Severe internal hydrocephalus. When to see a doctor. Hydrocephalus in newborns

Dropsy of the brain is the accumulation of fluid in the ventricles of the brain. Excess CSF puts pressure on the ventricles, increasing its volume and the size of the skull. As a result, the shape of the head changes. Increased CSF pressure can damage the brain tissue and cause a variety of violations of its functions and a delay in the development of the child.

Hydrocephalus of the brain can develop in people of any age, but it is most common in infants and the elderly. An operation that restores and maintains a normal amount of cerebrospinal fluid can help the patient. Physiotherapy methods, medicines, physiotherapy and other ways to restore impaired brain functions. Severe pathology in a newborn child requires urgent surgical intervention.

The disease in newborns occurs in 1 case per 500 births. It is difficult to estimate its prevalence among adults; such records are not kept. However, many patients with elevated intracranial pressure may have this disease.

The causes of the disease are completely unknown. Main risk factors:

hereditary genetic anomaly, leading to a narrowing of the outflow of cerebrospinal fluid;
neural tube malformations, such as spina bifida or anencephaly;
intrauterine infections (herpes, toxoplasmosis, cytomegaly);
premature birth complicated by intraventricular hemorrhage in the fetus;
disease nervous system: meningitis, brain tumors, trauma, hemorrhage in the subarachnoid space in hemorrhagic stroke.

All these conditions disrupt the free circulation of cerebrospinal fluid around the brain or its absorption into the venous bed.

Signs of pathology

Symptoms of the disease depend on the age of the patient, the severity of the pathology, as well as individual differences. For example, a child's ability to compensate for ventricular expansion differs from that of an adult. The skull of an infant under the influence of increased intracranial pressure expands as its sutures are not closed yet.

Signs of hydrocephalus in the congenital form of the disease:

rapid increase head or its size is too large;
vomit;
drowsiness, lethargy;
restlessness, prolonged crying;
rolling eyes down;
convulsions.

The appearance of the child acquires characteristics: the bones of the skull become thinner, the seams are expanded, the forehead is disproportionately large, the eyebrows hang over the eyes. The fontanel bulges, the veins on the scalp are clearly visible. There may be divergent strabismus, increased tone muscles.

In adults, the space inside the skull cannot increase. Their pathology is accompanied by such manifestations:

headache;
vomiting, nausea;
blurred or double vision, blurred vision (this condition develops due to swelling optic nerve);
rolling eyes down;
imbalance, gait;
urinary incontinence;
retardation of development;
lethargy, drowsiness, irritability;
personality changes, including memory loss.

signs outer shape diseases:

gait disturbance;
increased urination or urinary incontinence;
progressive dementia or mental disorders;
slow movements, weakness in the legs.

Often these symptoms appear due to the expansion of the cavities of the ventricles during atrophy of the brain substance caused by a stroke, tumor, trauma in adults. Required differential diagnosis with Parkinson's, Alzheimer's and Creutzfeldt-Jakob disease.

Hydrocephalus in children

Hydrocephalus of the brain in a newborn develops with wrong development nervous system due to genetic abnormalities, intrauterine infections, complications during childbirth. The cavities of the brain expand under the action of CSF pressure, the size of the head increases, its shape changes. Arise neurological disorders, but even earlier, convulsions and disruption of the heart appear.

Hydrocephalus in a child is often accompanied by endocrine diseases:

growth retardation;
underdevelopment of the genital organs;
not diabetes;
obesity;
hypothyroidism.

There are cases of hyperkinesis (tics, involuntary movements), lower paraparesis (weakness and lack of movement in the legs), impaired coordination of movements. If the operation is not performed on time, these disorders will steadily progress. When treatment is started in a timely manner, the disease does not threaten the life of the child.

Hydrocephalus in adults

Dropsy of the brain, or hydrocephalus in adults, leads to mental disorders, changes in gait, loss of control over urination and other pathological conditions.

There are several forms of the disease. External pathology in an adult, it is characterized by a retention of cerebrospinal fluid in the space under the membranes of the brain and compression of its tissues from the outside. If fluid accumulates in the cavities of the ventricles, it causes them to stretch. There is also a mixed form of pathology.

This chronic process accompanied by an increase in intracranial pressure. The first sign of the disease is a change in gait. It can occur acutely, against the background of normal health. Other symptoms develop after a few months.

The patient hardly takes the first step when walking, in the future he can simply stagnate. Hand movements are also difficult. Subsequently, the balance is disturbed, muscle tremor, sometimes the patient falls. AT severe cases he cannot sit, walk, or even get out of bed.

As a result of the disease, mental disorders occur. Are blunted emotional reactions, there is apathy, loss of sense of time. There are seizures and even hallucinations.

Moderate brain pathology in an adult is accompanied by frequent urges to urination, which is gradually replaced by urinary incontinence.

The listed 3 signs are the main symptoms of pathology in adults. Vomiting is not typical for them. The presence of this triad should alert the doctor. The patient is referred for a brain tomography.

Neurosurgery is performed to relieve symptoms and slow the progression of the disease. During it, the surgeon installs a shunt in the desired area of the brain, through which excess liquor is removed from the ventricles and spaces under the membranes.

Some patients are prescribed drugs that stop over-education cerebrospinal fluid.

moderate hydrocephalus

This condition usually occurs as a complication of strokes, trauma, meningitis, or brain tumors. The mild form of the disease is most often recognized after additional examination patient. The course of the disease is not accompanied by severe symptoms.

Moderate external hydrocephalus is accompanied by an increase in pressure in the cranial cavity and compression of its tissues. Cerebral manifestations are possible - headache, nausea and vomiting. With a stable or regressing form of pathology, drug treatment. If the severity increases, surgery is indicated.

Replacement hydrocephalus

With a decrease in brain volume, a substitution form of the disease develops as a secondary condition. It can occur in children, but is more common in adults. In children, the causes of congestion spinal cerebral fluid in the dilated ventricles, there may be congenital anomalies in the development of the brain. In older people, atrophy of the brain tissue occurs due to infections, malnutrition, circulatory disorders. Pathology can occur with normal or increased intracranial pressure.

Diagnosis of pathology is based on data on past illness brain, neurological examination and tomography parameters. Since the symptoms of the disease are secondary, surgery is usually not required, medications are prescribed. The operation is performed only with a significant violation of the outflow of cerebrospinal fluid.

Mixed hydrocephalus

With the accumulation of cerebrospinal fluid both in the ventricles of the brain and in the subarachnoid space, mixed hydrocephalus. It develops in people of any age and is manifested by a combination of signs of external and internal forms of pathology.

In children, hype is accompanied by an increase in head size and neurological disorders. In adults, it can appear acutely, for example, after an injury. Surgical treatment.

Internal hydrocephalus

With the accumulation of excess CSF in the cavities of the ventricles of the brain, internal hydrocephalus develops. It occurs when malabsorption of cerebrospinal fluid or as a result of deterioration of ventricular shunting.

inner form diseases are often accompanied by increased intracranial pressure, headache, nausea, neurological disorders. It can be congenital and acquired (after injuries, infectious diseases). Treatment of pathology is surgical.

Non-occlusive hydrocephalus

Communicating, or non-occlusive hydrocephalus, is caused by impaired absorption of CSF by the villi of the arachnoid membrane of the brain. It is usually a complication of meningitis. It also happens with excessive formation of cerebrospinal fluid due to a tumor of the choroid plexus. Examination reveals enlarged subarachnoid spaces.

The course of the disease is more favorable, since the normal flow of cerebrospinal fluid between the ventricles is maintained. However, with a long process in the body, changes occur that are characteristic of a severe form of the disease - neurological symptoms, visual disturbances, gait, headache. With this form of the disease, surgical intervention is necessary.

Occlusive hydrocephalus

The condition in which the circulation of cerebrospinal fluid from the ventricles under the membranes of the brain stops is occlusive hydrocephalus. Cerebrospinal fluid is not absorbed, the development of dropsy of the brain. Pathology caused congenital anomaly brain structures. In adults, it can be caused by a tumor, trauma to the skull, or another neurological disease. Treatment of pathology is only surgical.

Diagnosis of the disease

With symptoms of pathology, you need to contact a neurologist. Diagnosis of hydrocephalus begins with determining the age of the patient, his complaints, assessing the circumference and shape of the head. A neurological examination is carried out, including the diagnosis of the syndrome intracranial hypertension. The doctor determines whether acute or chronic course has a pathology, whether it was preceded by an infection (meningitis) or trauma. Appointed spinal tap and analysis of cerebrospinal fluid, an increase in intracranial pressure is recognized. An ophthalmologist is consulted.

Additional Methods diagnostics to clarify the form of dropsy of the brain and the state of its tissues:

tomography (computer or magnetic resonance);
monitoring of intracranial pressure.

The external form of the disease is characterized by an expansion of the intrathecal spaces, the internal form by an increase in the ventricles. The external replacement form of the disease is accompanied not only by an increase in the size of the ventricles, but also by atrophy of the nervous tissue. Depending on the data obtained, the tactics of helping the patient is determined - medical or surgical.

Symptoms of the disease

Signs of pathology depend on the age of the patient.

Symptoms of the disease in infants:

big head;
fast growth skulls;
tense fontanel;
feeding difficulties;
vomit;
lethargy.

Symptoms of hydrocephalus in children:

headache;
blurred vision;
violation of balance and coordination;
nausea, vomiting, drowsiness, behavioral disturbances, convulsions;
learning difficulties.

Symptoms of pathology in adults:

headache in the morning;
loss of balance;
frequent urination;
impaired vision, memory, attention, decreased performance.

Symptoms of cerebral hydrocephalus in the elderly:

urinary incontinence;
disorders of memory and thinking;
shuffling gait;
slow movements, poor coordination.

These signs are caused by a violation of the absorption of cerebrospinal fluid under the membranes of the brain or an obstacle to its normal outflow. The patient needs neurological examination. Health care is to appoint medicines or surgical intervention (bypassing the CSF outflow tract).

Treatment of the disease

Violation of the circulation of cerebrospinal fluid in the cavities of the brain and spaces under its membranes leads to neurological syndromes, vascular disorders. Pressure on the nerve tissue of the child causes a delay in its development. This condition is accompanied by vomiting, headache, muscle dysfunction. The problem may be congenital or acquired, due to a tumor or infectious process. But in any case, the treatment of hydrocephalus of the brain is carried out surgically.

Treatment of the disease includes 2 surgical methods: shunting and ventriculostomy.

One of the indications for shunting is open hydrocephalus, but the operation is used in other forms of pathology. A shunt is a long, flexible tube with a valve that directs CSF from the brain into the abdomen or heart chamber. The shunt is placed under the skin and can be replaced if necessary.

Treatment of the disease in adults and children with impaired outflow from the ventricles is endoscopic ventriculostomy. The surgeon, under video control, using endoscopic instruments, expands the hole in the 3rd ventricle, restoring the normal circulation of CSF.

Additionally, patients need the help of a physiotherapist, social worker, psychologist, teacher (for children with developmental delays).

Treatment external hydrocephalus brain in an adult with her mild degree and the absence of progression can be carried out with the help of drugs, such as diuretics. Neurotropic medications are prescribed to improve brain metabolism. In severe cases, the assistance of a social worker, a specialist in vocational training, psychiatrist.

Treatment of the external form of the disease, as well as the internal one, should begin as early as possible. A timely operation will enable the child to develop normally, and the adult to avoid neurological and mental disorders.

Disease prevention

It is impossible to prevent the appearance of dropsy of the brain. However, the prevention of hydrocephalus helps to reduce the risk of pathology.

The disease in children under one year old is prevented with regular prenatal examination and prevention of preterm birth.

Vaccination against infectious diseases is required. It will protect the body from meningitis, tuberculosis and other dangerous states that can cause a violation of the outflow of cerebrospinal fluid.

To avoid head trauma resulting in occlusal or open form diseases, it is necessary to observe safety measures: transport children in car seats, use non-traumatic devices for care, feeding, and so on. Children and adults must wear a helmet when riding a bicycle, scooter, skateboard, etc.

At the first symptoms of the disease, a neurological diagnosis is necessary. A study of cerebral fluid, ultrasound, tomography is prescribed. The consequences of hydrocephalus are dangerous, therefore it is necessary to carry out surgical intervention in time (bypass or endoscopic surgery) and take prescribed medications.

Video about hydrocephalus

Instruction

The cause of hydrocephalus in a newborn child can be an infection transferred by a pregnant woman (herpes, toxoplasmosis, cytomegalovirus infection). In the fetus, the exchange of cerebrospinal fluid is disturbed and its excessive formation occurs, resulting in increased intracranial pressure. Acquired hydrocephalus develops as a result of head trauma, chronic intoxication, as well as after suffering meningitis and meningoencephalitis, stroke.

An increase in intracranial pressure manifests itself differently in children under 2 years of age and older. In young children, the first symptom is an increase in the size of the head and a change in the shape of the skull. Since the fontanelles are not yet overgrown, the bones of the skull move apart due to the fact that the brain begins to increase in volume. Therefore, it is necessary to regularly measure the circumference of the head of the child, usually this is done by the pediatrician during the examination.

Another symptom of hydrocephalus is a bulging, greatly enlarged and pulsating large fontanel. Normally, it should close by the year, but with this disease, it can remain open for up to 2-3 years. The bones of the skull at the same time become thin, increase frontal part, a vascular network appears on the skin of the face and forehead.

The child begins to lag behind his peers in development, does not hold his head, sits or walks poorly, becomes capricious, whiny and lethargic. In a sick child, muscle tone increases, in severe cases seizures.

In older children, the bones of the skull overgrow, so hydrocephalus has other symptoms. The very first and frequent sign- Headaches accompanied by nausea and vomiting. Attacks of pain and nausea are more common in the morning and at night, not related to food intake. Often these symptoms are mistaken for poisoning, diseases gastrointestinal tract and the child starts receiving the correct treatment too late.

Other symptoms of hydrocephalus are visual disturbances, endocrine disorders (hypothyroidism, stunting, premature sexual development), convulsive seizures of the type of epilepsy, increased muscle tone, poor school performance. The diagnosis is made on the basis of the clinic, examination of the fundus, the most reliable method is MRI (magnetic resonance imaging).

In addition, it is possible to use drugs that promote the excretion of sodium from the body, which increases diuresis and reduces the production of cerebrospinal fluid.

Surgery to normalize intracranial pressure and optimize brain function, however, there may be problems associated with inflammatory complications, hyperdrainage and dysfunction of the drainage systems.

Violation of the processes of formation, movement and absorption of cerebrospinal fluid (cerebrospinal fluid, cerebrospinal fluid) in the human body provokes the development neurological disease – .

Translated from Latin, this means - water in the head, that is, the presence of an excess amount of liquor. Therefore, others medical name pathology is dropsy of the brain.

About liquor and its functional significance

Cerebrospinal fluid is mainly produced in choroid plexuses ventricles of the brain. It fills the ventricular system and the subarachnoid spaces of the brain and moves through them, constantly being updated.

Cerebrospinal fluid protects the brain, softening the effects of external mechanical influences, transports nutrition for nerve tissues, hormones and biologically active substances. It also removes waste from metabolic processes in its cells, stabilizes intracranial pressure, respiratory function.

In addition, it ensures the stability of the environment surrounding the brain (homeostasis), an immunological barrier that prevents the penetration pathogenic bacteria, viruses, tumor cells and others.

Therefore, any changes in the production, circulation and composition of CSF lead to malfunctions in the central nervous system and the occurrence of pathologies.

Excessive accumulation of fluid in the cavities of the ventricles of the brain is called internal hydrocephalus. The disease is most common among children early age especially in the first year of life.

Varieties and forms of internal hydrocephalus

Depending on the causal factors There are two forms of the disease:

open or communicating hydrocephalus resulting from hypersecretion of CSF or a violation of its absorption process;
closed or occlusive hydrocephalus, in which the exit of cerebrospinal fluid from the ventricles is blocked by a tumor, inflammatory, adhesive or other obstruction, this form is severe and is more common in children.

Internal dropsy of the brain can be congenital or acquired. Congenital hydrocephalus occurs in the prenatal period, acquired - in the process of life.

The form of the course of the disease can be:

Acute. with rapid progression of the disease.
subacute. The increase in symptoms continues up to 1 month from the onset of the disease.
Chronic. The development of obvious manifestations of the disease lasts up to half a year.

Moderate internal hydrocephalus is poorly recognized. Diagnosed by chance. Severe symptoms appear when violations of cerebral circulation and brain structure are already significant.

Also, the disease is divided into the following types:

progressive or active dropsy of the brain with a rapid accumulation of cerebrospinal fluid and the severity of symptoms;
stabilized or passive hydrocephalus proceeds without an increase in symptoms over time;
regressive dropsy does not need treatment, the signs of the disease disappear.

There are three stages of the disease:

Compensated. Does not require treatment. The diagnosis is made, the intellect is not changed.
Decompensated. Most often requires surgical treatment.
Subcompensated(partially compensated).

Hypertensive (with increased intracranial pressure) and normotensive (with normal intracranial pressure) dropsy of the brain are determined.

Factors contributing to the development of the disease in children

About 1% of all cases of the disease are diagnosed among newborns, but it can appear before the age of one or in older children.

Causes of congenital internal hydrocephalus:

After the birth of a child, pathology can manifest itself due to such factors:

birth injury or received craniocerebral;
oncological diseases;
inflammation of the brain and membranes;
and hemorrhages in the ventricles;
disturbances in the structure of cerebral vessels;
as the consequences of intrauterine infectious diseases;
genetic disease.

Such a disease will be acquired.

Causes of the disease in adults

Internal hydrocephalus of the brain in adults develops according to the following reasons:

, which are often localized in the cerebellar system;
with cerebral hemorrhage;
not traumatic- due to pathological lesions of the vessels of the brain;
acute cerebrovascular accident(), as a result of which its work is disrupted;
neuroinfections-, and tuberculosis;
drug addiction, alcoholism, diabetes, leading to violations of the formation of cerebrospinal fluid.

Features of the clinical picture depending on age

Hydrocephalus is a disease of this kind that progresses with the age of the patient.

Neurological symptoms of hydrocephalus in children

Manifestations of dropsy in young children and their features:

Symptoms are present from the first minutes of the birth of the child. At closed form respiratory failure may occur.

Children grow up, the disease progresses

In older children, the symptoms of the disease are exacerbated:

irritability with bouts of aggression;
headache;
lethargy;
spontaneous urination;
violations of memory, attention and consciousness;
decreased appetite;
drop in the level of vision to blindness;
convulsions;
impaired coordination of movements;
learning problems;
intellectual disability (mental retardation).

Cases of good mechanical memory, abilities for music and counting have been recorded in sick children.

Characteristic signs of the disease in adults

The main manifestations of the disease are a shaky, unsteady gait associated with disturbances in work. vestibular apparatus, loss of control over urination, memory impairment. It is difficult for a person to walk, he can fall. Dementia does not develop in all cases.

There are notes that do not always relieve pain medications. Vision deteriorates, there is pressure on the eyes.

There may be nausea and vomiting. Dissipation of attention and a decrease in its concentration are noticeable, thinking skills are lost.

Signs of mental disorders are not uncommon - emotional instability, aggression, change of apathy with emotional upsurge. Violations appear motor functions. Paralysis develops, contracture in the joints, or muscle tone increases.

Often, patients do not attach importance to these symptoms, taking them as signs of normal aging.

Methods of treatment

Compensated disease requires observation, sometimes diuretics, drugs aimed at improving cerebral circulation, vitamin complexes are prescribed.

For children, methods of treatment with music, games, physiotherapy exercises are used.

With severe hydrocephalus, drug treatment is prescribed for early stages diseases - they lower intracranial pressure and alleviate the patient's condition with diuretic drugs, drugs are used to treat the underlying disease that caused dropsy, the tumor is surgically removed.

But such a method only stops the pathological process, which continues its development and more often turns into a severe form.

Surgical intervention

Most often, it is necessary to apply the main method of treatment - operative, in which shunting of the place of CSF accumulation is performed.

In this case, a shunt is inserted into the brain, and the output tube is inserted into the abdominal cavity, ureter, or atrium to create a new path for the removal of fluid. It is left permanently in case of diagnosing a congenital disease.

Over the course of a lifetime, shunting is repeated several times. Treatment is effective, but there is big risk serious complications, due to which the replacement of the shunt is carried out (damage to the veins, the development of infections, the formation of hematomas).

In severe cases requiring urgent reduction of intracranial pressure and fluid removal, external drainage is used.

For this, a craniotomy is performed and drains are installed for outflow. They are also injected with blood-thinning medications, since the cause of this condition is most often a hemorrhage.

A more modern method of treatment is neuroendoscopic. Surgeons create new ways to drain fluid using a neuroendoscope with a mini-camera using several techniques. The operation is less traumatic, does not require installation foreign body- shunt, complications are rare, the patient's quality of life is improved.

Cerebral dropsy warning

Observation and examination of a pregnant woman will allow to identify abnormalities in the development of the fetus, to treat an infectious disease in a timely manner. special attention required by women whose close relatives suffer from hydrocephalus.

Careful attitude to the fetus will protect it from intrauterine injuries and diseases. Supervision by a specialist is required for newborns at risk.

It is necessary to protect young children from traumatic brain injuries, to protect them from neuroinfections. This will also prevent the development of the disease in adults.

Congenital hydrocephalus stops its development, but is not cured. Treatment for older children may be beneficial. It depends on the severity of the disease, the timeliness and quality of treatment.

Hydrocephalus of the brain is a serious pathology characterized by the accumulation of cerebrospinal fluid in the head. Most often it develops in young children, but adults are no exception. Their dropsy is considered acquired, and any external signs of it are not visible.

If the disease is not detected in time, the person may even die. The effectiveness of hydrocephalus therapy depends on when it was detected. Fluid accumulates in the subarachnoid compartments, as well as the ventricular system.

General description of pathology

The human brain has complex structure. It consists of a large number departments, which are protected by arachnoid, hard and soft shells. The space located between the first and last shell is called "subarachnoid". These tissues are interconnected by membranes that create the ventricular system. It consists of reservoirs connected by holes and channels. It is in them that the circulation of liquor occurs. Liquor flows through the ventricles, and then goes into the cisterns, located at the base of the brain. Next, the liquid washes the surface tissues, and then absorbed into the blood.

The ventricular system of the brain and the scheme of movement of the cerebrospinal fluid in it

The cerebrospinal fluid performs several important functions:

It is a kind of shock absorber for the tissues of the head and spinal cord protecting them from accidental damage.
Delivers nutrients to the brain, and then removes waste from it.
Regulates the amount of blood inside the skull.

Hydrocephalus of the brain is characterized by the fact that excessive cerebrospinal fluid presses on the brain, causing disorders of its functionality. This fluid surrounds the brain and spinal cord.

Varieties of the disease

Classification of hydrocephalus is very important for prescribing proper treatment. Vodyanka is of the following types:

Internal. It is characterized by the fact that CSF accumulates directly in the ventricles. The reason for this pathological condition is a violation of the process of absorption of excess amounts of cerebrospinal fluid. Moreover, its outflow is disturbed by a thrombus or tumor that blocked the path.
External dropsy. In this case, excess fluid accumulates in the subarachnoid space, as it is not absorbed into the circulatory system. At the same time, there are no disturbances in the ventricles of the brain. This form of hydrocephalus is extremely rare. If such a diagnosis is made, this indicates atrophy of the most important organ in human body. A very severe type of external dropsy of the brain is considered replacement hydrocephalus in adults. It is characterized by the fact that the volume of the brain decreases, and the free space is filled with cerebrospinal fluid.

Mixed hydrocephalus. Here, fluid accumulates in all parts of the brain. Most often, this form of the disease develops in adults who have reached old age. mixed type is heavy enough for a person.
Moderate type of dropsy of the brain. It is characterized by the fact that any symptoms and signs may be absent for years. However, at one fine moment, the disease manifests itself very sharply and the patient's condition is rapidly deteriorating.

In addition, dropsy can be classified by origin:

Congenital. Such dropsy develops from birth and is provoked by a hereditary predisposition to impaired functioning of the brain. main reason the appearance of pathology is a malformation.
Acquired. It is more typical for adults and develops due to traumatic injury brain and also infectious disease. Treatment of such a pathology is faster.

And hydrocephalus can be acute, subacute or chronic.

Fayyad Akhmedovich Farhat, a neurosurgeon of the highest qualification category, doctor medical sciences, associate professor of the department operative surgery MGMSU:

Hydrocephalus of the brain: symptoms and signs

So, the presented pathology in adults in a moderate form can be asymptomatic. Signs largely depend on the age of the patient. In more complex cases, dropsy has the following symptoms:

Mixed:

Headache that doesn't go away. In the morning it is marked by greater intensity.
Nausea. It also appears most often in the morning.
Drowsiness. This suggests that hydrocephalus has already affected the brain and caused some neurological signs: impaired memory and speech.

Drowsiness in daytime- very ambiguous symptom, often indicating the presence of many disorders and pathologies. Pay attention to the main reasons

outdoor:

Nausea and vomiting.
A feeling of tiredness that is always present.
Increased sweating.

Excessive sweating is known as hyperhidrosis. It is observed in many people and can lead to disastrous consequences.

Minor vision problems.
Gait disturbance.
Change sexual behavior in adults.

Internal:

Strong.
Headache of high intensity.

For more information about the symptoms, see the video:

Vomiting and nausea.
Violation of visual and auditory function.

Dropsy of the brain is also accompanied by such symptoms: inability to control and coordinate movements, temporary memory loss, increased irritability, sudden mood swings.

Also characteristic of hydrocephalus epileptic seizures, urinary incontinence, too rapid sexual development, inhibition of the function of the production of certain hormones. a serious sign hydrocephalus is confusion, impaired mental function up to the development of dementia. A person's personality can change.

The manifestations of dropsy also depend on the stage of its development. acute form the disease is characterized by the fact that its symptoms are similar to those of the pathology that provoked dropsy. Chronic hydrocephalus is characterized by symptoms characteristic of it.

In children, the disease manifests itself in its own way: the baby's skull increases in size, since the fibrous joints that connect the bones of the skull are still soft and not closed. As for adults, the manifestations of hydrocephalus can simultaneously speak of other serious pathologies: Alzheimer's disease, Parkinson's disease.

Dropsy of the brain in adults is often misdiagnosed, so treatment may be ineffective. This is especially true for the moderate form of pathology. It is possible to determine hydrocephalus only with the help of a thorough differential diagnosis.

Why does the disease develop?

Despite the fact that a mixed or moderate type of pathology is diagnosed in an adult, it develops due to the influence of such reasons:

Stroke.
Infectious lesions of the substance and membranes of the brain: encephalitis or meningitis.
Malignant or benign tumors that block the outflow of cerebrospinal fluid.
Head injury.

Problems with the functionality of the nervous system.
Low density of the substance of the brain.
Congenital or acquired developmental anomalies.
The presence of blood clots in the brain.
Rupture of an aneurysm or other vascular pathology.

Subarachnoid hemorrhage. This reason is considered one of the most common. With it, a mixed form of the disease is more often diagnosed.
Surgical intervention.
Excessive production of cerebrospinal fluid.
Bickers-Adams syndrome.

These reasons are the most common. Naturally, they need to be known in order to be able to correctly diagnose and begin effective treatment.

Features of the diagnosis of pathology

In order to determine the cause of the development of mixed or moderate hydrocephalus, the patient needs to undergo a thorough examination, which involves the following procedures:

External examination of the patient using neurological tests.
CT or MRI. The second procedure is considered safer.
Ultrasound of the brain (three-dimensional).

You can learn more about the procedure for ultrasound of the brain in this video:

Control of intracranial pressure.
Methods of screening monitoring.
Neurosonography.

In addition to these studies, Dopplerography is used to determine the hydrocephalus of the brain - a study of the vessels of the neck and head. Put accurate diagnosis can only comprehensive examination using several methods.

Traditional treatment of pathology

Hydrocephalus has its own ICD code: G90. Treatment with medications used, even if it is congenital, but has a moderate form of development. The patient is prescribed drugs that help lower intracranial pressure: Lasix, as well as diuretics.

Also, the patient may be prescribed drugs to eliminate epileptic seizures: "Diakarb". In addition, this medicine reduces high intracranial pressure. "Diakarb" has a low cost, but is quite effective. Naturally, the remedy has its own contraindications and causes many side effects. Only a doctor can prescribe "Diakarb".

The drug "Diakarb" is available in Russian pharmacies at a price of 230-270 rubles for 30 tablets

In addition to drugs, useful massotherapy. These therapies for hydrocephalus will help compensate for damage in an adult, but will not cure the disease completely.

Folk remedies can also be used to combat the disease. In some cases, they help reduce the intensity of symptoms. However, like tablets, folk remedies I can not completely eliminate the pathology.

Dropsy of the brain: surgical treatment

An operation is used for the full recovery of an adult. There are several types of surgical interventions:

Shunting. This method of operation is used most often. The intervention involves the introduction of special silicone catheters with valves into the cranial cavity. Through these devices, excess fluid is excreted into the abdominal cavity. Shunting ensures that optimal intracranial pressure is maintained. You can not perform such an operation in the presence of vision problems, chronic form hydrocephalus. Bypass surgery helps an adult return to normal life, restore working capacity, avoid disability. But after such an operation, there may be consequences. The disadvantage of the presented procedure is the small diameter of the shunt. The tube can quickly fail, which requires its replacement. Moreover, the procedure must be carried out immediately. In addition, the tubes may initially be infected, as well as provide too slow or too fast outflow of cerebrospinal fluid. The bypass operation lasts about 1.5 hours under general anesthesia.

Installation of an external drainage system. Hydrocephalus in adults is treated in this way only if it is impossible to get rid of excess CSF in another way. This procedure may cause maximum amount complications, for example: the patient may get serious infection which will further aggravate his condition.
Endoscopy. This method of treating cerebral hydrocephalus in an adult is the newest and most effective. However, its cost is quite high, because the procedure requires sophisticated technical equipment and high-class surgeon skills. But this method of treatment is the safest. During the operation, the doctor, using a neuroendoscope equipped with a microscopic video camera, penetrates into the brain canals. The entire procedure is displayed on the screen with high resolution. Further, using a special catheter, a hole is made in the right place, and the cerebrospinal fluid flows out of the place of accumulation along a previously prepared path. Such a surgical intervention is performed only once. At the same time, there is no need to introduce any tubes into the body - that is, the process allows you to achieve a permanent effect. However, endoscopy is not always performed.

More about the treatment of the disease surgical methods says the neurosurgeon Alexander Vyacheslavovich Pechiborsch:

Surgical treatment of cerebral hydrocephalus in an adult is preferable, as it allows you to partially or completely get rid of the problem. Naturally, a consultation of doctors should make a decision on the surgical intervention.

Features of nutrition and rehabilitation treatment

The fight against cerebral hydrocephalus in adults requires a review of lifestyle. In order not to aggravate the state of health of the patient, it is necessary to adjust the diet of his diet. The diet provides for improved metabolism water-salt balance. Therefore, you should stop using fresh bread, fatty meat and fish, smoked products, sausages, sweets - they all contribute to fluid retention in the body.

It's better to prioritize fresh vegetables and fruits, cereals. It is best to avoid fried foods. Meals are more useful to steam. important and drinking regimen. For example, to improve the extraction excess fluid folk remedies with a diuretic effect are used from the body: decoctions of parsley and oregano.

During the recovery period, it is necessary to protect the patient from possible postoperative infection, head blows, too much activity and other problems.

Disease prognosis

If signs of hydrocephalus are not detected in time, the consequences can be sad. Moreover, disability is not the worst thing that can happen to a patient. So, the consequences of the pathology are as follows:

Risk of improper physical and mental development.
Problems with the work of the nervous system.

Disruption of the nervous system affects the body much more seriously than it seems. To understand the full scale of the problem, just look at what functions lie on the central nervous system

Violation of mental function.
Disability.

These consequences are possible if treatment was not started on time. Timely therapy can significantly improve the quality of life of the patient, restore his working capacity. That is, the prognosis is positive in the case of high-quality work of doctors.

How to prevent disease?

Hydrocephalus in some cases can lead to lethal outcome therefore its treatment is mandatory. However, pathology can be prevented. To do this, you need to follow the following preventive measures:

Even during pregnancy, a woman is obliged to strictly follow all the prescriptions of doctors.
An adult should treat any infectious pathologies capable of provoking the development of hydrocephalus.
It is better to avoid injury to the head, which can also trigger the mechanism for the development of the disease.
It is also important to be careful and Everyday life(avoid falling and hitting). And this rule applies to both children and adults.

We hope that today's article has given you an idea of what hydrocephalus is, how it develops and is treated. This information will help to notice the signs of the disease in time and, having started therapy, to avoid any complications.

In everyday life, we sometimes suffer from headaches, which most often appear due to overwork after a strenuous labor day, lack of sleep, various stressful experiences, or increased blood pressure. Such pains in the head are common and reversible, but if the cause of their occurrence is hydrocephalus (dropsy), then you will not envy such a person. In this disease, in special cavities (ventricles) of the brain accumulates excess amount cerebrospinal fluid (CSF), which causes increased intracranial pressure. Besides that this pathology accompanied by severe symptoms, it can lead to serious disorders of the central nervous system. Therefore, in order to prevent the degradation of personality, disability and even death, the treatment of cerebral hydrocephalus in adults should be carried out without fail.

Reasons for development

Doctors of neurological and neurosurgical practice most often encounter childhood congenital cerebral dropsy, and in adults this severe disease is acquired. Moreover, hydrocephalus in mature and old age is not always possible to diagnose in a timely manner, since it is often confused with hypoxic, post-traumatic or alcoholic encephalopathy- death nerve cells brain due to circulatory disorders and oxygen deficiency. The development of dropsy is provoked by various pathological processes affecting brain structures. Hydrocephalus can occur as a result of a hemorrhagic or ischemic stroke, encephalitis, meningitis, develop against the background of the formation of benign or malignant tumor brain, arteriovenous aneurysm, traumatic subarachnoid intraventricular hemorrhage, toxoplasmosis.

Classification

According to the features of development pathological process There are three types of hydrocephalus. Firstly, dropsy of the brain can be communicating (open), in which the absorption (resorption) of cerebrospinal fluid into the venous bed is disturbed. Secondly, the disease may be occlusive (closed) in nature, due to blockage of the pathways intended for the circulation of CSF due to the formation of adhesions, tumors or blood clots(thrombi). There is also quite rare view hypersecretory dropsy, characterized by excessive production of cerebrospinal fluid.

Symptoms

Clinical manifestations acute stage of this pathology are pronounced and cause excruciating suffering to a sick person. The main sign of an exacerbation is a severe headache, which is most intense in morning time. An increase in intracranial pressure is accompanied by a feeling of nausea, bouts of vomiting, impaired focusing of vision (doubling of objects in the eyes), interruptions in the work of the heart, respiratory depression, up to loss of consciousness.

signs chronic dropsy of the brain in adults are not so painful, but they do not add optimism at all. The patient develops urinary incontinence night insomnia and, most importantly, inexorably progressive dementia (dementia), expressed in memory impairment, inappropriate behavior, speech and motor coordination disorders (shuffling, rocking gait), loss of self-service skills.

Diagnostics and drug therapy

Currently, echoencephalographic, ventriculographic and X-ray studies intracranial structures are rarely resorted to, since magnetic resonance and CT scan brain. Based on the results of these modern methods diagnosis and revealed hydrocephalus. On the early stages development, it is still possible to stop the progression of this pathology and normalize the outflow of cerebrospinal fluid from the cerebral ventricular system using drug therapy. For this purpose, appoint diuretics(Mannitol, Diakarb), drugs that improve cerebral circulation(Telectol, Cavinton, Vinpocetine), magnesium and potassium-containing medicines (Panangin, Asparkam), drugs from the nootropic group (Gliatilin, Cerepro). But in most cases, you still can not do without the help of a surgeon.

Surgical treatment

In the acute stage of hydrocephalus, a neurosurgical operation is performed in urgently. A ventricular drain should be placed immediately to create conditions for the outflow of cerebrospinal fluid and reduce intracranial pressure. This procedure is called external ventricular drainage, in which the drainage tube is installed in the cavity of the ventricle of the brain, and its other end is brought out and placed in a container to receive the drained cerebrospinal fluid.

For the treatment of chronic dropsy, modern shunt operations are used to ensure the excretion of cerebrospinal fluid into other body systems, where it is freely absorbed. Usually implanted shunts connect the ventricle of the brain with abdominal cavity(ventriculoperitoneal, cystoperitoneal, lumboperitoneal shunting) or with the right atrium (ventriculoatrial surgery). AT recent times the endoscopic minimally invasive method of ventriculocisternostomy has become widespread, in which a message is created between the third ventricle of the brain and specific expanded areas of the subarachnoid space (basal cisterns), where CSF absorption occurs.

Thus, the treatment of cerebral hydrocephalus in adults, although a difficult process, but with timely diagnosed pathology, in most cases, positive results are achieved.