Mp picture of the initial manifestations of external replacement hydrocephalus. Symptoms and treatment of moderate external hydrocephalus. Folk remedies as an additional treatment

Currently, the number of people who suffer from diseases of the nervous system is increasing. The provoking factors are stress, emotional overload, unfavorable environmental background and lifestyle. External replacement hydrocephalus can also be attributed to this group of diseases.

Key Aspects

In some cases of inflammatory diseases of the central nervous system, injuries and developmental disorders, pathological processes involving blood vessels are accompanied by the formation of external replacement hydrocephalus of the brain.

The essence of this syndrome, as well as open hydrocephalus, lies in the fact that there is a violation of the processes of production and absorption of cerebrospinal fluid. This leads to an increase in its amount and accumulation in the cranial cavity.

If the fluid is localized in spaces outside the structures of the brain, the prognosis will be more favorable compared to the pathological process that extends to the cerebral ventricles. With timely detection and treatment, the disease does not pose any threat to human life.

The cause of the formation may also be inflammatory processes. The peculiarity of their course lies in the fact that the volume of production of cerebrospinal fluid does not increase, but liquor stagnates.

But an important point that needs to be paid attention to is that in any case, an increase in the amount of cerebrospinal fluid in the cranial cavity leads to external compression (that is, compression) of the brain. There is a progressive decrease in the number of nerve cells. And this, in turn, leads to the formation of pathological symptoms, the appearance of which makes a person go to a medical institution.

Classification

The presented pathological condition is distributed depending on:

Origin. It can be either hereditary or acquired.
Flow features. Allocate acute, chronic and subacute hydrocephalus.

Acute features are considered to be that from the moment the first pathological symptoms appear to impaired functioning of the brain, it usually takes three days.

As for subacute, its duration is about a month.

Chronic develops from six months or longer. A latent form is distinguished, which is considered more dangerous than a progressive one, since it does not manifest itself in any way.

The disease is already in advanced form. It is characterized by a constant course, in which there is no decrease in brain volume and an increase in cerebrospinal fluid.

There is also a progressive form, in which there is a rapid increase in symptoms. Her treatment must be cardinal, otherwise there will be severe pain in the head, urinary incontinence, dementia, and even a violation of motor functions. If left untreated, the patient may die.

Causes

The main provoking factor in the formation of external replacement hydrocephalus is considered to be an imbalance between the formation of cerebrospinal fluid (its amount may increase as a result of the presence of vascular and metabolic diseases of the brain) and absorption (this process may be disturbed due to the presence of inflammatory processes that spread to the membranes of the brain and its substance) .

The list of causes that most often provoke the onset of the disease includes:

hypoxia fetus;
defeat nervous the child's system of an infectious nature, which occurred in utero or immediately after birth;
nervous system damage infectious character in an adult;
intoxication exogenous or endogenous origin;
state changes vessels, that occur with age;
traumatic brain damage;
shake brain and alcohol dependence in anamnesis.

Treatment of this pathological condition will be effective and efficient only if the provoking factor is correctly identified and measures are taken to eliminate it.

Clinical picture

The most common clinical manifestations of the disease include:

sensation pain in the head (a feature of this symptom is that it worries patients mainly in the morning);
alternating rises and falls in blood pressure pressure;
violation cardiac rhythm;
tachycardia;
an increase in the amount allocated sweat;
nausea;
vomit;
disorders sleep, which manifest themselves as a violation of falling asleep and drowsiness during the day;
elevated level nervousness;
emotional restlessness and irritability;
violation vision;
in some cases change walk.

Cases when the disease leads to memory loss, absent-mindedness and the inability to carry out even the simplest calculations in the mind are considered not uncommon.

As a result, the formation of dementia or mental disorders of a different nature can be observed. These pathological conditions, in turn, can cause epileptic seizures and even a coma.

Diagnostic measures

The following methods are used to diagnose hydrocephalus:

Magnetic resonance tomography. This study helps to obtain an MR picture, the analysis of which will provide information about the stage of the disease, the volume of fluid and its localization.
Computer tomography.
Ophthalmoscopy. With the help of this type of research, an examination of the fundus is carried out.
Analysis spinal fluid obtained as a result of the puncture.
Analyzes blood, which allow to detect the presence of pathogens in the body.
ultrasound(ultrasound examination) of the vessels of the head and neck.
Angiography(i.e. examination of the state of the vessels). The study is carried out by introducing a contrast agent into the lumen of the vessel.

These studies make it possible to identify the disease, find out at what stage of development it is, and also choose the best treatment option.

Treatment methods for the disease

The choice of treatment will depend on how severe the course of the disease is. Since one of the main symptoms of the disease is intracranial hypertension, treatment should be directed, first of all, to its elimination.

For this purpose, drugs are prescribed that are endowed with the ability to influence the production of cerebrospinal fluid in a certain way:

Diacarb;
vascular drugs;
trophic drugs.

If it is not possible to eliminate the pathological symptoms in a conservative way, then the symptoms of the disease are eliminated surgically, by carrying out:

spinal punctures;
shunting meningeal spaces of the brain using endoscopic or traditional neurosurgical operations.

Bypass surgery is preferred in most cases. This surgery allows you to create a bypass route for fluid. For this purpose, flexible tubes are introduced into the intracranial space and brought out into the internal environment of the body.

A significant number of neurosurgeons practice endoscopic operations, during which holes are formed through which excess cerebrospinal fluid flows into the cisterns of the brain. The process itself is monitored on the monitor, this is possible due to the fact that the endoscope is equipped with a microscopic camera.

This intervention has certain advantages:

Minimal risk of complications.
The best quality the life of the patient after surgery, as there is no need for regular checks on the condition of the shunts and clogging of the tubes.

Please note that replacement external dropsy is considered a disease, the risk of which accompanies a person throughout all the years of her life. Therefore, even after successful treatment, the patient should be regularly examined by his doctor.

Forecast

In the case of timely detection and treatment of external replacement hydrocephalus at the initial stage, the prognosis is considered positive, and the patient is much more likely to return to his normal life. However, there are cases when the disease leads to impaired speech function.

If medical care and treatment was not carried out in time, then the sick person will lose not only his ability to work and social status, but also his personality.

Consequences and complications

The consequences of external replacement hydrocephalus can be of a different nature. A person can not only become disabled person but also to die, since the processes of a pathological nature that occur in the brain in a given pathological condition can be irreversible.

It must be remembered that the development of external replacement hydrocephalus can also be prevented. To do this, you only need to be attentive to the state of your health and treat viral and infectious diseases (and not only) as early as possible.

The state of the cardiovascular system also requires special attention. A significant role in this matter belongs to proper nutrition. It is necessary to lead a healthy lifestyle, engage in moderate physical activity and give up all bad habits.

Diseases of the central nervous system in modern society are becoming a real problem for patients suffering from these diseases, and doctors who have to prescribe treatment. Very often, inflammatory diseases of the central nervous system, its injuries and malformations, pathological changes affecting the vessels of the arterial and venous bed, are accompanied by the occurrence of external replacement hydrocephalus of the brain.

The essence of this syndrome is that in the central structures of the nervous system, the unsteady balance between the production of cerebrospinal fluid and its reabsorption is disturbed. The volume of cerebrospinal fluid is constantly increasing, which leads to the fact that it accumulates in the cranial cavity - in the spaces located between the membranes of the brain and its substance.

An excess amount of fluid is formed in spaces that are located outside the structures that make up the brain - which is why this condition has a better prognosis than pathological processes affecting the brain ventricles. This pathology almost never poses a visible threat to the patient's life and, if detected in time, is easier to correct with medication.

Much less often, inflammatory processes become the cause of the development of external replacement hydrocephalus, as a result of which the normal circulation of cerebrospinal fluid in the spaces located around the brain is disturbed - its production does not increase, but local stagnation forms (most often - against the background of serous or purulent meningitis)

It is important to understand that the space enclosed in the cranial cavity has a finite volume - an increase in the amount of cerebrospinal fluid inevitably leads to external compression (compression) of the brain. As a result, the number of cells of the nervous tissue (various structures of the central nervous system) progressively decreases, which causes the appearance of the characteristic symptoms of this condition, which force the patient to seek qualified medical help.

Often occurs with mental disorders.

Causes of external hydrocephalus

Experts believe that the main mechanism explaining the development of external replacement hydrocephalus is an imbalance between the formation of cerebrospinal fluid (its production can increase against the background of vascular and metabolic diseases of the brain and their complications) and absorption, which is disturbed as a result of inflammatory processes affecting the substance of the brain and its shells.

The most common causes of external replacement hydrocephalus in patients of different ages are:

in children in the neonatal period and early age - intrauterine hypoxia and infection of the nervous system, transferred before birth or in the first months of life;
in children of preschool and school age, adolescents and adults - infections of the nervous system, exogenous and endogenous intoxications, metabolic disorders in the body, brain injuries (including old ones);
in elderly patients - age-related changes in blood vessels and diffuse metabolic disorders in the body (common forms of atherosclerosis).

It must be remembered that the effective treatment of this condition, which is necessary to restore normal well-being, is possible only after establishing the true cause of the disease and prescribing etiotropic treatment (therapy that affects the cause). Otherwise, the appointment of symptomatic treatment will improve the patient's condition only for a very short period of time, and the symptoms of external replacement hydrocephalus will appear again and again.

Despite the fact that the course of this form of hydrocephalus is benign and a vivid clinical picture of the disease develops in the later stages, the prognosis remains unfavorable - the volume of cerebrospinal fluid inside the cranial cavity cannot exceed some limit value, upon reaching which compression of the brain itself begins. However, with this variant of the disease, there is never a significant increase in blood pressure (unless there are concomitant pathologies that can be complicated by hypertension).

Diagnosis of replacement intracranial external hypertension

The program for examining a patient with this disease must necessarily include:

Magnetic resonance imaging;
CT scan;
angiography of cerebral vessels, vertebral and carotid arteries;
x-ray of the skull in two projections;
neurosonography of the brain - this research method can be used in children before the closure of the fontanelles of the skull);
serological blood tests to identify the true cause of the disease (the causative agent of an infection that can affect the brain) - toxoplasmosis, herpes virus, and cytomegalovirus.

The examination must be repeated once every 6 months, even if the patient's condition remains stable and he does not make any complaints - if symptoms of progression of hydrocephalus appear, an extraordinary examination is necessary.

Treatment of replacement intracranial external hypertension

The treatment program for this condition should focus on:

elimination of the cause of the disease (if possible)
elimination of symptoms of hypertension by conservative methods - diuretics are prescribed that can affect the production of cerebrospinal fluid (diacarb), vascular and trophic drugs;
elimination of symptoms of hypertension by surgical methods - spinal puncture, shunting of the meningeal spaces of the brain using traditional and endoscopic neurosurgical interventions.

The appearance of the first signs of deterioration (headache, sleep disorders, behavioral changes) should alert the patient and force him to seek medical help - it must be remembered that brain neurons are very sensitive to external influences and have very little ability to recover.

Hydrocephalus of the brain is a severe disease of the nervous system that leads to neurological defects and can be life threatening. This condition is congenital or develops in adulthood. Surgery is considered the most effective treatment.

There are several types of dropsy of the brain, each of which has its own causes, manifestations and the degree of risk to the life of the patient. The general mechanism for the development of pathology is associated with a violation of the outflow of cerebrospinal fluid from the ventricles of the brain. In children, this forms a characteristic appearance, in adults it leads to an increase in intracranial pressure (ICP).

Causes of congenital hydrocephalus:

pathology of head development;
trauma in childbirth;
hereditary diseases;
intrauterine infection;
side effects of drugs taken by the mother;
unhealthy lifestyle of parents (alcohol, smoking, drugs).

Congenital dropsy has a more pronounced effect on the development of the nervous system, almost always accompanied by atrophic processes in the brain. Causes of acquired hydrocephalus:

transferred meningitis, encephalitis;
consequences of strokes;
brain tumors;
head injury;
complications of chronic diseases (diabetes mellitus, tuberculosis, vascular pathologies).

Injuries to the skull are especially dangerous in that their consequences for a long time may not raise doubts either among the victim himself or his relatives. After a blow or fall, it can take a long time before a person notices that it has become difficult for him to concentrate, and his head hurts too often.

Depending on the causes, symptoms, and severity of the condition, there are several classifications of the disease. By origin, congenital and acquired hydrocephalus are distinguished. According to the features of the flow, it happens:

closed(occlusive) - there is an obstacle in the way of the exit of cerebrospinal fluid;
open(non-occlusive) - normal communication between the ventricles of the brain and the bloodstream;
hypersecretory- occurs due to excess production of liquor.

It is also accepted to divide into internal (fluid accumulates in the ventricles) and external (in the subarachnoid space) hydrocephalus. According to clinical signs, acute (up to 3 days), subacute (up to a month) and chronic (more than 30 days) form can be distinguished. According to the dynamics of the development of pathology:

progressive- the most dangerous type, characterized by a gradual increase in symptoms;
regressive- mild type, recovery is possible;
stable– there are no significant state changes.

If the ventricles are affected, then a monoventricular form is isolated, when only one of them is involved in the pathological process. More rare variants of the course are biventricular and triventricular dropsy. In this case, several ventricles are affected, and the outflow of fluid from them is impossible. Such pathologies are more severe and dangerous, worse treatable.

Symptoms of the disease

The clinic can be conditionally divided into deterioration of the general condition, cerebral symptoms and focal phenomena. In any case, the main damaging factors are fluid accumulation and increased intracranial pressure, hypotrophic and atrophic changes in the adjacent nervous tissue.

Deterioration of the general condition is a rather uncharacteristic and unexpressed symptomatology that does not allow an unambiguous diagnosis. It is manifested by moderate headaches, nausea, less often - discomfort in the eyes, which is paroxysmal in nature. These signs are most pronounced with internal hydrocephalus, and with external they are insignificant.

Cerebral symptoms are associated with malnutrition of the brain, at the initial stages they are accompanied by general signs, they are not of great value for diagnosis. These manifestations include convulsive syndrome, photophobia, tinnitus, impaired memory, attention, coordination of movements.

Of higher value for diagnosis are focal phenomena that are associated with the expansion of the cerebral ventricles. They accurately indicate the affected area. Most often they manifest themselves in the form of a violation of the sensitivity of the limbs, paralysis, partial convulsive seizures (when one area is affected, for example, an arm or leg), they can be both asymmetric and symmetrical.

In children of the first year of life, a hydrocephalic syndrome is formed - an increase in head volume, a lag in physical and intellectual development, up to severe mental retardation. With a mild degree of the disease, partial restoration of functions is possible, and with timely surgical intervention, hydrocephalus becomes curable. If the genesis of the disease is caused by intrauterine causes, the death of a small hydrocephalus during childbirth or during the first year of life is possible.

Characteristic signs of pathology in children are a disproportionately large head, retraction of the eyeballs. The fontanel does not pulsate, protrudes above the surface of the skull (hernia of the fontanel). The baby constantly cries or, on the contrary, is lethargic and does not show emotions.

Separately, it is worth mentioning another form of the disease - vicarious. Its other name is substitution. It develops mainly in the elderly. The essence of the disease is that atrophic processes in the nervous tissue are primary, which increases the volume of formation in which cerebrospinal fluid is collected. ICP does not rise, so this type of disease is called normotensive. It is practically incurable in itself, since it is a consequence, not a cause.

Diagnostics

The presence of hydrocephalus in adults is determined by a neurologist or neurosurgeon, in children - by a pediatric neurologist, and with obvious signs of a change in the shape of the skull - by a pediatrician. The doctor begins the diagnosis with an examination that reveals certain disorders, pathologies of perception (vision, hearing), swelling of the veins in the head, in young children - an increase in the size of the skull, retraction of the eyeballs. If acquired hydrocephalus is suspected in adults, anamnesis data becomes important: injuries, inflammatory diseases, etc.

But the first place in the diagnosis of dropsy belongs to instrumental methods. The most informative is MSCT (multispiral computed tomography). It allows you to see the dilated ventricles or subarachnoid cisterns, as well as tumors, if they are the cause of the disease. The same method allows you to distinguish between closed and open forms of pathology.

Echoencephalography (ultrasound of the brain) clarifies the condition of the vessels, the possible risk of complications on their part. The method is very important if the doctor suggests that the cause of dropsy was a hemorrhagic stroke. In newborns, a similar examination is used - ultrasonography, which allows you to identify hydrocephalus due to genetic causes or trauma in childbirth.

To determine the consequences of the disease, ophthalmoscopy is used (increased ICP can cause glaucoma), lumbar puncture (shows the composition and pressure of the cerebrospinal fluid), determining the patient's neurological status and identifying mental disorders, if any.

Differential diagnosis in adults is carried out with other pathologies of the nervous system that cause degenerative processes in the brain - dementia, Alzheimer's disease, tumors that do not interfere with the outflow of CSF.

An early way to detect congenital disorders is intrauterine determination of the size and shape of the transparent septum of the brain. This structure consists of two plates of brain tissue and a small cavity between them. Normally, it contains liquor. Thickening and cyst formation of the pellucid septum is a fairly common occurrence that easily resolves after birth. A much more dangerous sign is the partial or complete absence of structure, which leads to significant brain pathologies.

Surgery

Surgery is the most effective way to get rid of dropsy. For treatment, several types of intervention are used:

removal of the cause of the disease with a closed form(thrombus, tumors, partitions);
shunting with communicating(open) or hypersecretory form, if it is impossible to eliminate the cause of the pathology;
combined operations with a mixed type.

In most cases, the doctor decides to bypass the affected ventricle of the brain. The essence of the operation is that a tube (shunt) is implanted in the patient, which removes excess fluid from the focus of the disease. The free end of the implant is directed into the abdominal cavity, less often into the atrium. An artificial message allows you to get rid of unnecessary liquor and bring it to a place where absorption into the blood is not impaired. The result is the restoration of normal liquor circulation, the cessation of its accumulation in the cranial cavity. If the operation is performed on a child, then the shunt is installed “for growth” and is replaced every few years. So that due to the pressure difference there is no reverse flow of the liquid, it is equipped with a valve, the circuit of which allows the movement of the cerebrospinal fluid only in the right direction.

If the disease can be cured, the causative factors are eliminated: blood clots and blood clots, tumors, adhesions. Such operations can prolong the life of the patient. If the measures taken are not enough and the fluid continues to accumulate, an additional bypass may be performed.

There are a number of contraindications to the operation:

active inflammatory process in the nervous tissue- encephalitis, meningitis, ventriculitis;
stable or regressive form of dropsy;
irreversible consequences of the disease- blindness, neurological disorders, atrophy of the cerebral hemispheres;
exhaustion, severe pathologies of the heart, blood vessels, respiratory system.

To reduce the risk, endoscopic operations are widely used: installation and revision of a shunt, removal of hematomas and small tumors, destruction of adhesions and septa. This is relevant in case of monoventricular pathology, in more severe cases, techniques with craniotomy are used.

Rehabilitation and drug treatment

Medicines are prescribed for a stable or regressing form of the disease, with contraindications to surgery or in the recovery period after it. The choice of drugs depends on the patient's condition and the severity of the disease.

To improve the outflow of fluid, Mannitol or Diacarb is used, they bring it into the bloodstream. In addition to drugs, diuretics of the thiazide group are taken, for example, Furosemide. It prevents an increase in blood pressure while taking potassium-sparing diuretics.

To improve the nutrition of the nervous tissue and its blood supply, Detralex, Glycine and Piracetam are prescribed. As symptomatic agents, anticonvulsant, anti-inflammatory and sedative medications can be used. In the early stages, treatment at home is possible, but if the disease progresses, it is necessary to go to the hospital. The doctor will decide whether a course of drugs is enough or surgery is needed.

Rehabilitation measures help the patient to live with the consequences of the disease or shunt after surgery. He needs to limit physical activity, follow a diet with strict control of fluid and salt. You should also regularly undergo examination by a neurologist and attend medical procedures.

Modern medicine does not deny the use of some non-traditional methods of treatment. Hirudotherapy is considered the most effective among them: leeches reduce arterial and intracranial pressure. The use of various herbs to improve well-being is permissible only with the consent of the attending physician. The effectiveness of homeopathy and similar remedies has not been proven by clinical trials.

Complications and prognosis

Why is hydrocephalus dangerous? The prognosis of the disease should be considered separately for children and adults. Congenital forms caused by pathology of intrauterine development are considered the most severe. Most often, small patients are born with irreversible damage to the nervous tissue, which leads to death or severe mental impairment.

Babies who are traumatized at birth or in their first year of life are much more likely to improve if treatment is started on time. If not, the risk of disability is high. In the presence of a shunt, the baby develops normally, due to the plasticity of the nervous system, brain functions are quickly restored, but regular examinations and replacement of the implant are required as the child grows.

In adults, the prognosis depends on the form of the disease. Acute hydrocephalus can go away without consequences if it is treated in a timely manner. The chronic form is amenable to medical or surgical elimination, requires long-term rehabilitation. The most difficult thing is with the replacement type, when hydrocephalus is only a consequence of the underlying disease, so it is useless to fight it.

The most dangerous complications of dropsy of the brain:

oligophrenia in children;
paralysis, paresis of the limbs;
epileptic seizures;
mental disorders;
glaucoma and blindness.

The prognosis for working capacity depends on the result of medical manipulations. With successful treatment, it is possible for adult patients to return to work, and children to study and play. The only limitation is physical activity: patients should exercise caution and stop exercising if discomfort occurs.

Untimely or ineffective treatment leads to disability. At the same time, the cost of rehabilitation measures is quite high, despite the stipulated benefits. In the most severe cases, death is possible. Young men of military age who have a shunt are not considered fit for military service.

Conclusion

Dropsy of the brain is a serious disease that requires early surgical intervention. Surgery is the most reliable way to recover and avoid complications, medications, and even more so folk remedies, can only be used as additional and supportive measures.

The cost of rehabilitation measures, drugs and surgery may be high, but it fully justifies itself, allowing the patient to maintain a quality of life close to the previous one. Timely measures taken can save his health.

Various neurological pathologies are increasingly common in modern people. And the reason for this, as a rule, is not only the deplorable state of the environment, but also the dizzying rhythm of modern life, frequent stresses and other diverse and very dangerous factors that have already become part of our daily lives. One of the most serious and widespread neurological diseases is external replacement hydrocephalus, more popularly known as "dropsy of the brain".

Description of mixed replacement hydrocephalus

The basis for its occurrence are various pathological conditions that cause brain atrophy, for example:

Age processes of aging.
encephalopathy. This term refers to changes in brain tissue caused by a lack of nutrition. It, in turn, is provoked by the consequences of various head injuries, cholesterol deposits in the vessels, high blood pressure, diabetes mellitus, intoxication with alcohol and other poisons.
A number of genetic diseases.

Since this type of hydrocephalus occurs most often, its main danger is that for a long time it proceeds without symptoms, without manifesting itself. The first clinical signs and complaints speak of the already intensive progress of the disease. With this pathology, CSF (cerebrospinal fluid) accumulates in the internal cavities of the brain and directly under its membranes. In this type, neurologists also distinguish moderately pronounced external replacement hydrocephalus, when dropsy does not progress, but is in a latent form for a long time.

Internal replacement hydrocephalus.

With this type of hydrocephalus, fluid accumulates in the internal cavities of the brain without damaging the cerebral cortex (gray matter). The reason is a violation of the outflow of cerebrospinal fluid from the internal cavities, neoplasms of the brain (tumors, cysts). This condition is malignant. In the absence of restoration of normal fluid pressure, it will necessarily lead to death, since the effect goes directly to the respiratory and vascular centers. The disease manifests itself quite clearly: convulsive conditions, respiratory and heart rhythm disturbances. This pathology requires timely surgical treatment - a conservative one will not bring results.

Description and methods of treatment of external replacement hydrocephalus of the brain

What it is? As for the external replacement hydrocephalus of the brain, it is not a disease that can be called dropsy in the full sense of the word. This term means that the accumulation of fluid in the cranial cavity occurs due to a decrease in the size of the cerebral cortex due to its atrophy. Accordingly, the declining volume of the brain frees up space in the cranium, which is replaced by fluid. This is the standard physiological compensatory mechanism. In principle, the relationship between fluid production and absorption is kept physiologically acceptable. For this type of disease, bright clinical manifestations are uncharacteristic: headaches, convulsions, disruption of the sensory organs. The course of this pathology is divided into three stages.

initial stage

Diagnostics

Replacement hydrocephalus in all its forms is detected using:

Therapy

Conservative treatment

External, as well as internal and mixed varieties of the disease in acute phases need immediate treatment.

To do this, doctors first remove a small amount of fluid through punctures in the skull.

Further treatment of substitutive hydrocephalus of the brain depends on the severity of the disease.

General strengthening treatment, physiotherapy, balneotherapy - coniferous and salt baths, anti-inflammatory therapy are also prescribed.

Surgery

Conservative treatment is not always successful, so doctors carry out radical therapy - surgical intervention. Procedures such as bypass surgery and endoscopic surgeries are performed.

Creation of a bypass for liquor. Flexible tubes are placed in the intracranial cavity and removed into the internal environment of the body - more often into the peritoneum.

Operations are fraught with complications, as shunts often become clogged, bent and become unusable. This leads to the need for emergency replacement of the shunt.

Neurosurgical endoscopic operations are a priority direction in modern therapy of dropsy of the brain.

A hole is made in the cerebral ventricles through which the outflow of fluid into the cisterns of the brain occurs. The progress of the operation is monitored on the monitor screen, since the endoscope is equipped with a mini video camera.

Endoscopic treatment allows you to do without extensive intervention and has virtually no complications. At the same time, the patient's quality of life improves - he does not need to conduct a regular revision of shunts and be afraid of sudden clogging of the tube.

Replacement external dropsy is most often a lifelong diagnosis, so the patient, even if the treatment is successful, needs to be regularly examined in the clinic.

Prevention

It is possible to prevent diseases if timely treatment of infectious diseases is carried out, as well as to monitor the normal functioning of the vascular system.

A healthy lifestyle - giving up alcoholism, smoking, products that negatively affect the state of the vessels of the circulatory system - also reduces the likelihood of developing substitutive dropsy of the brain.

A very common reason for visiting a neurologist is such complaints as: headaches of various localization and intensity, swelling of the eyelids, blurred vision, nausea, vomiting, pressure drops, dizziness. These symptoms can appear abruptly, or they can increase gradually over time, while reducing social adaptation, professional skills, self-care skills, etc. Older and middle-aged people fear that this condition may further progress into dementia (dementia). Unfortunately, in some cases these fears are not unfounded. However, these symptoms rarely lead to dementia. The most common cause of this condition is external replacement hydrocephalus of the brain. In common parlance, this disease is also called dropsy. There is congenital and acquired hydrocephalus. The first is in the field of activity of the pediatric service and is a topic for a separate conversation. Hydrocephalus of the brain in adults is always acquired.

In medicine, a number of terms are distinguished, such as:

Mixed replacement hydrocephalus.
External replacement hydrocephalus.

Of course, these diseases are very dangerous and can lead to severe disorders of the central nervous system.

Description of mixed replacement hydrocephalus

The basis for its occurrence are various pathological conditions that cause brain atrophy, for example:

Age processes of aging.
encephalopathy. This term refers to changes in brain tissue caused by a lack of nutrition. It, in turn, is provoked by the consequences of various head injuries, cholesterol deposits in the vessels, high blood pressure, diabetes mellitus, intoxication with alcohol and other poisons.
A number of genetic diseases.

Internal replacement hydrocephalus.

With this type of hydrocephalus, fluid accumulates in the internal cavities of the brain without damaging the cerebral cortex (gray matter). The reason is a violation of the outflow of cerebrospinal fluid from the internal cavities, neoplasms of the brain (tumors, cysts). This condition is malignant. In the absence of restoration of normal fluid pressure, it will certainly lead to death, since the impact goes directly to the respiratory and vascular centers. The disease manifests itself quite clearly: convulsive conditions, respiratory and heart rhythm disturbances. This pathology requires timely surgical treatment - a conservative one will not bring results.

Description and methods of treatment of external replacement hydrocephalus of the brain

What it is? As for the external replacement hydrocephalus of the brain, it is not a disease that can be called dropsy in the full sense of the word. This term means that the accumulation of fluid in the cranial cavity occurs due to a decrease in the size of the cerebral cortex due to its atrophy. Accordingly, the declining volume of the brain frees up space in the cranium, which is replaced by fluid. This is a standard physiological compensatory mechanism. In principle, the relationship between fluid production and absorption is kept physiologically acceptable. For this type of disease, vivid clinical manifestations are uncharacteristic: headaches, convulsions, impaired functioning of the sense organs. The course of this pathology is divided into three stages.

initial stage

At the initial stage, the picture of external replacement hydrocephalus is characterized by the absence of pronounced clinical manifestations and, accordingly, the patient's complaints. Changes can be detected by chance at the stage of an in-depth examination, for example, with magnetic resonance imaging. MRI picture of external replacement hydrocephalus is accompanied by slight atrophy of the cortex. It is manifested by some increase in the distance between the furrows and convolutions. However, a reliable conclusion can only be made based on the results of a comparison of images taken several years ago and at the present time.

Stage of moderate change

Moderate external replacement hydrocephalus always has noticeable symptoms. The decrease in self-criticism and social adaptation is noteworthy. A person does not perceive new information well, there are episodes of disorientation in new places and circumstances, it becomes difficult to concentrate, it is difficult to switch from one type of activity to another. With moderate external hydrocephalus, the MRI picture shows signs of obvious changes characteristic of lesions of the cerebral cortex: the cortical grooves expand, lacunar infarctions (microscopic hemorrhages) are noted, and the speed of reactions decreases.

Stage of pronounced changes

Obvious disturbances occur in the cerebral cortex, which quickly turn into dementia - dementia. At the same time, a number of neurological symptoms join: ataxia - a partial loss of a sense of balance; dysarthria - speech disorders; dysphagia - the impossibility of the swallowing process due to spasm of the upper esophagus, etc.

Household, professional and social disadaptation is expressed. In MRI diagnostics, a pronounced dysfunction of the cerebral cortex and underlying sections (hippocampus) is noted. A person with this degree of the disease can be said to be a severely disabled person.

Survey

The algorithm is based on a competent analysis of the patient's complaints by a neurologist and MRI results. In laboratory studies, it is necessary to find out the level of cholesterol fractions in the blood, blood clotting and a number of other biochemical parameters, including the hormonal profile. You may need to consult an endocrinologist, an ophthalmologist, as well as a study of the vessels of the neck and brain using ultrasound scanning and Doppler diagnostics. It should be determined whether the hydrocephalic syndrome is due to excessive production of cerebrospinal fluid or whether atrophy of the medulla comes first. This is important because different causes require different treatment approaches.

NZG differs from other types in that it does not pose a clear threat to life. Infections, injuries, tumor processes, hormonal disorders, lack of B vitamins and psychogenic factors have only an indirect effect on its development. The determining factors for the onset of the disease are the individual characteristics of the body: heredity, lifestyle. They lead to true hydrocephalus, causing the corresponding symptoms, and require a radically different approach to diagnosis and treatment. There is still an opportunity to treat and correct NCG, including at the stage of primary care.

Sometimes there is no clear cause to be found. Then the therapy algorithm is directed to the correction of risk factors: the mode of work and rest, diet, the exclusion of habitual intoxications (alcoholism, smoking, occupational hazards), the elimination of stress factors, and, if possible, the normalization of relations in the family and society.

Medical therapy

The use of nootropic drugs of various classes is rational, but most of these drugs still do not have proven effectiveness. Effective may be the use of drugs that reduce the level of glutamate (a substance that destroys the function of nerve cells - neurons) in the blood; antioxidants - medicines that remove free radicals and prevent intracellular oxidation. Treatment is needed to improve the conductivity of nerve cells, as well as B vitamins. It should be borne in mind that all these drugs are prescribed only under the strict supervision of the attending physician and after the obligatory clarification of the diagnosis, since they are all quite aggressive and are sold strictly according to prescriptions. The question of the use of diuretics such as "Diakarba" and potassium preparations is very controversial. They are almost never used by specialists, although these drugs are still used by self-medicated patients, which puts their health at serious risk. It is also impossible to use neurotropic drugs without consulting a specialist in any case.

Surgery

Surgical interventions in this pathology are most often inappropriate. They are carried out only in the presence of decompensated dropsy - a clear violation of the outflow of fluid from the cranial cavity and an increase in intracranial pressure. Modern neurosurgical care is based on minimally invasive endoscopic methods, i.e. with minimal trauma for the patient, usually through the nasal passages. Workarounds are established for evacuating excess fluid from the cranium into the vascular bed and bloodstream. At the same time, intracranial pressure normalizes and the quality of life stabilizes.

Rehabilitation Therapy

They use physiotherapy, salt-coniferous baths, mineral therapy, electrotherapy, for example, with high-frequency currents and other rehabilitation procedures.

It should be remembered that destructive diseases of the central nervous system from the second stage and above do not have a reverse course. It is not possible to transfer the second stage to the first. Therefore, the sooner measures are taken, the sooner it will be possible to stop the process of replacing the gray medulla with fluid.

To avoid the development of this unpleasant disease, it is necessary to undergo a mandatory medical examination at the local therapist, without fail voicing all the changes that occur in well-being. Persons over 50 are recommended to consult a neurologist at least once a year. The most important thing to remember is that self-diagnosis using information obtained from dubious Internet forums and self-treatment based on the advice of experienced people are absolutely unacceptable.