Hypertensive syndrome

Hypertension syndrome, also known as hydrocephalic syndrome, is a specific pathological condition in which cerebrospinal fluid is produced in an increased amount. This fluid, medically called cerebrospinal fluid, usually accumulates within meninges and in small amounts in the ventricles of the brain.

Western doctors most often attribute this disease to one of the types of pathologies from the development of the brain. Despite this, hydrocephalus is considered in most cases to be a syndrome.

A distinctive feature of the disease is that often hypertension-hydrocephalic syndrome, as one of the diagnoses, is set incorrectly, and this happens in almost 98% of cases. The situation can be explained by the fact that this pathology is very rare in humans.

Varieties of the disease

Hypertension syndrome is classified depending on the age of the patient.

Therefore, this disease exists only in three forms:

in newborns;
in children;
in adults.

In most cases, the syndrome manifests itself in newborns due to congenital causes . As for children or adults, the disease is acquired.

But each of these groups has its own factors that directly affect the appearance of the disease.

Causes of the syndrome in newborns

Hypertensive hydrocephalic syndrome has many possible causes in newborns, and here are the main ones:

The occurrence of complications during pregnancy, often provoked by infectious or viral diseases.
Fetal hypoxia.
Deviations in the work of the cardiovascular system.
Damage to the fetus during childbirth, which is mechanical in nature.
Retardation of intrauterine development.
Traumatic brain injuries that can be inflicted on a child both during pregnancy and directly during childbirth.
Anomalies in the development of the fetus.
Births that occur prematurely or late.
Fetal dehydration that lasts more than 12 hours.
chronic diseases future mother.

Causes of the acquired syndrome

Hypertensive syndrome in children, as in adults, is acquired. Often the result of its appearance or even a concomitant diagnosis is cerebral palsy.

Before establishing this diagnosis, it is necessary to know what hypertension syndrome is and how it manifests itself. Its symptoms include two conditions at once, which occur both with hypertension and with hydrocephalus.

Hypertension is an increased intracranial pressure, and - a deviation in the form of an increase in the amount of fluid (liquor) within the brain.

The main symptoms of hypertension in newborns are:

poor reaction to the breast and refusal to feed;
moaning and crying for no reason;
marked decrease muscle tone;
lack of a pronounced swallowing reflex;
tremor or leg cramps;
eye changes - swelling of the apples, strabismus, the presence of a white line between the pupil and upper eyelid iris hidden behind the lower eyelid;
tension in the fontanel;
dynamic increase in head diameter, which reaches 1 cm per month.

The hypertensive-hydrocephalic syndrome in children manifests itself a little differently:

severe morning headache;
nausea and urge to vomit;
complicated lifting of the eyes and pain that occurs when turning the head;
pale skin and constant weakness leading to dizziness;
muscle pain and abnormal function vestibular apparatus;
fear of bright lights and too loud sounds;
reduced memory, concentration and thought process.

Hypertension syndrome manifests itself in adults in almost the same way as in children. In addition to the above symptoms, this group of people is characterized by deterioration visual function and consciousness, sharp headaches and the urge to vomit, which as a result leads to the appearance of convulsions. Very rarely, a coma can occur.

Diagnosis of the disease

Determining the syndrome is very difficult, and making a diagnosis with a full guarantee of its probability is an impossible task. The congenital syndrome is determined by the correct functioning of the reflexes, as well as the size of the head circumference. To confirm or detect its presence in children or adults, an examination is carried out eye vessels, tomography, ultrasound, as well as puncture of the cerebrospinal fluid.

Symptom management in newborns and children

Liquor-hypertension syndrome requires a special treatment regimen, which differs for different groups sick.

Newborns should see and be treated by a neurologist until they are one year old. In the presence of special indications this period may be extended. Depending on the severity of the disease, as well as its manifestations, the specialist should draw up necessary treatment.

It may include those drugs whose action is aimed at removing excess cerebrospinal fluid. They are Triampur, Glycerol, etc. Also in this case, it is necessary to prescribe funds that provide vascular tone - for example, Aescusan.

Often the cause of the syndrome is a violation nervous system. Despite the prescribed treatment, in order to prevent and restore young parents, it is necessary to provide the child with correct mode sleep and nutrition, frequent walks on fresh air, lack of irritants and infections. Subject to treatment and all recommendations, normalization can be observed already after 6 months. intracranial pressure, which will not deviate from the norm in the future.

Older children should receive counseling pediatric neurologist at least twice a year, during which the fundus is measured and an X-ray of the skull is prescribed. After a traumatic brain injury or in the presence of inflammatory processes in the brain or its membranes, observation and treatment in a dispensary is necessary.

Treatment methods for adults

Treatment of adults is also extremely important, since a neglected disease can become a threat not only to health, but also to life. Action high pressure over a long period does not allow the brain to function properly, which leads to a decrease in intellectual abilities and even dysfunction nervous regulation towards internal organs. Often the result is a hormonal imbalance.

Treatment of hypertension in adults includes the use of diuretics, which contributes to the activation of CSF secretion, as well as its absorption. This therapy carried out in several courses, and in complicated forms, drugs should be taken every week. If the disease is easy temper, then treatment without the use of medicines is possible.

However, for this you need to follow a few recommendations:

normalize drinking regimen;
perform a set of special gymnastic exercises that help lower intracranial pressure;
get rid of excess head venous bed with the help of osteopathy or manual therapy.

Very rarely, hypertension becomes a serious threat to human health.. In this case, surgical intervention is necessary. This operation involves the implantation of shunts, with the help of which the cerebrospinal fluid will be removed from the brain. The result of this will be a gradual decrease in the manifestations of the symptoms of the disease and, as a result, getting rid of it completely.

Timely contact with a specialist is always right decision when the first signs of illness appear. If treatment is started on time, the disease will not have the opportunity to acquire a chronic or severe form.

Hypertensive (hypertensive-hydrocephalic) syndrome - increased intracerebral pressure. This syndrome is due to the accumulation cerebrospinal fluid(liquor) under the membranes and in the ventricles of the brain. It occurs as a result of an obstruction to outflow, excessive formation and violation reverse suction liquor. Hypertension syndrome is the most common syndromic diagnosis in pediatric neurology, especially in children. early age with perinatal encephalopathy.

The causes of hypertension-liquor syndrome include: unfavorable course of pregnancy and childbirth, deep prematurity, ischemic brain damage, intracranial hemorrhages, intrauterine infections, birth defects brain development, etc.

Clinical signs of hypertension in children are severe paroxysmal headaches that end in vomiting.

When examining a sick child, an expansion of the ventricular system of the brain is determined, which is detected by ultrasound of the brain, and also, using echoencephalopathy data, an increase in intracranial pressure is recorded. In more severe cases the symptoms of hypertension syndrome include a disproportionate increase in the size of the cerebral part of the skull, and sometimes, in the case of a unilateral pathological process, head asymmetry can be observed.

With hypertensive-hydrocephalic syndrome in children, either hydrocephalus can dominate, which is manifested by the expansion of the ventricular system of the brain, or hypertension syndrome, accompanied by an increase in intracranial pressure. With an increase in intracranial pressure, the child becomes restless, irritable, sleeps lightly and often wakes up. With the dominance of the hydrocephalic syndrome in children, lethargy and drowsiness are observed, they are inactive, sometimes there is a developmental delay.

Treatment of hypertension in newborns or adults is carried out on an outpatient basis. The doctor prescribes medications, usually diacarb, which increases the outflow and reduces the secretion of cerebrospinal fluid. The treatment effect is achieved with correct assessment process steps and causation various factors. Hyperdiagnosis of hypertension syndrome in a newborn may lead to unjustified prescription of dehydration agents. In case of ineffective treatment with diacarb, increasing atrophy of the medulla, further progressive enlargement of the ventricles, confirmed by neuroimaging data, hospitalization in a neurosurgical clinic is indicated.

It is worth focusing on the fact that in young children, the relationship between the presence of a large head (macrocephaly) and hydrocephalus is not detected. Children are often diagnosed with mild hypertension syndrome" or "moderate hypertension syndrome" without data support comprehensive survey. The diagnosis of "hypertensive-hydrocephalic syndrome" is possible only on the basis of a comparison of clinical manifestations with the results of studies that are confirmed by the presence of changes in the size of the brain ventricles. The conclusion of a neuropathologist, ophthalmologist, radiologist, psychiatrist, as well as data from echoencephalography, neurosonography, CT, MRI, electroencephalography, rheoencephalography is required. The data of the children's city consultative neurological polyclinic make it clear that after a comprehensive examination of children referred with a diagnosis of "hypertensive syndrome", in 97% of cases it is not confirmed.

Hypertensive syndrome: signs, treatment, causes, prognosis

Hypertension syndrome (HS) is found quite often in the diagnoses of neurologists, it affects both adults and children. P an increase in intracranial pressure is almost always a symptom of a serious illness, so it cannot be ignored. At the same time, in pediatric practice, cases of overdiagnosis of this condition are not uncommon, and with a detailed examination more than 90% of babies with " mild form' is not confirmed.

The cranial cavity is limited by bones and has a constant volume, so an increase in its contents is always accompanied by clinical symptoms. An increase in intracranial pressure accompanies neoplasms, the appearance of excess fluid, hematoma, head trauma, it can be acute and chronic, but always requires the close attention of specialists.

If in adults everything is more or less clear with, then in children the issues of correct diagnosis and treatment have not yet been finally resolved. The fact is that in infants, pressure in the skull often rises with prolonged and strong crying or screaming, this can be considered a variant of the norm in the absence of other reasons. Such transient hypertension is not always clinically manifested, because the bones of the skull in babies have not yet completely fused, there are fontanelles, which makes it possible to “smooth out” the manifestations of ICH.

It happens that the child provisional diagnosis is exhibited only on the basis of the fact that his head is relatively large, and the baby is restless and often cries, however, studies show that there is no clear relationship between big size head and hypertension syndrome. For these reasons, it is worthwhile to carefully examine the baby and be very careful about the conclusions about the presence pathological ICP and, moreover, to the appointment of treatment.

Causes and types of hypertension syndrome

The reasons for the increase in pressure inside the skull is usually the appearance of some additional tissue or volume of fluid in it, which does not fit in the available space and compresses the brain. Among the most likely factors for the development of HS are:

into the brain tissue or under the membranes.
Violation of the circulation of the cerebrospinal fluid.
Injuries.
Neuroinfections and inflammatory processes (meningitis, encephalitis).
Pathological course of pregnancy and childbirth (intrauterine hypoxia and fetal infections, rapid, premature or late delivery, trauma during passage through birth canal etc.).

Along the way, hypertension syndrome can be sharp and chronic. In the first case, there is rapid increase pressure in the cranial cavity and an increase in symptoms of brain damage, coma and displacement are possible brain structures. Chronic ICH is characterized gradual increase pressure, which usually does not reach the maximum and life threatening digits.

the occurrence of HS due to a hematoma (or formation) in the cranial cavity

A large group of causes of ICH are various kinds formations that lead to pathology mainly in adults. These include both malignant and benign tumors, metastases, and large sizes. All these processes create additional volume in the skull, the contents of which begin to fit poorly, resulting in an increase in pressure and compression of the brain.

Often, ICH appears with an increase in the size of the brain due to its edema associated with strokes, inflammatory processes, bruises, toxic lesions with liver pathology, poisoning, severe hypoxia. The enlarging brain takes up more and more space, and the pressure in the skull builds up.

Circulatory disorders in the vessels of the brain can also contribute to HS. So, the difficulty of venous outflow in dyscirculatory encephalopathy, anomalies of the vascular bed, defects in the bone structures of the spine leads to the accumulation of venous blood in the cerebral sinuses, which contributes to a chronic, gradual increase in pressure in the skull.

Hypertensive syndrome in children often occurs due to the pathology of liquorodynamics, which may include over-education cerebrospinal fluid, violation of its excretion or circulation through the intershell spaces and ventricles. The cerebrospinal fluid creates an additional volume that even the pliable bones in infants are unable to compensate for, and ICH develops, which is called the cerebrospinal fluid-hypertension syndrome.

Liquorodynamic disorders are accompanied by accumulation of excess fluid in the cavities - the ventricles of the brain.. The latter expand, pushing the brain tissue to the periphery, which can lead to atrophy of the hemispheres. Such forms of ICH are called hypertensive-hydrocephalic syndrome, thereby indicating the presence of both ICH and. In the clinic, the predominance of both symptoms of hydrocephalus and intracranial hypertension is possible.

In newborn babies, an increase in pressure inside the skull contributes to birth trauma and pathology of the course of childbirth, prolonged hypoxia, intrauterine infection cytomegalovirus, toxoplasma and other pathogens. Against this background, even before birth, cysts, malformations and anomalies that prevent the normal flow of CSF can form in the child's brain. Such children can be diagnosed already in the hospital.

Regardless of the causes, the consequence of intracranial hypertension is always a violation of the function of neurons due to compression of the brain, inadequate oxygen supply, ischemic damage, so the manifestations of ICH are usually stereotyped.

Signs of increased pressure in the skull

In the presence of symptoms suspicious of an increase in intracranial pressure, it is necessary to correctly evaluate all the available signs, especially in young children, because correct diagnosis is the key to effective treatment.

Hypertensive syndrome is accompanied by:

Headache;
Nausea and vomiting;
Various degrees of depression of consciousness (acute forms);
Restlessness, irritability and sleep disorders;
weather sensitivity;
visual impairment;
Developmental delay in children and cognitive decline in adults.

The most important symptom that most patients indicate is considered to be headache. It can be sudden, pulsating, abruptly arising in acute ICH or gradually increasing in the chronic course of the pathology. Usually there is a symmetry of the lesion and localization of pain in the frontal and parietal regions. Adult patients describe it as "bursting", emanating, as it were, from the inside of the head. Cranialgia is more common in the morning hours or when the patient is taking horizontal position, since in this case the circulation of cerebrospinal fluid becomes difficult.

With significant numbers of intracranial pressure, cranialgia is accompanied by a feeling of lightheadedness, nausea and even vomiting, depression of consciousness is possible up to coma, heart rhythm disturbances (bradycardia or tachycardia). Sometimes ICH leads to seizures.

Many patients complain about autonomic disorders in the form of dizziness, sweating, fluctuations in body temperature and blood pressure, fainting. These symptoms, coupled with cranialgia, often become a reason to seek help.

Adult patients note a violation of both physical and mental capacity for work, a decrease in memory and concentration, the appearance of irritability and emotional instability. Possible pain in the eyeballs, decreased visual acuity. Both children and adults with ICH are very sensitive to the weather, and any change in the weather can cause an increase in symptoms.

In children, diagnosis can be difficult due to the fact that small patients cannot always describe their complaints, and breast babies and not ways to speak at all. On the presence of hypertension syndrome in infants and younger age they say:

Sharp anxiety and prolonged crying;
Sleep disturbances, frequent awakenings, difficulty falling asleep;
Rejection of the breast;
Regurgitation, often - a "fountain".

The children's brain is very sensitive to trophic disorders, so prolonged ICH is usually accompanied by a delay in mental and physical development. The kid lags behind in development, motor skills, speech, thinking suffer. In due time, the child does not sit, does not learn to walk and does not speak, is not capable of learning.

New parents are often frightened by the prospect of a developmental disorder in an infant who is suspected to have increased intracranial pressure. It should be noted that in many cases proper treatment helps to eliminate the symptoms of brain pathology and restore its proper functioning. Even the already existing signs of a delay in psycho-speech development can be eliminated through therapy and sessions with a specialist.

With hypertension-hydrocephalic syndrome in children, the predominance of one or another of its manifestations can be noted. So, with pronounced hypertension, the baby is restless, crying, sleeping poorly, and with moderate hypertension, but severe hydrocephalus, on the contrary, there is a tendency to lethargy, lethargy, low activity child.

External signs of HS do not always occur. With significant numbers of intracranial pressure in adults, dark circles under the eyes, which are not associated with sleep and rest, and upon closer examination, you can see small subcutaneous veins. In young children, when the final formation of the sutures between the bones of the skull has not yet occurred, prolonged ICH against the background of hydrocephalus causes brighter external changes: the head becomes very large, venous vessels appear in the skin.

Diagnosis and treatment of hypertension syndrome

The correct diagnosis of HS still causes great difficulties. Doctors do not have a common opinion on which pressure fluctuations should be considered the limit of the norm, especially in children in the absence of causative factor VCHG. Of particular difficulty are reliable methods for determining the pressure of the cerebrospinal fluid. Majority diagnostic procedures provide guidance based on indirect signs pathology, and it is possible to accurately determine ICH only by invasive and complex methods available to neurosurgical hospitals.

In the presence of symptoms of hypertension syndrome, it is indicated to carry out echoencephalography, inspection ophthalmologist, radiography skulls. Ophthalmoscopy shows papilloedema, vascular changes, which can indirectly talk about ICH. An x-ray of the skull bones can detect a change in the shape of the bones, their deformation, “finger impressions”.

expansion of the ventricles of the brain in hydrocephalic HS

To search for the cause of hypertension, use ultrasonic methods, computer and magnetic resonance tomography, angiography with suspicion of aneurysms or vascular malformations.

The most reliable and, at the same time, the most in a radical way diagnosis of hypertension is lumbar puncture with measurement of liquor pressure. In some cases, they resort to puncture of the cerebral ventricles, but this requires trepanation of the skull. Whenever possible, doctors try to avoid dangerous invasive procedures by examining the patient as much as possible in safer ways.

Treatment intracranial hypertension- the prerogative of neurologists. Efficiency largely depends on the quality of diagnosis and the literacy of the doctor. It is still not uncommon for it to be prescribed unreasonably, especially in pediatric practice, so it is important for parents to consult a specialist who can be trusted with the health of the child.

Conservative therapy is usually carried out at home, in cases of chronic ICH and is aimed at improving the outflow of fluid from the cranial cavity. In the acute onset of pathology, a conservative approach is indicated if there is no sharp increase in intracranial pressure and there is no threat of displacement of brain structures.

The main group of drugs to reduce intracranial pressure - . Diacarb, veroshpiron, hypothiazide are prescribed. Pediatricians usually use diacarb. In severe cases, intravenous mannitol is administered.

In addition to diuretics, drugs are used to treat the underlying disease:

Antibiotics and antivirals for infectious lesions;
Vascular preparations (cavinton, cinnarizine) and venotonics (detralex) in case of circulatory disorders in the brain;
Anticancer therapy in case of neoplasms.

To level the symptoms of compression of the brain tissue, drugs are shown that improve the metabolism of neurons - phezam, cerebrolysin, sermion, etc. Children, in addition to drugs, need corrective exercises if ICH causes a developmental delay.

Apart from medical appointments, the patient should avoid physical and emotional stress, exclude work at the computer, watching TV and listening to music, reading, since eye strain can provoke an increase in the symptoms of hypertension.

In mild cases, small doses of diuretics are prescribed, it is recommended to establish a regimen, limit drinking. Possible effect from special exercises, massage, manual therapy.

In acute HS with a risk of displacement of brain structures, in coma, surgery . It may consist of decompression trepanation when an additional hole is created in the bones, which allows to reduce the pressure in the skull to acceptable numbers, or a ventricular puncture is performed, indicated for hydrocephalic syndrome.

If the cause of the pathology was a tumor, cyst, aneurysm, then surgery may consist in their removal to eliminate the source of ICH. At congenital pathology vessels (aneurysm of the vein of Galen, for example), shunt operations are performed to allow the discharge of "excess" venous blood from the vessels of the brain.

Children who have been diagnosed with hypertension should be constantly in the field of view of neurologists, at least 2 times a year, undergo examinations and monitor the course of the pathology. The task of parents is to ensure the correct regimen, protect against infections and overload, take them to the doctor for a consultation on time.

Impaired brain function in the form of cognitive disorders, vegetative symptoms and decreased ability to work significantly worsen the quality of life of patients chronic form hypertensive syndrome. In children, this pathology, in the absence of adequate measures, can lead to a sharp lag in development, up to imbecility. Considering dangerous consequences, intracranial hypertension requires close attention from neurologists and timely treatment.

The prognosis for hypertension syndrome depends on the severity, the rate of development of the pathology, the root cause. It is clear that if a child has serious malformations of the nervous system or brain vessels, then it is not always possible to expect a complete recovery. In cases of moderate ICH conservative treatment able to completely eliminate the symptoms of pathology and restore working capacity in adults and mental development in children. If you suspect intracranial hypertension, the presence of symptoms of pathology, it is important not to wait for spontaneous recovery, but to get to a competent specialist in time.

Hypertension syndrome is a pathological condition that occurs against the background of increased intracranial pressure. In another way, this phenomenon is called hypertensive-hydrocephalic or cerebrospinal fluid-hypertensive syndrome.

General characteristics of the disease

Hypertension syndrome is one of the causes of headaches. Intracranial pressure rises against the background of venous blood stasis, which often accompanies pathologies of the cervical spine, for example, osteochondrosis.

in the barrel spinal cord excess cerebrospinal fluid (CSF) disturbing circulation. As a result, the liquor in the ventricles of the brain and under its membranes stagnates, causing an excess of venous blood and a subsequent increase in the ventricles of the brain.

Causes, risk groups

Hypertension syndrome can affect both adults and children. Among adults, pathology more often affects men; in children, such selectivity by gender is not observed.

Hypertension syndrome can be congenital or acquired.

Congenital pathology can be caused by the following factors:

complicated pregnancy;
difficult childbirth;
brain hypoxia;
prematurity (up to 34 weeks);
late birth (after 42 weeks);
birth trauma to the head (subarachnoid hemorrhage);
intrauterine infections;
congenital defects of the brain;
long waterless period (over 12 hours).

In neurology, hypertension syndrome is often diagnosed in children against the background of perinatal encephalopathy, that is, brain damage of unknown origin.

Acquired pathology may be a consequence of the following factors:

tumors, hematomas, cysts, abscesses;
foreign body in the brain;
traumatic brain injury, if there are fragments of cranial bones in the brain;
spontaneous increases in pressure without a clear cause;
infections;
stroke and its consequences;
problems with the endocrine system.

Often, hypertension syndrome is accompanied by an infectious lesion of the brain. Children and adults differ not only possible reasons disease, but also its clinical manifestations.

Symptoms of hypertension syndrome

In adults

The first sign of pathology in adults is usually a headache. More often, its manifestations are especially noticeable in the morning and evening, when a person is located horizontally. This position activates the release of fluid and reduces its absorption.

Another important symptom- Nausea, which can turn into vomiting. More often this condition accompanies the patient in the morning. Pathology and other signs are manifested:

increased nervousness;
fatigue, and not only after physical, but also mental stress;
decreased libido;
pre-fainting state;
fluctuations in blood pressure;
weather dependence;
heartbeat;
sweating;
dark circles under the eyes and fine venous mesh in this region.

Similar symptoms are characteristic of other diseases of the brain, therefore, a comprehensive differential diagnosis and taking a detailed history.

In children

It is possible to suspect hypertensive syndrome in a newborn child by restless behavior and sleep disturbance. The baby often begins to cry loudly and strongly. Perhaps increased sweating, nausea with vomiting, temperature changes. On examination, a neuropathologist can detect pathology for some specific features:

enlarged large fontanel;
open small fontanel;
open seams between cranial bones;
a prominent developed network of saphenous veins in the region of the forehead and temples;
an increase in the circumference of the head above the norm;
visible strip of protein above the iris of the eye.

In newborns, there is a decrease in muscle tone. The child may react poorly to the breast, refuse to feed. Expressed swallowing reflex missing.

Older children have a severe headache in the morning. They experience nausea and vomiting. It is difficult for a child to raise his eyes, and turning his head causes pain. There is a feeling of weakness, causing dizziness. Skin turn pale, bright light and loud sounds cause fear.

Hypertensive syndrome can lead to a decrease in memory and concentration, difficulty in the thought process. Possible disturbances of consciousness, signs of mental instability and backwardness.

Diagnostics

It is possible to identify pathology only on the basis of the results of complex diagnostics, including clinical and instrumental studies. The examination of the patient should be performed by several specialists. Usually they involve a neurologist, an ophthalmologist, a psychiatrist, a neonatologist (for newborns), a neurosurgeon.

To establish the cause of the pathology, it is necessary to conduct the following studies:

x-ray of the skull (children are performed from 1 year old);
echoencephalography to detect brain lesions;
rheoencephalogram to assess venous outflow of blood;
electroencephalography, which determines the level of activity of brain processes (electrical impulses are used);
examination of the vessels of the fundus for edema, hemorrhage, vascular spasms;
cerebrospinal puncture to determine the pressure of the cerebrospinal fluid;
magnetic resonance or computed tomography.

In children under one year old, the fontanel has not yet grown, because necessary information can be obtained using neurosonography - a study of the brain through ultrasound scanning.

It is important to know that diagnosing hypertensive-hydrocephalic syndrome is quite problematic. More often such a diagnosis is made to children, but in most cases it turns out to be erroneous. This is due to the fact that the syndrome of neuropsychic excitability has similar symptoms.

Treatment of hypertension in children and adults

Suitable therapy prescribed only after a full diagnosis. This is done by a neurologist. In the treatment can be used as conservative methods and surgical intervention.

Therapy for adults

Hypertension syndrome is life-threatening, therefore, correct treatment should be prescribed immediately after diagnosis. Important point therapy - taking diuretics. They allow you to accelerate the withdrawal of cerebrospinal fluid and contribute to its absorption. With constant relapses of the disease, such treatment should be continuous.

If hypertensive syndrome manifests itself in mild degree, then in this case, you need to follow some recommendations:

normalize the drinking regime;
perform gymnastic exercises that reduce intracranial pressure;
to unload the venous bed, it is useful to resort to manual therapy and osteopathy (alternative medicine).

To improve the dynamics of CSF, diuretics can be prescribed: Diacarb, Furosemide, Acetazolamide. You can improve cerebral circulation with the help of Cavinton and Cinnarizine. At infectious lesions brain treatment should include antibiotics. Such drugs and their dosage are selected individually.

Physical therapy is effective. These include acupuncture, electrophoresis, circular shower. Important physiotherapy. good effect provided by swimming, daily walking. Physical activity should be moderate.

Any therapeutic methods must be agreed with the doctor. Reception herbal preparations, various exercises, Alternative medicine can harm.

Treatment in children

With congenital hypertension syndrome, therapy should be carried out during the first year of life. This is necessary to prevent various complications and developmental delays.

Treatment in children is aimed at reducing the production of CSF. It is also necessary to accelerate the venous outflow. For this, appoint:

Furosemide;
Diacarb;
solution magnesium sulfate (25%);
glycerin solution (50%);
solutions of Sorbitol (glucite), Rigematin, Eufillin.

This therapy reduces intracerebral pressure. If the pathology is not accompanied by a brain tumor, then they resort to physiotherapy, for example, therapeutic massage.

The treatment includes taking vitamins of group B, glutamic acid, Aminalon, Lipocerebrin (general tonic), nootropic drugs. If necessary, sedatives are used.

With exacerbation of hypertension syndrome, treatment is performed in stationary conditions. For children under one year old, it is important to provide such conditions in order to minimize the incidence of crying. It is important to observe the regime of the day, frequent exposure to fresh air, avoidance of infections.

In most cases, intracranial pressure returns to normal within 6-12 months, but the disease can remain for life. It is important for older children to visit a neurologist at least once every six months. It is also necessary to examine the fundus and X-ray of the skull. In case of traumatic brain injury or inflammatory disease, dispensary observation is required.

Surgical intervention

Surgery may be needed for various pathologies accompanying hypertension syndrome. This mainly concerns tumors, hematomas, abscesses.

In some cases, it is required to restore the natural outflow of cerebrospinal fluid or create a detour for it. In this case, shunting of the brain cavities is performed.

Surgery may also be needed for blockage of blood vessels.

Possible complications, prognosis

Hypertension syndrome is dangerous for patients of any age. The most serious complications of this pathology include:

delay in physical and mental development;
bulging fontanel;
incontinence (urinary incontinence);
fecal incontinence;
blindness;
deafness;
epilepsy;
paralysis;
coma.

Successful treatment is possible at any age. However, if the pathology is not detected in a timely manner and the necessary treatment is not carried out, among the consequences it is possible fatal outcome.

Prevention

Prevention of hypertension syndrome is the exclusion of stress and overwork. It is important to avoid infections, and if they are detected, carry out timely and complete treatment. This is especially true of encephalitis, meningitis, syphilis.

preventive measure congenital pathology serves healthy lifestyle mother's life. This applies not only to the entire duration of pregnancy, but also to the period of its planning.

Hypertension syndrome is a serious condition that requires regular monitoring by a specialist. Increased intracranial pressure threatens not only the health, but also the life of the patient. It is possible to normalize the condition thanks to timely complex diagnostics and correct treatment.

Hypertension syndrome is a clinical manifestation of increased intracranial pressure. In the occurrence and development of intracranial hypertension, disorders of secretion, resorption and circulation of cerebrospinal fluid play a role, venous congestion in the cranial cavity, an increase in brain volume. These changes occur in various pathological conditions: inflammatory diseases of the brain and its membranes (meningitis, encephalitis, arachnoiditis), viral infection(flu, measles, chicken pox, parotitis and others), craniocerebral injuries, brain tumors, anomalies in the development of the brain and liquor system (cranial hernia, hydrocephalus, microcephaly, craniostenosis, intracranial aneurysm).
Despite the variety of diseases leading to an increase in intracranial pressure, hypertension syndrome has characteristic neurological features that make it possible to distinguish it in the general clinical picture underlying disease. The main manifestation of hypertension syndrome is headache. Oka occurs as a result of irritation of the branches of the trigeminal and vagus nerves, receptors of the pia mater, veins, and sinuses of the brain. Headache occurs paroxysmal, more often in the morning, sometimes at night, has a diffuse bursting character, intensifies after physical activity with tilting the head down, jumping, running, prolonged exposure to the sun. It is usually accompanied by vomiting that occurs suddenly, without regard to food intake. The pathogenetically mechanism of vomiting is explained by irritation of the vomiting center and the vestibular analyzer due to sharp increase intracranial pressure. Patients do not tolerate riding, swings, etc.
Intracranial hypertension quickly leads to asthenia of the nervous system and emotional disturbances. Often there is a general lethargy, lack of initiative, a decrease in memory, attention, performance, academic performance. Against this background, children often have attacks of disinhibition, psychomotor agitation. Many people have sleep disturbances. Noticed; that children with hypertension prefer to sleep on a high pillow. In young children, the symptom complex of increased intracranial pressure is manifested by general anxiety, screaming, bulging of the large fontanel, and vomiting.
Among the causes leading to the development of hypertension syndrome, the consequences of inflammatory diseases of the brain and its membranes, as well as traumatic brain injury, deserve special attention. Such patients account for 15% of the visits to pediatric neurologists. Hypertensive syndrome they usually develop during the 1st year after the acute period. Its course is remittent, with periods of deterioration, which are accompanied by hemolytic-dynamic (hypertensive) crises. They are characterized by a paroxysmal onset, a combination of headache with nausea, vomiting, dizziness. After the crisis, patients feel better. The frequency of crises is different - from 2-3 times a year to 1-2 times a month. It has been noted that children school age curves develop less frequently and in the interictal period, most patients do not complain of headaches. In school-age children and in the interictal period, there are fatigue, sleep disorders, behavior, memory loss, academic performance, headache after exercise. Apparently, these differences are associated with the anatomical and physiological characteristics of the CSF system and the degree of adaptive mechanisms in children. different ages. The deterioration of the condition in most patients occurs in the autumn and spring periods, as well as after repeated injuries, acute respiratory infections, exacerbations of the underlying disease.
In children who have had CNS lesions during childbirth, hypertension often has a transient (transient) character. This is due to the fact that it is often based on functional disorders liquorodynamics with dysfunction of liquor-producing systems due to hypoxic exposure combined with birth stress. As circulation is restored cerebral circulation, maturation of resorbing systems, disappearance of edema, normalization of liquorodynamics, stabilization, and then reverse development of the hypertension syndrome occur.
The skull and brain of a child have great compensatory potential for increased intracranial pressure. The capacity and size of the skull easily increase due to the softness of the bones, the divergence of the seams, and the elasticity of the brain. This leads to initial period The tumor process in children is secretive, asymptomatic. The debut of intracranial hypertension in these cases is a change in behavior and hypertensive syndrome. The latter in such cases is steadily progressive in nature with frequent hypertensive crises, repeating first in the morning and at night, then at any time. Headache becomes constant, head size increases, symptoms appear focal lesion brain. If its tumor is suspected, especially in children of the first years of life, it is necessary to take into account the possibility prolonged absence focal symptoms and do not delay the consultation with a neurosurgeon.
In the diagnosis of hypertension syndrome, along with general clinical studies, otoneurological examination and lumbar puncture play a leading role.
X-ray picture of the skull in patients with intracranial hypertension is varied. Craniograms reveal changes in the shape of the skull, an increase in its size, thinning of the bones, smoothing of the arches of the arch, flattening of the base, changes in sutures and fontanelles, increased pattern, “finger impressions”, changes in the internal relief of the skull, Turkish saddle. However, the listed X-ray changes of the skull in full are observed quite rarely. Identification of the pattern of finger impressions in children, if it is not combined with clinical symptoms, does not necessarily indicate an increase in intracranial pressure.
An important role in the diagnosis of hypertension syndrome is played by the study of the fundus. Found in the fundus initial signs disc edema optic nerves(obscuration of borders, expansion, tortuosity, plethora of veins) with hemorrhages and prominence, symptoms of secondary atrophy of the optic nerves. The study of the fundus plays a leading role in the dynamic monitoring of patients with hypertension. It should be noted that in a number of patients, the syndrome of intracranial hypertension in the initial stage proceeds latently and its first sign is often edema of the optic discs, detected during a routine examination.
In young children, the method of transillumination of the skull is widely used in the diagnosis of hypertension syndrome. AT last years echoencephalographic study has become widespread. Intracranial hypertension is manifested on the echoencephalogram by the expansion of the ventricle, a change in echo signals.
So far, the most reliable method diagnosis of intracranial hypertension is direct measurement liquor pressure at lumbar puncture. The latter is carried out after performing the study by the described methods, not only for diagnostic, but also for therapeutic purposes.
The main thing in the treatment of patients with hypertension syndrome is measures to reduce the production of cerebrospinal fluid, improve cerebrospinal fluid resorption, and accelerate venous outflow. Treatment in acute period and during the period of exacerbation in most patients is carried out in stationary conditions.
As a means of reducing the production of liquor and at the same time causing an increase in diuresis and dehydration, diacarb is used. For the same purpose, you can use furosemide (lasix), a 25% solution of magnesium sulfate, a 50% solution of glycerin, sorbitol. To improve the outflow of cerebrospinal fluid through the venous system of the brain, eufillin and rigematin are prescribed. In addition to these medical measures aimed at reducing intracranial pressure, courses of anti-inflammatory, desensitizing and resolving therapy, physiotherapy procedures (if a brain tumor is excluded) should be carried out. For improvement metabolic processes in nerve cells and reduction of cerebrosthenic symptoms, B vitamins, aminalon, glutamic acid, lipocerebrin, nootropil, courses of sedative therapy. Very effective preventive courses of dehydration, anti-inflammatory, restorative therapy in the autumn and spring periods.
Patients with hypertension syndrome should consult a pediatric neurologist at least 2 times a year. Mandatory examination of the fundus (at least 1 - 2 times a year) and x-ray examination skulls (1 time in 2 - 3 years). With frequent exacerbations, training in sanatorium-forest schools is recommended. Children who have undergone inflammatory diseases of the brain, its membranes, as well as traumatic brain injury, are subject to dispensary observation.
The appearance of frequent headache, combined with vomiting, dizziness, should alert the average medical workers. Hypertension Syndrome - formidable complication and manifestation serious illnesses therefore, when its first signs appear, an urgent examination of the child is necessary to establish the cause of hypertension and carry out the necessary therapeutic measures in the hospital.