occur as a result of formations in the organ.
10. congenital hydrocephalus. As a result of genetic predisposition and malformations in development, hydrocele of the brain can develop from birth, which causes serious violations of the functions of the organ.
11. Post-traumatic hydrocephalus. Fluid accumulation occurs after severe traumatic brain injury.
12. Atrophic hydrocephalus is accompanied by atrophy of the brain, in which tissues are replaced by fluid.
13. Vicarious hydrocephalus. Pathology is manifested by an increase in the ventricles in the absence of changes in the anatomical.
14. Asymmetric hydrocephalus. This problem is spoken of when one ventricle is enlarged. All ventricles may be enlarged.

Hydrocephalic syndrome in adults can be of different types. But in each case, the prognosis depends on the stage at which treatment was started. If therapy is carried out when the pathological process has not led to, then there is a possibility of restoring the functions of the organ.

Risk factors

Pathology most often develops in newborns, but can also occur in adults. According to research, any disruption in the functioning of the central nervous system can cause a problem. Such causes are called acquired. In this case, hydrocephalus is caused by:

Dropsy of the brain can affect all systems of the brain. To fix the problem, you need to determine the cause of its development.

Symptoms of the disease

Manifestations of the disease occur when intracranial pressure rises and various structures of the organ are compressed.

Symptoms of hydrocephalus in adults are signs of intracranial hypertension, they are gradually accompanied by neurological disorders, with increased pressure on the tissues, the symptoms worsen.

Hydrocephalus can be suspected in such cases:

1. If you are worried about headaches and a feeling of heaviness, which are especially aggravated during sleep and in the morning after waking up. The exact location of the pain center cannot be determined. If a person takes a horizontal position, then the symptom intensifies, which is explained by an increase in CSF pressure.
2. With morning sickness and vomiting, regardless of what and when a person has eaten.
3. If there is pressure in the eyes.
4. At the counter.
5. If a person began to get tired quickly, he constantly feels weak and drowsy, often yawns.
6. Difficulty concentrating and doing simple things.
7. With nervousness, apathy, decreased intelligence.
8. If the blood pressure changes dramatically, the pulse speeds up or slows down.
9. A person constantly has dark circles under his eyes. If the skin on them is stretched, it will be seen that the capillaries are overflowing with blood.
10. Significantly increased perspiration. There is a possibility of loss of consciousness.

These are symptoms of intracranial hypertension. Manifestations of neurological disorders will be as follows:

1. Vision is impaired. The eyes double, it is difficult to focus on one object, visual acuity decreases.
2. Fields of vision fall out.
3. Due to compression, the optic nerve atrophies, which can lead to complete blindness. This is possible if the disease proceeds for a long time.
4. Strabismus develops.
5. The pupils do not react to bright light.
6. There are violations of the functions of the vestibular apparatus. The patient suffers from dizziness, gait becomes shaky, in the ears, involuntary vibrations of the eyeballs appear.
7. Paralyzes limbs.
8. Increased reflexes and muscle tone.
9. Sensitivity decreases or disappears completely.
10. The arms and legs become stiff and cannot be straightened, as the muscle tone has increased.
11. There are signs of cerebellar ataxia, in which there is a sweeping handwriting, impaired motor function.
12. A person becomes emotionally unstable, mood changes dramatically.
13. If the pressure inside the skull rises sharply, the patient becomes aggressive.

Diagnostic methods

The diagnosis of "hydrocephalus" can be confirmed only after a series of laboratory and instrumental studies. More information is provided by instrumental methods. Laboratory tests are prescribed to determine the general health of the patient. In order to determine the presence of a pathological process, the following procedures are carried out:

• measure the circumference of the head with a tape. If a child suffering from hydrocephalus is checked, then the diagnosis is confirmed if the head has increased by more than one and a half centimeters in a month. In adults, any increase is considered a sign of illness;
• ophthalmologist examines the fundus of the eye. In the presence of edema of the optic nerve discs, I confirm that the pressure inside the skull is increased. This may also indicate that dropsy of the brain is developing;
• conduct an ultrasound examination of the skull, which is also called neurosonography. This technique is very inaccurate and allows you to get the necessary information only when examining infants through the fontanel. For adults, the study is almost never prescribed;
• prescribed magnetic resonance imaging. This is the main diagnostic technique if hydrocephalus is suspected in a person. With its help, you can not only confirm the presence of a problem, but also determine what disorders caused it, and assess the degree of damage to brain structures and the vascular bed. The procedure allows you to determine: external hydrocephalus of the brain in humans or internal, or its other types. Confirm the diagnosis if there is evidence of periventricular edema;
• tomography. This is an x-ray method that does not provide as much detailed information as magnetic resonance imaging, so it is not often prescribed;
• echoencephalography and rheoencephalography are also used to determine the disease;
• they can perform a lumbar puncture to examine the condition and composition of the cerebrospinal fluid;
• X-ray of the skull is prescribed infrequently. But the procedure allows you to determine that the bones of the skull are thinned.

The main evaluative criteria for diagnosis are the results of magnetic resonance imaging and examination of the fundus. If, after passing all the studies, the diagnosis is confirmed, then the treatment of hydrocephalus begins. If the results of the procedures are inconsistent, hydrocephalus is rejected and it is found out which disease caused similar symptoms.

Therapy

Dropsy of the brain is a severe and dangerous pathology. It is possible to treat this disease only with the help of a set of measures, since there is no one medicine that can eliminate the problem. Depending on whether the person has congenital hydrocephalus, atrophic, occlusive, or normotensive hydrocephalus, treatment may include medications and surgical procedures.

Some try to improve the situation with folk methods. But this can be done only after consulting a doctor and used as an auxiliary treatment.

Conservative treatment

With this pathological condition, treatment is carried out using:

• diuretic drugs. They slow down the production of cerebrospinal fluid. Doctors achieve a similar result with Diakarb, Piracetam, Glyzerol. They are used in the form of injections. Since the use of diuretics is accompanied by the excretion of sodium, magnesium, and potassium from the body along with the liquid, vitamin-mineral complexes are prescribed to prevent a deficiency of these substances;
• antibacterial agents. They are prescribed if an infectious process develops in the body. Usually, drugs are used to eliminate hydrocephalus that develops in the fetus;
• drugs to improve blood circulation in the brain;
• vitamin remedies. In particular, vitamins of groups B, C and E are used. They improve metabolic processes at the cellular level;
• animal enzymes. Lidaza and pyrogenal break down and remove excess fluid from the body;
• glucocorticoids. Hormonal drugs are prescribed in extreme cases.

If conservative treatment has not yielded results, then they try to eliminate the problem surgically.

Surgical treatments

In the acute and chronic form of the disease, surgery may be prescribed. If there is severe inflammation in the brain, and the infectious process has spread to the entire body, then surgical procedures are contraindicated. First, the infection is eliminated, and then treatment is carried out.

During surgical treatment, paths are formed through which the CSF can exit the cranium. This procedure is called "". If there are tumors or adhesions in the organ, they are first eliminated, and then bypass is performed.

Dropsy of the brain is also removed with the help of:

• palliative interventions. It is carried out with open dropsy with, in the presence of contraindications to radical operations and for the treatment of children through the eye cavity;
• radical operations. The procedure can be carried out with any type of dropsy. During the procedure, shunts are placed to remove excess fluid. They can be external or internal. With external interventions, there is a high risk of contracting meningitis, so they are practically not used. With the help of internal drainage, fluid is removed to another system or organ.

In most cases, with the help of surgical treatment, it is possible to effectively eliminate the problem. If there is a malignancy in the brain that caused dropsy, surgical procedures can extend life by several years.

After surgery, exacerbations may occur in the form of:

• development of the inflammatory process;
• blockage of the lumen of the drainage tube;
• loss of a tube from an organ into which excess fluid should be removed.

To reduce the risk of such consequences, for any symptoms, you should contact a specialist.

Folk remedies

With the help of folk remedies, you can alleviate the course of the disease. This effect is achieved with:

• infusion of adonis. The plant in the amount of a tablespoon is poured with a glass of boiled water and kept on fire for 20 minutes. After that, use 50 ml three times a day before meals. The duration of the course is 3 weeks, after which they rest for a week and continue treatment;
• infusion of parsley. Puffiness can be reduced by preparing a medicine from chopped parsley. It is poured with boiling water and insisted. After that, it is consumed during the day before meals;
• infusion of juniper. Two tablespoons of cones should be poured with boiled water, placed in a thermos and insisted. The tool allows you to eliminate swelling due to diuretic properties. You need to drink the infusion half an hour before eating food in the morning and evening. The course of treatment should last several months. If a person has kidney problems, then the medicine is contraindicated;
• real cornflower. With the help of this tool, you can achieve a choleretic and diuretic effect.

All these funds can only be used as an addition to the main therapy. It is impossible to eliminate hydrocephalus with herbs alone.

Complications and prognosis

If you do not start treatment for hydrocephalus on time, then there is a high probability of death. Life expectancy and the development of the consequences of the disease are affected by:

1. The stage of development of the disease. Severe disease causes disability or death.
2. Time to start treatment. If therapy was prescribed when the pathology was actively progressing, then the mental state of the patient cannot be restored.
3. The correctness of the selected therapy.
4. Associated pathological processes.

Under the influence of these factors, the following complications can develop:

• weakens the tone of the muscles of the limbs;
• impaired auditory and visual functions;
• failures in the work of the cardiovascular and respiratory systems develop;
• the water-salt balance is disturbed;
• there are seizures of epilepsy;
• develops;
• if atrophic processes have begun, then the probability of death is very high.

If pathological changes were diagnosed at the beginning of development, and the treatment was chosen correctly, then it is quite possible that the problem can be completely eliminated.

Hydrocephalus in children

Congenital hydrocephalus is quite common. It develops as a result of:

• anomalies and malformations. Their formation occurs during fetal development under the influence of various factors. These may be infectious processes that the mother suffered during the laying of the brain. Pathology most often develops after rubella, herpes, cytomegalovirus infection;
• the use of alcoholic beverages, narcotic substances and smoking by a woman during the period of bearing a child;
• intracranial injury received during childbirth. In this case, hemorrhage can occur in the subarachnoid spaces of the brain or inside the ventricles. The chances of developing pathology increase if the baby is born with a low body weight and prematurely.

Hydrocephalus in children can be acquired. This happens as a result:

• inflammatory processes;
• tumors in brain tissue;
• skull injuries;
• rupture of malformations.

The pathological process in infants has slightly different manifestations than in other children. The main manifestation is an increase in the head. Since up to two years the bones have not yet grown together tightly and are quite elastic, under the pressure of the cerebrospinal fluid they diverge, and the seams between them increase. The fontanel can also bulge and pulsate if the pressure has increased significantly.

At the same time, the child does not sleep well, cries a lot, spits up profusely after feeding.

The disease in children can be treated conservatively and surgically. The first option is suitable if the disease has an open and non-progressive form.

To improve the flow of CSF, the child is prescribed diuretics and drugs to improve blood circulation. If they do not give results, then they can perform surgery. Usually, liquor shunting operations are performed. During the procedure, systems of tubes and valves are installed, with the help of which the cerebrospinal fluid is removed to the abdominal cavity, atrium, and small pelvis. The procedures are quite traumatic, but they give a chance for a normal life, as they prevent violations of physical or intellectual development.

The impact of the disease on the mental development of children depends on many factors. In 30% of children who have undergone pathology, there are violations of speech function. In 20% of cases, patients find it difficult to express joy, happiness, and other positive emotions. There is also a delay in the reaction.

If surgery is performed at the last stage of the development of the disease, then psychomotor disorders may develop. Although there are cases when mental development is not disturbed.

Most children after hydrocephalus grow up benevolent, normally communicate with people around them. Only a small part of children suffer from depression, grow up gloomy and cruel.

If attacks of increased intracranial pressure persist, then the patient may suffer from psychosis and confusion.

Disease prevention

The occurrence of dropsy of the brain in both adults and children can lead to disability or death, so every effort should be made to prevent this. To reduce the risk of developing the disease, you can use the following recommendations:

• a woman during the period of bearing a child should lead a healthy lifestyle and closely monitor the state of her body and the course of pregnancy;
• it is important to timely treat all infectious pathologies that can contribute to the development of hydrocephalus;
• it is necessary to try to avoid head injuries, as they can also give impetus to the development of pathology;
• in everyday life you need to be careful, avoid collisions and falls.

Hydrocephalus is not so easily cured. Especially if the therapy was carried out at the advanced stages of the development of the disease. There are chances of recovery if you notice the development of pathology in the initial stages and take measures to eliminate it. Treatment options should be selected only by a qualified specialist, self-medication in such cases is unacceptable. It can lead to death.

Mixed replacement hydrocephalus is a pathology that is often diagnosed during magnetic resonance imaging of the brain in the elderly. Patients do not always understand what is happening to them and what danger the detected disease poses, so we will understand the causes, mechanisms of development and features of the course of the disease in question.

Hydrocephalus (dropsy of the brain) is a severe pathological condition in which cerebrospinal fluid accumulates in the liquor-containing spaces of the brain.

Why does hydrocephalus develop?

Liquor (liquid that bathes the brain and spinal cord) is formed by the cells of the membrane of the ventricles of the brain. From the ventricles, this fluid penetrates into the space located under the arachnoid membrane of the main organ of the central nervous system. In the subarachnoid space, CSF is absorbed into the venous bed. The uninterrupted functioning of the system of formation and resorption of cerebrospinal fluid ensures the constancy of its volume. If the work of this system is disrupted, hydrocephalus occurs. Depending on the origin, mechanisms of development and the place of fluid accumulation, the following types of hydrocephalus are distinguished:

• congenital and acquired.
• Occlusive (associated with blockage of the channels through which the CSF circulates).
• Hypersecretory (accompanied by excessive formation of cerebrospinal fluid).
• Dizresorptive (caused by impaired absorption of cerebrospinal fluid).
• Acute and chronic.
• Internal and external.
• Hyper-, hypo- and normotensive.

In addition, there is another form of pathology - substitution hydrocephalus. It stands apart from all other varieties of the disease in question due to the fact that the mechanisms of its development are not associated with a violation of the circulation of the cerebrospinal fluid.

Replacement hydrocephalus: what is it?

The name of the pathology speaks for itself:

• replacement, because the brain tissue is replaced by cerebrospinal fluid;
• mixed, because the ventricles and subarachnoid space expand.

With this type of hydrocephalus, the amount of cerebrospinal fluid remains normal, but the volume of brain tissue decreases. In this regard, some researchers tend to believe that it is not entirely correct to attribute this pathological condition to dropsy of the brain. Diseases in which substitution hydrocephalus develops:

• Atherosclerosis.
• Arterial hypertension.
• Chronic alcoholism.
• Pathological change in the cervical spine, which is accompanied by compression of the vertebral arteries.
• Autoimmune diseases of the connective tissue and blood vessels.

With all these ailments, a chronic violation of cerebral circulation develops and, as a result, a gradual atrophy of the medulla. The vacant space in the subarachnoid space is filled with cerebrospinal fluid.

Symptoms of the disease

If atrophy and hydrocephalus are moderate, there may be no pronounced neurological symptoms for a long time. With the progression of the disease, signs of dyscirculatory-dystrophic damage to the brain appear:

• headache;
• frequent dizziness;
• distraction;
• "noise in the head";
• memory impairment;
• sleep disorders;
• various mental disorders.

In severe advanced cases, a person becomes disabled, because he absolutely cannot control his actions. Moreover, the cause of this condition is not hydrocephalus at all, but atrophic processes in the brain.

Treatment

Medical care for patients with hydrocephalus replacement consists in the treatment of the underlying disease and the correction of cerebral circulatory disorders. Patients are usually prescribed:

• Vasodilator drugs. Choose drugs that act selectively on the vessels of the brain.
• Antihypertensive drugs, if there are problems with blood pressure.
• Diuretic drugs if there are signs of increased intracranial pressure.
• Neuroprotectors. These drugs protect the nervous tissue from harmful effects and further destruction.
• Psychotropic drugs to reduce the severity of mental disorders.

Patients and their relatives should understand that it is impossible to restore brain tissue. If atrophic changes have occurred, it is no longer possible to return normal anatomy and functionality to the main organ of the central nervous system. But do not despair, with the help of modern therapy, the doctor can improve the patient's condition and stop the progression of the disease.

In many patients, replacement hydrocephalus remains until the end of life. At the same time, if changes in brain tissues are not critical, people can work and serve themselves. The main thing in such situations is to prevent the deterioration of the course of the underlying disease: take medications that normalize blood pressure, lead a healthy lifestyle, eat right, and be regularly examined by a neurologist.

Under normal conditions, CSF constantly circulates in the brain, supplying soft tissues with nutrients. As a result of adhesions, tumors and other disorders, the flow or outflow of fluid increases.

Hydrocephalus of the brain occurs due to excessive filling of the ventricles. An increase in the volume of the cavities leads to an increase in pressure on the brain tissue, thinning of the walls and subsequent rupture of the ventricles. The disease is accompanied by neurological disorders and complications.

What is dropsy of the brain

Circulation disorders lead to the accumulation of cerebrospinal fluid and, as a result, the development of dropsy, a neurological disease. Depending on the etiology, it is customary to distinguish between acquired and congenital hydrocephalus.

Types of dropsy of the brain

To date, it has been clinically proven that although hydrocephalus mainly occurs in newborns, it can also occur in adults.

According to the clinical manifestations, disorders in the circulation of the cerebrospinal fluid are usually divided into the following groups:

Regardless of the etiology of dropsy, it is a dangerous neurological disease with characteristic disorders of the hemispheres, difficulty in thinking and perceiving information. It is extremely important to diagnose the pathology at an early stage and prevent its development.

Causes of hydrocephalus

In a normal state, the inflow and outflow of fluid is in equilibrium. CSF circulation performs its function and does not affect the patient's well-being.

Disorders due to trauma, tumor development, past infectious diseases and congenital factors lead to an increase in intracranial pressure. If normotensive hydrocephalus is observed, then the pressure remains normal, only the internal ventricles increase. In this case, a violation of some functions of the brain is diagnosed. External and mixed dropsy is accompanied by skull deformity, increased pressure in the cranial cavity, and neurological manifestations.

The disease is often the result of a stroke and an intracerebral tumor of a malignant and benign nature.

What are the manifestations of dropsy

1. Headache.
2. Nausea.
3. Vomit reflexes.
4. Violations of visual functions.
5. Change in the anatomical position of the eyeballs.
6. Problems of the vestibular apparatus.
7. Psychical deviations.

Since the first signs of dropsy are well disguised as other neurological diseases, a neuropathologist will prescribe additional types of examination to determine the exact diagnosis:

• brain MRI- the optimal diagnostic method for determining deviations in the structure of soft tissues. The image obtained by a tomograph clearly shows the localization of pathological formations.
  With the help of tomography, it is also possible to determine the catalyst for violations. In children under one year old, neurosonography is an alternative to MRI.
• Examination of the fundus.
• Puncture - the diagnosis of hydrocephalus for children under 3 years of age is complicated by the fact that during the analysis there is a need to use general anesthesia.

Without instrumental diagnostic methods, it is almost impossible to make an accurate diagnosis at an early stage in the development of dropsy.

What is dangerous hydrocephalus for humans

• The baby has increased excitability, lack of normal sleep, increased muscle tone. One of the most negative manifestations is developmental delay, as well as mental abnormalities.
• Preschoolers suffer from aggressiveness, hysteria, stuttering, strabismus, and mental and emotional retardation.
• Schoolchildren complain of memory loss, headaches, neuropathic disorders. As a rule, studying at school is quite difficult. Even simple tasks are challenging.
• Adults - benign hydrocephalus manifests itself in the development of epileptic manifestations, nervous excitability, psycho-emotional disorders and hallucinations. Malignant formations, due to the complexity of therapy, often end in death.
  The danger of hydrocephalus of the brain in adults mainly lies in the development of mental abnormalities and disorders of motor skills, motor functions. Without timely treatment, disability occurs.

Hydrocephalus of the brain in adults

In adults, disturbances in the circulation of cerebrospinal fluid are caused mainly by secondary factors:

1. Strokes.
2. Injuries.

Internal cerebral hydrocephalus in adults has a favorable prognosis. It is often diagnosed after the CSF circulation has returned to normal. Diagnosed by dilated ventricles.

Dropsy of the brain in children

The development of children with dropsy is extremely difficult due to psycho-emotional and neurotic problems. It is difficult for a child to concentrate, to adapt in society.

Congenital pathology is accompanied by an increase in the size of the skull to almost 50%. The causes of the development of disorders are genetic abnormalities, meningitis, hemorrhage. An increase in the volume of cerebrospinal fluid is accompanied by:

1. Capriciousness.
2. Bad appetite.
3. Change in skin tone.
4. Excessive opening of the eye.
5. Change in gaze direction.

How is hydrocephalus treated?

Along with medical methods of therapy, massage is widely used. Dropsy affects the occurrence of increased muscle tone. Stroking, rubbing - helps to relax muscle tissue and restore normal motor functions.

Manual therapy is another effective method of treatment used along with a course of medication. The beneficial effect is aimed at activating the body's own reserves. Good results are especially achieved in the case of secondary hydrocephalus.

Medicines for dropsy, drug therapy

Treatment of external hydrocephalus of the brain in an adult in the acute stage is associated with the following drugs:

With the help of medicines, it is possible to stabilize the patient's condition and prepare him for surgery.

Brain shunting for hydrocephalus

The essence of bypass surgery is to install a permanent drain to drain excess cerebrospinal fluid into internal areas for which volume increases are not so critical. The success of surgical intervention is achieved in 85% of cases.

The consequence of shunting is the complete cure of the patient and the return to normal life. After a certain period of time, a partial or complete replacement of the shunt is required.

Endoscopic treatment of dropsy

Neuroendoscopy of the brain is performed using microsurgical instruments. They are introduced into the localization of the accumulation of cerebrospinal fluid using an endoscope.

The symptoms and treatment of substitutive hydrocephalus of the brain are interrelated. So, with a constant increase in the intensity of the symptomatic manifestation, it can be confidently diagnosed that the tumor or cystic formation continues to grow in size and blocks the outflow or inflow of cerebrospinal fluid. After removal of the tumor, the patient's condition improves almost instantly.

Replacement dropsy occurs due to the development of a malignant and benign tumor. It is strictly forbidden to treat the last neoplasms with the help of endoscopy. The decision on how to treat cerebral hydrocephalus in adults is decided by the neurosurgeon, after a complete examination of the patient and determining the causes of the pathology.

Folk remedies for hydrocephalus

The following decoctions are traditionally used:

• Diuretic herbs - for collection, you will need to take two tablespoons of a dry composition, consisting of approximately equal parts of bearberry, oregano and parsley.
• Juniper berries have a similar effect. Two teaspoons of juniper fruit are poured with boiling water and allowed to brew in a thermos.

Diet for dropsy of the brain

Strictly contraindicated:

• Fresh baked goods.
• Fatty varieties of poultry and meat.
• Smoked products.
• Sausages.
• Confectionery.

Instead of "harmful" foods, it is recommended to introduce a large amount of vegetables and fruits into the diet, except for sorrel, garlic, onions and radishes. Steamed meat, stale bakery products, well-boiled cereals are allowed.

A healthy lifestyle with dropsy, moderate exercise, walks in the fresh air contribute to the recovery of the patient and the maintenance of his mental and mental form. With psychoneurotic manifestations, such activities help reduce irritability and stress.

Dropsy of the brain is a serious neurological disorder that does not go away on its own and requires careful and qualified treatment. The advanced stages are practically not amenable to treatment. It becomes quite problematic to stabilize the patient's condition. If congenital dropsy is diagnosed, the child needs lifelong follow-up with a specialist.

Hydrocephalus, which is also commonly defined as dropsy of the brain, is a disease in which there is an increase in the volume of the ventricles in the brain, and often to a very impressive size. Hydrocephalus, the symptoms of which are manifested due to excessive production of cerebrospinal fluid (cerebrospinal fluid between the communicating ventricles of the brain) and its accumulation in the area of ​​\u200b\u200bthe brain cavities, mainly occurs in newborns, but this disease has a place in the incidence of other age categories.

general description

In the normal state, the substance of the spinal cord and brain is constantly washed with cerebrospinal fluid (cerebrospinal fluid). The cerebrospinal fluid is colorless, has a transparent appearance and simultaneously performs several functions, the main of which include protecting the brain and providing it with additional nutrition. From the outside, CSF circulation occurs between the choroid and the pia mater along the cerebellum and the surface of the cerebral hemispheres. This space is defined as subarachnoid.

The base of the skull under the brain has additional places where fluid accumulates, they are defined as "cistern". These tanks, when connected in different directions, make the transition to the CSF subarachnoid space of the brain, in addition, they are also connected to the spinal subarachnoid space, in which the spinal cord is washed with cerebrospinal fluid from the cervical to the lumbar.

The location of the cerebrospinal fluid in the brain is concentrated in its ventricles, of which there are several - in the cerebral hemispheres there are two lateral ventricles, along the midline - the third. Somewhat lower, through a thin channel located in the brain stem, fluid passes to the fourth ventricle, which is already located between the cerebellum and the brain stem. This ventricle, through two lateral openings, connects to the cisterns at the base of the brain and passes below to the central canal belonging to the spinal cord, after which it spreads down to the lumbar region.

In total, the volume of cerebrospinal fluid in a person is about 150 ml, and during the day it undergoes a complex renewal three times. As for the factors of formation and absorption of this fluid that are of interest to us, which are directly related to hydrocephalus, it can be noted here that in the normal state, the indicators of these processes correspond to the level of dynamic equilibrium. Accordingly, at any time, a practically constant volume of cerebrospinal fluid and the pressure exerted by it are maintained.

The excess accumulation of cerebrospinal fluid is ensured by meeting two main conditions - a violation in the circulation of the liquid and an imbalance in the formation-absorbability, in which, against the background of a standardly produced liquid, its absorption is much less. Thus, both of these mechanisms act as the leading factors in the occurrence of hydrocephalus and its development.

Hydrocephalus: the main forms of the disease

In the practice of the course of the disease, the following forms are distinguished:

• General hydrocephalus. It is characterized by an increase in the content of cerebrospinal fluid in the subarachnoid space and ventricles of the brain.
• Internal (ventricular). It is characterized by excessive content of cerebrospinal fluid in the ventricles.
• external hydrocephalus, the symptoms of which are infrequent, characterized by the presence of an excessive content of liquor in the subarachnoid space, while at the same time normal indicators of its content in the ventricles. Development occurs ex vacuo as a result of brain atrophy.

Internal hydrocephalus: symptoms

This type of hydrocephalus, resulting from excessive accumulation of CSF in the cerebral ventricles, can manifest itself in congenital or acquired form. The development of this type of hydrocephalus begins as a result of a malformation of the central nervous system, serious injuries, inflammatory processes, or the growth of neoplasms that are concentrated in the area of ​​\u200b\u200bthe meninges. The current course of the disease implies a sharp dilatation in the system of cerebral ventricles, as well as thinning of the medulla.

The development of internal hydrocephalus is also possible in a situation in which the brain, due to atrophy or during fetal development, began to occupy a smaller volume in the cranium. This, in turn, leads to the filling of the empty space with CSF.

Focusing directly on the symptoms, first of all, one can note an increase in intracranial pressure, which is accompanied by severe headaches, as well as nausea and vomiting, visual and hearing impairments. In this form, young children experience disorders in the form of bulging and tension of the fontanel with constant tilting of the head to the back and displacement of the eyeballs downwards.

Based on the specific cause that contributes to the appearance of internal hydrocephalus, a change in symptoms is possible. The disease can occur in a chronic or acute stage. For acute, the symptoms of the underlying disease are characteristic, against which hydrocephalus arose. The chronic stage is characterized by manifestations of hydrocephalus itself, the course of which is complicated in the absence of the necessary treatment.

External replacement hydrocephalus: symptoms

Hydrocephalus itself is a disease that occurs due to disturbances in the work of the central nervous system, but if defined more precisely, it is due to an incorrect absorption process of the cerebrospinal fluid filling the intracranial box. Both infants and older people are equally susceptible to the disease, despite the difference in causes. It should be noted that hydrocephalus is an extremely dangerous and complex disease, which, accordingly, excludes the possibility of negligent treatment of it.

The course of hydrocephalus can occur in an open or closed form, which determines the differences in symptoms. One of the forms of the disease is external hydrocephalus of the brain, the symptoms of which, in particular, manifest themselves in the form of a decrease in the volume of the brain and in the filling of the space previously filled with brain cells with cerebrospinal fluid. It is noteworthy that this form differs from other varieties of the disease. So, replacement hydrocephalus, the symptoms of which may not appear for many years, due to the filling of the empty space with liquid, proceeds, respectively, without the characteristic headaches and increased blood pressure.

Older people are faced with hydrocephalus mainly against the background of their existing or. In addition, the diagnosis of the disease is possible as a result of processes caused or excessive alcohol abuse. Hydrocephalus in general can be relevant in the constancy of its own course or in the progression of the course.

Hydrocephalus in adults: symptoms

Pathogenesis (features of the course and development of the disease due to the action of specific mechanisms) determines hydrocephalus in its following varieties:

• Hydrocephalus occlusive (non-communicating, closed). In this case, the outflow of cerebrospinal fluid is disturbed due to the closure of the pathways for this. As the reasons for the closure, a thrombus, a tumor, or an adhesive process that has arisen against the background of inflammation is determined. When blockage occurs within the cerebral ventricles, a secretion is produced proximal form, in case of blockage within the basal cisterns - distal form.
• Hydrocephalus communicating (dysresorbative, open). The reason for the appearance is based on violations in the processes of absorption of cerebrospinal fluid into the venous system, which occurs as a result of violations of the work of specific structures.
• Hydrocephalus hypersecretory. It is formed due to excessive production of cerebrospinal fluid, for example, as a result of papilloma formed in the choroid plexus.

In addition, hydrocephalus of the brain, the symptoms of which are manifested in adults, is also divided into an acute form - the interval between the moment of development of the disease and the occurrence of phenomena characteristic of decompensation is no more than 3 days. For the subacute form, this interval is defined as a month, for the acute form, respectively, more than a month.

As for the symptoms, there are manifestations indicating an increase in intracranial pressure: headaches, nausea / vomiting, stagnation in the optic nerve head (vision is suppressed), displacement along the axis of the brain, drowsiness. Upon awakening, the headache is most severe, which is associated with an increase in intracranial pressure during sleep. Nausea/vomiting is also most intense in the morning, in some cases, their completion leads to a decrease in headache. The most dangerous symptom is drowsiness, which acts as a harbinger of the onset of neurological disorders of a serious scale.

The specified symptomatology is characteristic to a greater extent for the acute form. In relation to chronic, a slightly different picture of manifestations can be noted. In particular, this includes changes in sleep patterns (drowsiness during the day, disturbed night sleep), which subsequently manifests itself in general constant fatigue. Passivity of patients, their lack of initiative is noted. Short-term memory is subject to disturbances, especially with regard to numerical information.

Further, there are intellectual violations of gross specificity, which may even exclude the possibility of self-care of patients, inadequacy in answers to questions. There is also apraxia of walking, in which in the supine position the patient can imitate cycling or walking, and in an upright position these movements are sharply disturbed. Among the non-permanent and late symptoms, urinary incontinence is also distinguished.

Hydrocephalus in newborns: symptoms

In this case, the disease manifests itself similar to the previous variants of the specificity of occurrence. The only thing is that newborns have 15-20 ml of cerebrospinal fluid, by the age of 12 months its volume is about 35 ml. Hydrocephalus as a whole is accompanied by an increase in the volume of cerebrospinal fluid up to 1.5 liters. It is noteworthy that its formation in children is more intense than in adults - renewal can reach 8 times / day.

Hydrocephalus in children, the symptoms of which are manifested under the influence of a number of reasons, during the intrauterine formation of the disease, completely excludes the possibility of their reliable determination. Due to this disease, a characteristic deformation of the skull occurs, there is a significant predominance of the brain section over the facial section. At the same time, the forehead protrudes strongly, and venous superficial vessels are determined on the temples. Babies experience a strong expansion of the fontanelles, which are closed due to this very late. Among other things, the symptom of the so-called "setting sun" is relevant, accompanied by a shift of the eyes upward, where they hide under the eyebrows.

The beginning of head growth occurs at the stage of intrauterine development, in connection with which childbirth is subsequently difficult. Also, there are symptoms in the form of manifestations from the nervous system: trembling of the hands and chin, as well as other parts of the body, disturbance in the movements of the eyeballs, convulsions. Often, symptoms of the nervous autonomic system (blanching of the skin, arrhythmias, etc.), symptoms of increased intracranial pressure (headache, nausea / vomiting, drowsiness) also join. The progression of hydrocephalus is characterized by retardation in the development of children, poor retention of the head and passivity. The asymptomatic course of the disease is also possible, which leads only to its accidental detection.

Diagnosis of hydrocephalus

In diagnosing the disease, the leading role is played by computer or magnetic resonance imaging. Through these studies, an assessment is made of the state of the cerebral ventricles, as well as the subarachnoid spaces, their size, degree of deformation, location, etc. It is only when conducting these studies by highlighting hydrocephalus and its features that it is possible to determine adequate therapy.

Treatment of hydrocephalus

When diagnosing a disease at an early stage, the possible effectiveness of drug therapy is determined. Meanwhile, if hydrocephalus continues to progress rapidly, urgent surgical intervention will be required. Previously, shunting was the only common method in it, but this required, due to the imperfection of the shunts, their systematic replacement.

An endoscopic third ventriculostomy (ETV) is also applicable, in which an opening is made in the cerebral ventricle, through which the cerebrospinal fluid subsequently drains. With a congenital form of hydrocephalus, this method is applicable in case of unsuccessful shunting or infection in its process. Now this method is not as effective as compared to other possible options, it is prescribed to children from 6 months.

Innovative surgical methods are applicable in the treatment of the disease, for example, neuroendoscopy - an operation using a neuroendoscope equipped with a mini-camera, by obtaining an image from which the fluid is drained by doctors.

With any form of hydrocephalus, a visit to a neurologist is necessary.

Moderate external hydrocephalus is a mild degree of the disease in which the brain decreases in size, and cerebrospinal fluid takes its place. Liquor accumulates in the subarachnoid and subdural space. This comes with some symptoms.

Symptoms

The replacement of functionally active nervous tissue (neurons and conductive fibers) with cerebrospinal fluid does not go unnoticed. Signs of moderate external hydrocephalus:

1. Nausea, vomiting.
2. Migraine-like headache, worse lying down.
3. Vision problems (double vision).
4. Asthenic syndrome: fatigue, weakness.
5. Movement disorders: disorder of coordination of movements, gait, convulsions.
6. Mental retardation, memory loss.
7. Loss of control over urination, defecation.
8. In newborns, the appearance of dilated veins on the head, the divergence of the sutures between the bones of the skull, and a decrease in appetite are possible.

Classification and causes of external hydrocephalus

There are several types of moderate external dropsy of the brain:

1. An open form of moderate external hydrocephalus. There are no obstacles (occlusion) for the outflow of fluid in the CSF pathways, it circulates freely, although the intracranial pressure is increased.
2. closed form. CSF circulation is disturbed due to obstruction (occlusion). Intracranial pressure may be normal or decreased.
3. Hypersecretory. There is an increase in the production of liquor.
4. Substitutive. Nervous tissue is replaced by cerebrospinal fluid.

There is an acute, subacute and chronic course, which differs in duration: up to 3 days, a month, more than 3 weeks, respectively.

The open, or non-occlusive, form is usually caused by inflammatory diseases of the central nervous system (encephalitis). There is an increase in the activity of hyaluronidase and proteolytic enzymes, which increase the permeability of blood vessels due to the formation of micropores in them, through which plasma fluid seeps from the blood.

Liquor in the spaces between the hard, arachnoid, soft shells becomes more and more, respectively, the intracranial pressure increases. Intrauterine and others (rubella, herpes virus, Epstein-Barr, toxoplasmosis) make a significant contribution to the development of pathology.

Substitutive dropsy occurs when there is a violation of the blood supply to the brain (atherosclerosis) and drying of gray, white matter in toxic lesions (alcohol, heavy metals). Pathology develops with Alzheimer's disease, amyloidosis, autoimmune damage. The free space is filled with liquid. Possible post-traumatic decrease in the volume of brain tissue.

Diagnosis and treatment

The following methods are used to check the brain:

1. Echo and electroencephalogram, neurosonography in newborns.
2. REG, ultrasound dopplerography of cerebral vessels.
3. Magnetic resonance imaging.

Treatment of moderate external hydrocephalus involves drug therapy:

1. The use of diuretics, potassium, magnesium salts to replenish the water and electrolyte balance, relieve edema, reduce intracranial pressure.
2. Anticonvulsant therapy, taking anticonvulsants.
3. Appointment of neuroprotectors: Cytoflavin, Cerebrolysin.
4. Antihypoxants () to increase the resistance of neurons to adverse factors.
5. Angioprotectors: Aescusan, Diosmin, Troxevasin.
6. Means that improve cerebral circulation: Cinnarizine, Cavinton, Vasobral, Nicergoline.
7. With neuroinfections: antibacterial drugs, antiviral (Acyclovir, Ganciclovir).

Diuretic drugs Mannitol, Furosemide, Diakarb quickly remove swelling of the brain, reducing intracranial pressure and eliminating seizures with moderate hydrocephalus. Glycerin is also used as an osmotic agent that draws excess moisture from the interstitium (intercellular space) and neurons. To replenish potassium reserves, Asparkam is prescribed.

Exudation during inflammatory processes is reduced by angioprotectors that reduce the permeability of the vascular wall induced by hyaluronidase and proteolytic enzymes. This is Askorutin or Troxerutin.

With intracranial hypertension, it is recommended to sleep on a high pillow to improve the circulation of CSF. Less sodium should be consumed in the form of table salt. It exacerbates puffiness, contributing to water retention.

In Alzheimer's disease, memory-improving drugs (the cholinergic drug Neuromidin) should be used, which increases the supply of acetylcholine in the nerve endings. They optimize the intellectual processes affected by the death of neurons.

Nootropic drugs help mental activity with moderate hydrocephalus replacement: Encephabol, Piracetam, Noopept, Glycine, Glutamic acid.

B vitamins improve the overall functioning of the central and peripheral nervous system. Pyridoxine increases the synthesis of dopamine in existing cells, which is important after the death of neurons in strokes, atherosclerosis.

Lipoic and nicotinic acid are used to stop the progression of atherosclerotic lesions in moderate hydrocephalus replacement. They lower cholesterol levels. Vitamin B3 dilates constricted blood vessels.

A moderate degree of external hydrocephalus is treatable if it is started in a timely manner. The exception is substitutive dropsy, in which the tissues have already died and cannot be restored, doctors are fighting to preserve the existing functions. With occlusion, surgery is indicated.