Is unexpressed external hydrocephalus dangerous? Prices for the diagnosis of external open hydrocephalus in adults. Reading strengthens neural connections

Hydrocephalus is a pathology associated with excessive accumulation of cerebral fluid in the ventricles of the brain. The disease can occur at any age, but most often doctors diagnose it in a newborn or infant in the first months of life. Dropsy causes the ventricles, greatly enlarged in size, to put pressure on other parts of the brain, causing neurological disorders.

Classification of pathology

Exist different kinds pathologies associated with the cause and form of the disorder:

open external hydrocephalus. AT this case there is a destruction of brain tissues, which become unable to absorb cerebrospinal fluid, the production of which is not disturbed.
Hypersecretory hydrocephalus. Occurs due to excessive synthesis of cerebrospinal fluid. Its quantity becomes such that the brain tissues cannot absorb it, so the volume begins to fill the cavity cranium.
Hypotrophic hydrocephalus is associated with malnutrition of brain tissues.

Closed hydrocephalus is associated with blockage of the CSF space and impaired fluid movement, so its level begins to fluctuate. The main reason for this condition is the development of a tumor or the formation of blood clots, which become an obstacle to movement. cerebrospinal fluid.

External replacement or non-occlusive hydrocephalus is considered the most dangerous, as it leads to a decrease in the amount of gray matter in the brain, which is replaced by cerebrospinal fluid. In this case abrupt change intracranial pressure does not occur. Therefore, the patient may for a long time not pay attention to the changes that are taking place and turns to medical care already when the pathology acquires external manifestations.
Moderate external hydrocephalus of the brain. In this case, the cerebrospinal fluid begins to fill the subarachnoid space.

Causes of external hydrocephalus

Dropsy of the brain in an adult or child may appear on different reasons, which are always associated with mechanical damage or neurological disorder. Most often, external hydrocephalus occurs due to:

Inflammatory processes that have affected the central nervous system, which can be provoked by some infections (encephalitis, tuberculosis, etc.).
Violations in the cervical vertebrae.
Functional disturbances blood vessels in the brain.

Traumatic brain injuries. As a result of mechanical impact on the head, there is a violation of the structure of the brain tissues, so they cannot fully absorb the cerebrospinal fluid. Gradually, the cerebrospinal fluid fills the free spaces. If you do not seek medical help in time and do not start competent treatment, then soon, slightly pronounced external hydrocephalus of the brain will begin to progress, causing dangerous consequences.

Neoplasms, including malignant.
Disorders in the development of the central nervous system.
Surgical intervention on the brain.

Symptoms

External hydrocephalus manifests itself sharp rise pressure and headache. This is due to a decrease in the volume of the brain and the filling of free space with cerebrospinal fluid. As a result of its accumulation, the liquid causes. The patient constantly feels severe fatigue and drowsiness, nausea and vomiting occur.

The danger of pathology lies in the fact that long time(sometimes even for several years) she does not give herself away in any way. And because of hypertension and atherosclerosis, other symptoms characteristic of external hydrocephalus develop. Over time, cerebral circulation is disturbed, which ultimately leads to sharp deterioration the patient's condition. Only then can one pay attention to danger signs illness.

Moderate external hydrocephalus except common features manifests itself:

Constant migraines.
Urinary incontinence.
Patients may experience double vision.

The neurosurgeon Fayyad Akhmedovich Farhat tells about the symptoms and treatment of the disease:

Change in gait.
Violation of coordination of movement.
Constant fatigue provokes violation mental state patient who develops depression and increased irritability. A person stops responding to others, can confuse the name of things.

If at least a few symptoms of a pathology are detected, it is important to immediately consult a doctor, since many of them may be characteristic of other equally dangerous diseases. If he confirms the diagnosis of mild external hydrocephalus, then the patient will be prescribed a medical course of treatment. Sometimes, surgery is needed to correct external hydrocephalus.

In an infant, the symptoms of internal or external forms of hydrocephalus are more pronounced. They begin to actively increase the volume of the cranium, which is associated with high pressure liquor. Since the bones of the skull in babies are still very fragile and not fully fused, the size of the head increases, from the outside it can be seen even with the naked eye.

In the case of replacement hydrocephalus, the symptoms will be slightly different, since this type of brain pathology is considered the most complex and actively progressing. In this case, the patient is concerned about:

Severe memory loss. The victim speaks very slowly and inappropriately, does not remember his name and does not react to others.
There is a violation of coordination of movement. The gait becomes unsteady.

More details about the violation of coordination of movements and its treatment are described by the neurologist Mikhail Moiseevich Shperling:

A person is not able to control the process of urination.
Dementia develops.

Diagnostics

Physicians have great amount diagnostic methods, which help to identify the accumulation of cerebrospinal fluid in the brain. However, the most informative of them are computed (CT) and magnetic resonance imaging (MRI).

Thanks to these diagnostic methods, the doctor can not only establish the fact of hydrocephalus, but also identify the causes of its occurrence, stage and degree of development. MRI allows you to explore the cranial cavity, the brain, to detect possible neoplasms and liquorodynamic changes.

MRI image of hydrocephalus

To detect hydrocephalus, inject contrast agent not needed in the body. However, doctors often recommend doing this in order to determine the state of the vessels located in the brain.

One of the new methods for examining the state of the brain is cisternography, which allows you to evaluate the process of CSF circulation. In addition, for the diagnosis of external hydrocephalus, the following can be used:

(conducted for children of the first year of life).
Angiography - assessment of the condition of blood vessels, blood clots and aneurysms. The examination reveals the presence of cysts and tumors in the brain.
Examination of the body for the presence of viruses and other infections in it.

Ultrasound examination of the brain

For staging accurate diagnosis(external hydrocephalus) the doctor should find out specific complaints from the patient. Therefore, it is important to clearly describe all violations that have occurred recently.

Treatment

The therapy should be based on a set of measures aimed at improving cerebral circulation and the functionality of the central nervous system. With moderate external hydrocephalus, drug treatment is effective. For this, the patient is assigned:

Drugs with a diuretic property ("Diakarb"), which help to remove excess fluid from the body.
Saluretics.
Solutions of plasma substitutes.

The average price in pharmacies for 30 tablets of the diuretic drug "Diacarb" is 250 rubles

Drugs that strengthen the vascular walls.
Barbiturates.
Glucocorticosteroids.
Painkillers.

The patient is prescribed physiotherapy and a course of exercise therapy. During treatment, it is important for the patient to adhere to special diet With low quantity fatty foods and reduce the amount of fluid consumed so as not to provoke the development of puffiness. In addition to taking medication, he can use folk remedies which have a diuretic effect. But, it is worth remembering that they independent use will not cure external hydrocephalus.

If such treatment does not bring the desired result, the doctor will decide on an operation. Also surgical intervention becomes the only treatment option for hydrocephalus caused by cerebral hemorrhage, or if replacement pathology is diagnosed.

Today for surgical treatment any form of hydrocephalus uses minimally invasive techniques. During the operation, the surgeon performs a shunt, which allows the CSF to drain into other cavities. For this, a microscopic incision is made and a neuroendoscope is used. According to patients, this operation is well tolerated and contributes to a significant improvement. general condition person.

The prognosis for the patient will depend on the timeliness of the visit to the doctor and the start of competent treatment. It is important to identify and eliminate the underlying cause of external hydrocephalus. If external hydrocephalus in adults is accompanied by atrophy, then the patient may develop serious neurological disorders. The danger is also replacement hydrocephalus which requires timely, qualified medical care.

Neurosurgeon Alexander Vyacheslavovich Pechiborsch talks about the surgical treatment of the disease:

Prevention

External hydrocephalus is considered a dangerous disease that can cause serious health problems. To avoid its development, you must adhere to some rules:

Avoid head injury.
Timely treatment of hypertension and vascular pathologies.
prevent development infectious processes in the body.
Monitor weight and, if necessary, take measures to reduce it.

Rheumatologist Pavel Valeryevich Evdokimenko talks about ways to treat hypertension:

To refuse from bad habits.
Eat properly.
Do sport.

When the first signs of the disease appear, it is important to immediately consult a doctor to start timely treatment which will help to avoid serious consequences.

Hydrocephalus is a disease that is accompanied by the accumulation of excess amounts of cerebral fluid in the ventricles of the brain. All conditions have been created for the treatment of patients with hydrocephalus in the Yusupov hospital. In the clinic of neurology, rooms of increased comfort are presented. Air conditioners allow you to create a comfortable temperature regime. Patients are provided with individually selected nutrition and personal hygiene products.

Professors and doctors work in the neurology clinic the highest category having knowledge and experience in treating patients with hydrocephalus. Neurologists use the most effective drugs having high efficiency and minimal expression side effects. Neurosurgical operations for hydrocephalus are performed by leading neurosurgeons in partner clinics.

Symptoms of external hydrocephalus

Neurologists distinguish the following types of hydrocephalus:

open external hydrocephalus in adults;
closed hydrocephalus;
replacement (non-occlusive) hydrocephalus of the brain in an adult;
moderate (mild) cerebral hydrocephalus in adults;
hypotrophic hydrocephalus;
hypersecretory hydrocephalus.

Severe external hydrocephalus of the brain is accompanied by the destruction of brain tissues, which become unable to absorb cerebrospinal fluid, the production of which is not disturbed. Closed hydrocephalus is characterized by blockage or obstruction of the movement of cerebrospinal fluid and its accumulation in the brain tissues. Neoplasms, hematomas, blood clots, adhesions that have arisen due to inflammatory processes act as obstacles blocking the outflow of cerebrospinal fluid.

In the presence of replacement (non-occlusive) hydrocephalus in adults, fluid fills the spaces in the brain structures that have been released due to a decrease in gray matter volume. Hypotrophic hydrocephalus occurs when there is a malnutrition of the brain tissues. Hypersecretory hydrocephalus is the result of excessive production of cerebrospinal fluid, which is not able to absorb brain tissue. In such cases, cerebrospinal fluid begins to fill the intracranial cavities.

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

inflammatory diseases central nervous system;
violation of the stability of the cervical vertebrae;
pathology of cerebral blood vessels;
traumatic brain injury;
dyscirculatory encephalopathy;
defects in the development of the central nervous system;
brain tumors;
surgical interventions on the brain.

The main signs of external hydrocephalus in adults are headache and increased intracranial pressure due to a decrease in brain volume and filling of free space with cerebrospinal fluid. As a result of its accumulation increases intracranial pressure. The patient constantly feels drowsiness and severe fatigue, he is disturbed by nausea and vomiting.

Mild external hydrocephalus in adults is dangerous because it may not manifest itself in any way for several years. Over time, cerebral circulation is disturbed, which leads to a sharp deterioration in the patient's condition. Mild external hydrocephalus is manifested by persistent headaches resembling migraine attacks, persistent migraines and urinary incontinence. Patients may experience double vision, gait changes, and coordination of movements may be disturbed. Constant fatigue causes a violation of the mental state of the patient, who develops increased irritability and a depressive state. A person can confuse the name of things, stops responding to others.

Most informative methods, allowing to identify open external hydrocephalus in adults, are computed and magnetic resonance imaging. In the Yusupov hospital, the study is performed using modern devices leading European and American firms. Tomography allows you to identify not only the signs of hydrocephalus, but also the stage, as well as the degree of development. To determine the state of the vessels of the brain, doctors perform contrast angiography. Cisternography allows you to evaluate the process of CSF circulation.

Conservative treatment of external hydrocephalus in adults

In the presence of mild hydrocephalus of the brain in adults, neurologists at the Yusupov hospital conduct drug therapy. Patients are prescribed the following drugs:

diuretics;
plasma-substituting solutions;
barbiturates;
glucocorticosteroids;
analgesics.

In the rehabilitation clinic, physiotherapy procedures and physiotherapy exercises are carried out. During treatment, it is important for the patient to follow a special diet with a low amount of fatty foods. In the Yusupov hospital, cooks are preparing diet meals, which palatability no different from home cooking.

With inefficiency drug treatment a neurosurgeon is invited for a consultation. He decides on the advisability of performing surgery. All severe cases hydrocephalus is discussed at a meeting of the expert council.

Neurosurgery for hydrocephalus

Palliative interventions are performed by neurosurgeons in the presence of open dropsy of the brain and the inability to perform a radical operation for closed hydrocephalus. Doctors perform spinal, ventricular puncture. After taking 100 ml of CSF, the patient's condition temporarily improves.

Ventriculoperitoneal shunting is a radical neurosurgical operation. Using a system with a valve, cerebrospinal fluid is transferred through the catheter into abdominal cavity where it is absorbed into the bloodstream. During the Küttner-Wenglovsky operation, a drain is placed through which the cerebrospinal fluid passes from the ventricle of the brain to the subdural space.

In order to reduce the release of cerebrospinal fluid during a neurosurgical operation, the choroidal components of the brain ventricle are removed. If there is a speck, they are dissected. Fluid outflow is also produced from rear wall ventricle into the spinal canal.

External hydrocephalus - dangerous disease, which may cause serious problems with health. To prevent the disease, head injuries should be avoided, adequate therapy arterial hypertension and cerebral atherosclerosis to prevent the development of infectious processes. If you have the first symptoms of external hydrocephalus, call the Yusupov hospital, where doctors will conduct a comprehensive examination, determine the cause and severity of the disease. After the final diagnosis is established, an individual treatment will be prescribed. Specialists of the rehabilitation clinic will conduct physiotherapy and a course physiotherapy exercises, contributing to the speedy recovery of impaired functions.

Bibliography

ICD-10 ( International classification diseases)
Yusupov hospital
"Diagnostics". - Brief Medical Encyclopedia. - M.: Soviet Encyclopedia, 1989.
« Clinical Assessment results of laboratory research”//G. I. Nazarenko, A. A. Kishkun. Moscow, 2005
Clinical laboratory analytics. Fundamentals of clinical laboratory analysis V.V. Menshikov, 2002.

Prices for the diagnosis of external open hydrocephalus in adults

*The information on the site is for informational purposes only. All materials and prices posted on the site are not public offer determined by the provisions of Art. 437 of the Civil Code of the Russian Federation. For exact information, please contact the clinic staff or visit our clinic. List of rendered paid services listed in the price list of the Yusupov hospital.

*The information on the site is for informational purposes only. All materials and prices posted on the site are not a public offer, determined by the provisions of Art. 437 of the Civil Code of the Russian Federation. For exact information, please contact the clinic staff or visit our clinic.

External hydrocephalus is also called "dropsy". This pathology has several forms at once. The main characteristic of the disease can be considered an excessive accumulation of cerebrospinal fluid in the spaces of the brain, and in some cases also a violation of its production and outflow.

External hydrocephalus: what is it?

This pathology is classified as a serious disease of the neurological sphere. It occurs in the ventricular system and the subarachnoid space of the brain. The peculiarity of the pathology is manifested in the accumulation of excess cerebrospinal fluid in these areas and the violation of its outflow. At the same time, the amount of cerebrospinal fluid in the brain significantly exceeds the norm. Doctors distinguish congenital (obtained due to pathologies) prenatal development) and the acquired form of the disease.

Previously, hydrocephalus was considered exclusively a childhood disease, since it was almost always congenital and was recorded in approximately 2-10 babies per 1000 newborns. Later, the disease began to be detected in adults. In this case, the disease is formed as a complication after other pathologies of the brain, such as stroke, traumatic brain injury, certain neoplasms, infections, or meningitis. Sometimes the disease is also “independent”, that is, it is formed solely as a result of improper outflow of cerebrospinal fluid and its accumulation in the spaces of the brain.

Forms of the disease

Depending on the pathogenesis, doctors distinguish several forms of the disease:

open (non-occlusive);
closed;
hydrocephalus ex vacuo.

In the first case, the disease is formed as a result of a violation of the production and absorption of cerebrospinal fluid, and free communication of spaces carrying cerebrospinal fluid is assumed. At closed form these spaces are divided into different levels. Hydrocephalus ex vacuo is characterized by the consequence of atrophy (wasting) in the case of certain CNS pathologies (for example, Alzheimer's disease) or normal process aging.

There are other options. Vicarious hydrocephalus is accompanied by an increase in the size of the ventricles, however, normal anatomy the brain is not affected. inner form significantly different from the outside. In the second case (with an open external form), the space under the membranes of the brain expands, the "dropsy" overflows, as a result of which thinning of the medulla may occur in the future. At internal hydrocephalus it doesn't happen.

Signs of external hydrocephalus

Symptoms of this disease can be different, to a greater extent they depend on the form of the disease and the characteristics of its course. To possible indications external hydrocephalus should include:

A mild or mild stage of the disease may not be accompanied by changes in well-being at all. In this case, the patient writes off fatigue, weakness and mild headache to unfavorable weather, stress or workload at work or at home. Clinical picture- unexpressed, the patient has only weak manifestations of the initial signs.

With absence necessary treatment The patient develops replacement hydrocephalus. It is accompanied by significant changes in the body and can threaten such unpleasant symptoms as a violation of memory and thinking, as well as dementia. Separately, it is necessary to highlight the signs of hydrocephalus in infants. Usually in babies, the disease is pronounced and is accompanied by such symptoms as swelling of the veins and fontanelles, excessive head volume, discrepancies in the areas of connection and fusion of the bones of the skull, loss of appetite, inhibited reaction, and others.

Diagnostics

Most effective method examinations of patients with this pathology consider MRI (magnetic resonance therapy). It allows you to assess the severity of the disease and its form. However, in some cases, other diagnostic methods may be recommended, for example, computed tomography, angiography (contrast x-ray examination vessels), ultrasound procedure brain, some laboratory tests. CT is necessary to diagnose the contours of the anatomical structures of the brain, to identify other anomalies, such as neoplasms.

Treatment

The tactics of therapy primarily depend on the form of hydrocephalus and age category patient. In most cases, the first conservative therapy. The patient is prescribed diuretics and vasodilators. They normalize the functioning of the central nervous system and control the outflow of cerebrospinal fluid. At the same time, special drugs are prescribed to reduce the production of cerebrospinal fluid and improve venous outflow. Most often, conservative treatment can only slow down the development of the disease and alleviate the patient's condition, only occasionally it helps to achieve a complete recovery.

If therapy with drugs for several months did not help stabilize the process, and the accumulation of cerebrospinal fluid progresses, the patient is recommended surgical intervention. Most often this is a bypass or endoscopic surgery. Both methods have their advantages and disadvantages, as well as indications and contraindications, so only a qualified neurosurgeon can decide on the type of intervention. Remember that conservative treatment and folk therapy or traditional ways ineffective in external hydrocephalus. Do not self-medicate, it is not only useless, but can be dangerous to your health!

People who first encountered hydrocephalus (cerebral dropsy) do not know what it is and are afraid of death. However, this disease can be cured if detected in time. It has many types and forms, so it can concern not only kids, but also adults. For this reason, external hydrocephalus is divided into congenital, that is, obtained during childbirth or during fetal development and acquired. The second type concerns adults and occurs due to many causes, such as trauma, dementia (dementia), impaired blood flow, etc.

Hydrocephalus is characterized by disruptions in circulation, which in medicine is called cerebrospinal fluid. Due to its accumulation, the brain cavities, which are the brain stomachs (ventricular space), increase. Gradually soft tissues atrophy, and with moderate external replacement hydrocephalus, the vacated space is filled with cerebrospinal fluid. At the same time, neurological symptoms appear in a person, for example, the fingertips go numb, it darkens in the eyes, coordination of movements is disturbed, etc.

The problem of pathology is a weak outflow of cerebrospinal fluid or its excessive production. You can understand all the features of the pathology, focusing on its forms:

Asymmetric dropsy. In this case, a volumetric accumulation of cerebrospinal fluid occurs in one of the ventricles;
Double-sided. Fluid overflows all cerebral cavities;
Mixed dropsy. This type of disease is considered the most severe, since there is an internal and external increase in cerebrospinal fluid. The prognosis is negative and the patient suffers from paralysis individual groups muscles, epilepsy, seizures, etc.;
Atrophic. This form begins to manifest itself due to the injury. It can be external and internal, depending on the nature and severity of the injuries received. On the initial stage the problem does not manifest itself and the formation of cerebrospinal fluid begins in 2-3 weeks. Such a reaction is quite natural, as the body tries to replace the tissues that have been damaged with cerebrospinal fluid. It is necessary to treat atrophic dropsy immediately, since on advanced stages this is difficult to do;
Vicarious dropsy. The brain cavities increase, but there are no abnormal changes in the structure of the brain. Symptoms are unexpressed and if the course of therapy is completed in a timely manner, then the prognosis is mostly positive;
Hypotrophic. The beginning of the development of this form of pathology is associated with insufficient nutrition of the brain. The manifestations of hypotrophic hydrocephalus are no different from the signs of other varieties of the disease. A person has a headache and the work of the vestibular apparatus is disturbed;
Compensatory dropsy. This type of pathology is a residual effect after the treatment. Circulation and CSF production have returned to normal, but the ventricular space is still slightly enlarged;
Partial. A kind of disease occurs due to an increase in the synthesis of cerebrospinal fluid. She is characterized by neurological disorders, including seizures of epilepsy;
Discirculatory dropsy. You can meet this type of pathology in people with impaired cerebral circulation, and at the same time, atrophy of brain tissue is observed.
External hydrocephalus of the brain. In this case, an increase in volume is observed around the brain and in the peripheral space;
Internal hydrocephalus of the brain. The form is characterized by an increase in the cerebral ventricles and the median pathways through which the CSF passes;
Closed external hydrocephalus (occlusive). It is characterized by a violation of the circulation of the fluid due to a certain obstacle. Usually they are congenital anomaly structures, tumor, hematoma, etc.;
Open external (non-occlusive). Excessive synthesis of CSF or its insufficient absorption is characteristic. The circulation is not disturbed;
External replacement hydrocephalus of the brain. It is characterized by atrophy of brain tissues, the place of which is occupied by cerebrospinal fluid. Replaced areas of the brain are responsible for important processes in the body, so this process usually does not pass without a trace. This form is divided into several subspecies:
- Moderate outdoor.

Moderate external replacement hydrocephalus is common. This disease is characterized atrophic changes brain tissues with subsequent filling of the formed spaces with cerebrospinal fluid. It can be cured, but for this you will have to find out the cause of the development of dropsy and undergo a course of therapy.

The reasons

Moderately severe external hydrocephalus develops due to the following reasons:

Violations of cerebral circulation;
Failures in the nervous system;
Psychoorganic syndrome;
dementia;
Inflammation of the brain tissue;
Pathology of the cervical region;
head trauma;
Incorrect course of therapy after a stroke;
encephalopathy.

The acquired form of external hydrocephalus in an adult has the same causes of development as in a baby.

However, in newborns, the disease may be congenital and should be treated as soon as it is discovered. Otherwise, pathology can lead to lethal outcome. This type of hydrocephalus occurs due to damage received during childbirth, a brain anomaly, or fetal hypoxia.

Symptoms

With mildly pronounced external hydrocephalus in adults, the disease does not particularly manifest itself. Of the signs of such a pathology, the most basic can be distinguished:

confusion;
General fatigue;
Vomiting;
Insomnia;
visual impairment;
Headache.

With an external replacement of the congenital type, babies become whiny and irritable. If not treated pathological process, it often leads to disability and death.

Moderate hydrocephalus in adults sometimes turns into chronic stage. The course of the pathology becomes sluggish and the consequences are usually irreversible. It often results in dementia.

After trauma hydrocephalus of the brain in adults develops after about 2-3 weeks. The patient's coordination of movements weakens, and various functional failures develop, for example, urinary incontinence and memory impairment.

Diagnostics

Congenital dropsy of the brain in infants is easy to diagnose by outward signs(enlargement of the head). However, it is not so easy to find out about the presence of a problem in an adult, and for this you will have to use instrumental methods examinations:

Tomography (computer and magnetic resonance);
radiography;
Angiography (examination of blood vessels).

An MRI report can tell about the form of moderate external hydrocephalus of the brain. Having determined the type of disease and severity, the doctor will draw up a treatment regimen.

Medical treatment

Moderate outer shape on the early stages amenable to drug treatment. Drugs are used to dilate blood vessels and excrete excess fluid from the body, as well as drugs to normalize the nervous system.

Symptoms and treatment usually go hand in hand, so symptomatic therapy also no less important. It includes medicines for the relief of emerging signs of pathology. However, if after 2 months the symptoms of the disease do not disappear, the doctor will recommend surgery.

Surgery

Basically, operations are performed to eliminate excess amounts of cerebrospinal fluid, for example, CSF shunting. In most cases, it is extremely effective and the result of therapy is visible almost immediately. Held surgical intervention using a set of tubes and valves to drain CSF into the body cavity, where it will not cause harm and will be disposed of. After the operation, the patient expects a long recovery period (at least 7 months). If the system is broken, you will have to perform a second surgical intervention. Such a procedure is required mainly to replace the shunt or adjust the design.

Generally doctors advise endoscopic operations, since you do not have to install a complex structure and the outflow of cerebrospinal fluid is faster. Such surgery involves the creation of a small hole in the ventricular space for the withdrawal of cerebrospinal fluid. This procedure is suitable mainly for the closed type of hydrocephalus. After it, the patient usually recovers completely and does not feel much discomfort. However, it is prescribed only in 10% of cases, and in all other situations it is necessary to use CSF shunting.

Moderate external hydrocephalus does not particularly manifest itself and often becomes chronic, which is characterized by the development of dementia. To prevent this, it is necessary to be examined in a timely manner and undergo a course of treatment aimed at eliminating the cause of the disease.

External hydrocephalus of the brain is quite serious illness, which is due to the excess volume of cerebrospinal fluid, that is, cerebrospinal fluid. It is for this reason that the people call such a pathology dropsy. The cerebrospinal fluid itself does not cause any harm, its presence is mandatory for the brain, but only when its level is within normal limits. Most often, a violation of fluid circulation occurs due to vascular damage and traumatic brain injury. A little more rare causes become a stroke or an infection transferred by the patient.

External hydrocephalus is not only an acquired pathology, it can also occur in newborns (the reason for its development is intrauterine infections).

Types

Depending on what are the causes of violations and their forms, the following types are distinguished this disease:

Hydrocephalus open. Cerebrospinal fluid is produced, but the brain cells do not absorb it.
Hydrocephalus closed. It is characterized by blockage or difficulty in the movement of fluid, as well as its accumulation in the brain tissues. In the form of obstacles that block the cerebrospinal fluid channels, blood clots, tumors, formations that appear due to the inflammation processes transferred by the patient, hematomas can act.
External hydrocephalus of the brain is non-occlusive (or replacement). Liquid fills the spaces in brain structures, which turned out to be free due to a decrease in the amount of gray matter, that is, this pathological form dangerous if there is no timely therapy, since it is characterized by the onset of symptoms at a late stage of development.
Hydrocephalus is moderate. CSF fluid due to defects in its circulation directly accumulates in the subarachnoid space.
Hydrocephalus hypotrophic. Appears with malnutrition of brain tissues and is accompanied by a number of acute symptoms, including vomiting, decreased vestibular functioning, nausea, intense headaches.
Hypersecretory hydrocephalus is the result of too high production of cerebrospinal fluid, the brain tissues are not able to absorb a large amount of it, and the fluid in this case fills the cavities inside the skull.

External hydrocephalus in its origin is acquired or congenital. An acquired disease appears after diseases of the vertebral and vascular systems, intracranial injuries, increase in tumors, inflammatory and infectious processes that affect the brain.

Mild illness

External hydrocephalus in adults in the first stage may not manifest itself. This is typical for mild degree diseases. For minor violations brain system the body is able to restore fluid circulation on its own. Thus, mild external hydrocephalus of the brain of the head has a very optimistic prognosis in terms of specific therapy and consequences.

Symptoms in an adult

In an adult patient, in the absence of diagnosis, the pressure on the brain system increases, an external hydrocephalus of the brain of the head of a pronounced type appears, which is distinguished by a number of specific symptoms:

migraine and headaches;
drowsiness;
nausea;
impaired functioning of vision (double vision);
excessive fatigue;
weakness.

If signs of external hydrocephalus occur after injury or past illness you need to contact a specialist immediately.

Hydrocephalus replacement

In the absence of timely conduct of the necessary treatment, external replacement hydrocephalus of the brain of the head may appear, which differs more bad symptoms:

gait and coordination disorders;
features of dementia;
voluntary urination.

Often these symptoms are age-related changes, and thus the consequences of the disease are even more complicated.

Diagnostics

Although there are quite a few diagnostic methods for determining an excessive amount of fluid in the brain of the head, the main value in the examination is most often given to CT, that is computed tomography, and MRI, that is, magnetic resonance imaging. Such procedures help to quickly make the correct diagnosis.

Thanks to CT and MRI, the causes and symptoms of the pathology, its stage and, of course, the level of its neglect are determined. With the help of procedures, specialists examine the cranial cavity, the contours of the brain of the head and possible tumors and cysts.

When examining the brain for the presence of external hydrocephalus, a contrast agent is not required, but many doctors still advise injecting it into the body in order to simultaneously check the condition of the blood vessels. Of course, the effect of the circulatory system on the excess amount of cerebrospinal fluid is not too great, however, CT or MRI with contrast in some cases can diagnose other diseases, if any, in the patient's body.

In addition, specialists can record the patient for a procedure such as cisternography. This is one of the newest diagnostic methods for studying the brain of the head, which is aimed at analyzing the circulation of cerebrospinal fluid.

Other procedures

In addition to the listed outpatient research methods for determining hydrocephalus, in some cases procedures such as:

angiography - used to diagnose the condition of blood vessels, the presence or absence of cysts, tumors, blood clots and aneurysms;
Ultrasound of the brain of the head;
radiography;
examinations for infections and viruses.

It is also obligatory for a specialist to interview a patient about existing complaints. The patient must describe the symptoms that he has. Thanks to this, doctors will be able to make the correct diagnosis and choose the right therapeutic course, which will reduce outward manifestation pathological signs.

Consider how external hydrocephalus is treated.

Therapy with medications

Although drug therapy is not the most effective, it is at the same time more gentle. Conservative treatment may be prescribed based on the patient's age, general condition, and type of hydrocephalus. Focuses on diuretics, vasodilators medicines and saluretics of strong action, which increase the outflow of cerebrospinal fluid. At the same time, such pharmacological preparations which slow down its production. The patient is also prescribed concomitant medications that allow the treatment of external hydrocephalus.

The standard recipe includes the following means:

"Acetazolamide" - a drug that lowers pressure inside the eye;
"Glimarit", "Diakarb", "Manit" - diuretic drugs;
barbiturates and painkillers;
and "Furosemide" - means that remove salts from the body and excess water;
albumin solution at a concentration of 20% to adjust the composition of plasma and blood;
a solution of magnesium sulfate 25%, "Troxevasin" and "Glivenol" - drugs that improve blood circulation;
"Prednisolone", "Methylprednisolone", "Dexamethasone", "Betamethasone" are hormonal-type steroids that have an anti-inflammatory effect.

Conservative treatment only in some cases leads to recovery, its primary task is to alleviate the patient's condition and the development of hydrocephalus of the external type. If it is impossible to achieve steady state surgery is required within two to three months. Drug therapy is also not allowed for diseases in acute clinical form.

Shunting

In adult patients, one of the most effective ways The therapy for external cerebral hydrocephalus is brain shunting. Satisfactory results are achieved in 85% of cases. Thanks to the system of valves and pipes excess amount cerebrospinal fluid is withdrawn by force and natural ways in those cavities of the body in which the accumulation of fluid is not so critical.

Complete recovery is the main advantage of this technique, however, along with this, there is a possibility of inconvenience and complications for the patient, among which the most frequent are:

from time to time the emerging need for a complete or partial replacement of the shunt;
the risk of hematomas due to intense fluid outflow;
dependence on the functioning of the system;
too low churn;
the possibility of epilepsy, bedsores, inflammation.

There are also contraindications for shunting:

neurological diseases;
hydrocephalus in chronic form;
blindness;
epilepsy;
mental disorders.

Endoscopy

Most often, the indication for endoscopy in adult patients is a tumor or traumatic formations. Thanks to this technology, it is possible to eliminate the obstacle that impedes the CSF circulation, without opening and trepanation of the cranium. With the help of an endoscope, instruments are inserted into those places where cerebrospinal fluid accumulates, through which excess fluid is sucked out to normal limits. Compared with this method, the advantages of endoscopy are obvious: its initial goal is to normalize the natural flow of cerebrospinal fluid, minimize injuries during surgery, and increase the likelihood of recovery. Moreover, the body lacks foreign body. Thanks to the endoscope, it becomes possible to completely eliminate neoplasms that caused blockage of the CSF circulation, as a result of which the patient's condition improves almost immediately after the operation. Often, this is the only method eliminate malignant or benign tumor. The attending physician decides on the use of endoscopic intervention for external hydrocephalus of the brain in an adult.

Diet

Dietary prescriptions for adults with external cerebral hydrocephalus focus on stabilization water balance in the body. The diet includes products that do not contain salts and sugar:

steamed lean meat;
boiled eggs or steamed omelet;
vegetables and greens;
stale bread;
porridge.

Dishes that promote fluid accumulation should be excluded from the patient's menu:

confectionery and freshly baked flour products;
fried, smoked, fatty meat, sausages;
mushroom and fish soups;
carbonated drinks;
onion, garlic, radish.

Forecast

The prognosis of external cerebral hydrocephalus in adults is not always predictable. This is a fairly serious disease, the neglected form of which can lead to death. Even a successful and timely operation does not guarantee the absence of complications and some restrictions in the future. Experts note not only physiological, but also psychoneurological disorders. To relieve stress, the patient will help moderate physical exercise, regular walks. Practice shows that in most cases it is possible full recovery after surgical treatment and return to a full life.