Ventriculomegaly in the fetus: causes, features of diagnosis and treatment. Ventriculomegaly - how serious can the consequences be? Moderate ventriculomegaly in infants

Ventriculomegaly is a developmental disorder of the brain caused by enlargement of the lateral ventricles.

The lateral ventricles of the brain have a complex structure, and therefore are the subject of special studies. As the fetus grows, the lateral ventricles change greatly. Special tables were created in order to correctly estimate the sizes of different sections of the lateral ventricles.

What does the expansion of the lateral ventricles mean

The term "ventricuglomegaly" is used in cases where the width of the lateral ventricles is more than 10 mm. Borderline ventricuglomegaly means that the width of the ventricles varies from 10 to 15 mm. Expansion of the ventricles is undoubtedly associated with an increased risk of various anomalies of the central nervous system of the child.

Ventriculomegaly of the lateral ventricles in children should be observed in dynamics. By itself, the expansion of the ventricles does not mean anything. If a rapid expansion of the ventricles is detected, then there is a threat of hydrocephalus. If there is no expansion in the dynamics, then you need to consult a neurosurgeon.

Causes of ventriculomegaly of the lateral ventricles in children

Currently, the causes of ventriculomegaly have not been studied in detail. Pathology can develop due to obstructive hydrocephalus, physical trauma, infectious diseases, hemorrhage, hereditary factors can play a big role.

The defect is aggravated by other developmental anomalies.

There is a relationship of pathology with the age of the mother: in children born to women over the age of 35, ventriculomegaly is observed three times more often than in children born to young women. On average, the incidence rate is 0.6%.

Fetal ventriculomegaly can be diagnosed already during pregnancy (from 17 to 33 weeks) using ultrasound and spectral karyotyping.

To establish an accurate diagnosis, a transverse scan of the child's head is done to determine the size of the lateral ventricles of the brain. If their size is more than 10 mm, the diagnosis of ventriculomegaly is made. The size of the ventricles of the brain with ventriculomegaly can reach up to 12-20 mm.

Treatment of ventriculomegaly of the lateral ventricles in children

If the ventriculomegaly is caused by an infection, then the doctor will prescribe treatment for the mother and, of course, a second ultrasound.

In the case of isolated borderline ventriculomegaly, doctors continue to monitor the fetus until delivery. Usually moderate ventriculomegaly does not affect the development of the child.

Ventriculomegaly becomes dangerous if accompanied by intracranial hypertension. Such cases require medical treatment and, in the most extreme cases, surgery.

If the child develops normally, there is no dynamics of an increase in the lateral ventricles, then there is nothing to treat.

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Let's try to find out when ventriculomegaly is dangerous?

Moderate fetal ventriculomegaly - what is it?

Ventriculomegaly is the expansion of the lateral ventricles of the brain. Already at the 17th week of gestation, pathology can be detected using ultrasound. The obtained pictures clearly show the enlargement of the sinuses. An expansion considered pathological is more than 10 mm.

In this case, we are talking about a moderate stage of expansion. If the ventricles are enlarged by namm, they speak of a borderline condition. When the fetal ventricles are dilated by more than 15 mm, there is a pathology in the development of the brain.

Unlike hydrocephalus, this pathology during pregnancy is most often characterized by the expansion of organs without the absence of head growth. In this case, a pair extension is optional. The defect may affect only one of the ventricles.

A person has 2 lateral ventricles, from which the produced cerebrospinal fluid is discharged into the third, and then into the fourth, connected to the spinal canal. With difficulty in the withdrawal of CSF, the sinuses expand, causing an increase in intracranial pressure and compression of the surrounding tissues.

Why is fetal ventriculomegaly dangerous?

The consequences are really serious. With ventriculomegaly, the outflow of CSF fluid into the spinal cord, which is contained in the lateral ventricles, is disturbed. As a result, abnormal development of the fetal nervous system occurs. Subsequently, the child may develop such developmental anomalies as cerebral palsy, hydrocephalus. However, such anomalies are noted only in the case of a rapid process. Often, a fetus in which a pathology is found is not viable.

It is worth considering that ventriculomegaly in the fetus progresses if proper measures are not taken in a timely manner. Therefore, it is so important not to miss an ultrasound scan and strictly adhere to all medical recommendations.

Fetal ventriculomegaly: causes

Unfortunately, the cause of this anomaly has not yet been clarified.

However, there are a number of provocateurs that can lead to a violation:

obstruction of the outflow of cerebrospinal fluid from the lateral ventricles, caused by excessive secretion of this fluid;
physical trauma to the brain;
heredity;
infectious diseases of the mother affecting the fetus;
insufficient amount of brain tissue;
vascular diseases of the brain.

The frequency of pathology does not exceed 0.6%. But it has been noticed that in women over 35 years old, the fetus is 3 times more likely to be at risk of anomalies.

In addition to the hereditary factor, toxoplasmosis and cytomegalovirus infection are of particular danger. However, it is worth remembering that any infectious disease during pregnancy can cause disturbances in the development of the child, especially with improper, self-treatment using drugs prohibited in this provision.

Fetal ventriculomegaly: symptoms

If during pregnancy the ventriculomegaly of the lateral ventricles in the child was not detected and the violations were of a moderate nature, the consequences are expressed in an overly excited state of the newborn, excessive tearfulness.

Sometimes, the child, on the contrary, may be too calm.

Moderate ventriculomegaly in a newborn child does not lead to serious developmental anomalies, unless it progresses and is not accompanied by complications from the nervous system.

Otherwise, symptoms are observed corresponding to chromosomal pathologies such as Edwards, Down or Patau syndrome. Symptoms of a complicated course of the disease: protrusion of veins, increased head size, convulsive movements.

Therefore, ultrasound should not be neglected during pregnancy. If the fetus was exposed to infections or hypoxia, which led to a moderate expansion of the ventricles, only 82% of children do not have a violation of the functionality of the central nervous system after childbirth. Approximately 10% of children with a complicated course of the defect have gross violations of the central nervous system, leading to disability.

Treatment of ventriculomegaly in infants

Treatment of pathology is based on the diagnosis. It is worth considering that the correction of a defect in the fetus is almost impossible. In the case of moderate pathology, the doctor may recommend measures that reduce the risk of progression of the defect.

If the fetus is characterized by a high degree of pathology, doctors suggest terminating the pregnancy, since the vast majority of childbirth will lead to the birth of a non-viable child or a child doomed to disability.

Treatment of a fetus with a mild degree largely depends on the cause. For example, termination of pregnancy with a moderate but progressive anomaly is recommended if chromosomal abnormalities have previously been identified in relatives of the mother or father.

If the pathology is caused by an infection in a pregnant woman, the cause is treated, diuretics are prescribed to remove excess fluid from the body, and the lack of potassium is compensated. It is often recommended to take antihypoxants that saturate tissues with oxygen. Of the physical procedures, exercises are shown that help strengthen the muscle tissues of the pelvic zone, massage.

Any treatment is carried out under the supervision of a doctor who monitors the course of pregnancy. If an abnormality is detected in a newborn, treatment is also based on symptoms and diagnosis. Often, in addition to ultrasound, a child may be prescribed an MRI of the brain, which allows a detailed study of the defect.

A newborn baby has an ultrasound of the brain in the first 1.5-2 months of life. It is during this examination that special attention is paid to the structure of the organ, revealing the slightest deviations in its development.

When a newborn has a mild degree of expansion of the lateral ventricles without progression, no treatment is required. The appointment of drugs that remove fluid and compensate for the loss of potassium is, rather, of a preventive nature.

However, with a tendency to progression or in the presence of a severe degree, the help of a neurosurgeon is often necessary.

In this case, we are talking about surgical treatment. The essence of the operation is the installation of a special shunt, which facilitates the task of removing excess fluid from the lateral ventricles, thereby reducing intracranial pressure and eliminating the risk of complications.

Of course, surgical treatment will not help get rid of genetically caused complications. Surgical treatment allows you to eliminate the problem caused by other disorders, prone to the development of neurological abnormalities. However, it has been practically proven that surgical intervention, even with chromosomal pathologies, normalizes sleep in a child, relieves severe headaches.

To prevent ventriculomegaly in the fetus, treatment is not necessary. In the absence of a hereditary factor, it is enough for a woman to follow general preventive recommendations - avoid stress, eat right, walk more often, do not smoke or drink alcohol.

In case of any infection, you should immediately contact your doctor, avoiding self-administration of medications and common folk remedies. In a word, pay more attention to the health of an unborn baby.

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ventriculomegaly

Ventriculomegaly is a disease caused by a pathological increase in the size of the ventricles of the brain in the fetus during intrauterine development.

The function of the ventricular system of the brain is to ensure the production of cerebrospinal fluid, and its entry into the spinal canal.

Due to the fact that with ventriculomegaly the ventricles increase, the outflow of cerebrospinal fluid is disturbed, and serious disturbances develop in the formation of the central nervous system. The disease often develops against the background of Turner, Down and Edwards syndromes. In addition, it disrupts the activity of the heart, the maturation of brain structures and the functions of the musculoskeletal system.

Pathological formation of the fetal ventricles is usually detected by ultrasound examination at about a week of pregnancy. Sometimes ventriculomegaly manifests itself in the unborn child only in the third trimester of intrauterine development.

Causes and symptoms of pathology

Ventriculomegaly in the fetus can develop as an independent pathology. But it can also occur in conjunction with other developmental anomalies.

The ventricles of the brain, having a normal width of 10 mm, with ventriculomegaly can reach 20 mm or more.

The main causes of the anomaly are chromosomal changes in the body of a pregnant woman. Such disorders occur in approximately 18% of women with pathologies of pregnancy development.

Ventriculomegaly can occur with trauma to the pregnant woman, infectious diseases, obstructive hydrocephalus, hemorrhage, and genetic predisposition.

The presence of other anomalies in the development of the fetus accelerates and enhances the development of pathology. At the same time, a single development of ventriculomegaly reduces the severity of its consequences.

The risk of developing brain disease in ventriculomegaly is determined by the attending physician based on the characteristics of ventricular enlargement.

Experts have established a pattern of increasing the incidence of the disease in the fetus in the age category of pregnant women who have passed the 35-year mark.

Types of ventriculomegaly

According to the nature of the course of the disease, three types of pathology are determined:

The mild type of ventriculomegaly is determined with a single change in the ventricle not exceeding 12 mm and does not need significant adjustment;
The middle type is characterized by an increase in the ventricles up to 15 mm and noticeable changes in the outflow of cerebrospinal fluid.
A severe type of the disease is accompanied by serious pathologies of the brain as a result of a significant increase in the ventricles.

Diagnosis of the disease

As already mentioned, ventriculomegaly is usually detected by ultrasound during the week of pregnancy. In this case, spectral karyotyping of the fetus is performed.

If this pathology is suspected, the anatomical features of the structures of the unborn child are examined, paying special attention to the ventricles of the brain. By scanning the size of the lateral ventricles, the threshold value of the pathology is determined.

Treatment of ventriculomegaly

The main direction in the treatment of ventriculomegaly is the prevention of complications arising as a result of the disease. Medications are prescribed to prevent the development of brain defects and disorders in the central nervous system.

Treatment is carried out by a neurologist and a pediatrician. Diuretics, antihypoxants and vitamin therapy are definitely recommended. To prevent further progression of ventriculomegaly, massage and physiotherapy exercises with a load on the pelvic floor and muscles are used. An indispensable condition for reducing the risk of severe consequences is prescribed drugs for the accumulation and retention of potassium in the body.

Treatment of ventriculomegaly in the fetus should be aimed at eliminating the negative consequences of such a pathology - in particular, severe diseases of the brain, as well as the central nervous system.

With an infectious origin of the disease, treatment is aimed at detoxifying the body, followed by a second examination.

A mild form of ventriculomegaly does not require cardinal medical intervention and only provides for constant monitoring of fetal development.

Late postpartum detection of pathology is difficult to treat and the prognosis is usually disappointing, because. Currently, no significant methods have been developed to eliminate such violations.

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Ventriculomegaly - what to do if it is detected?

A month and a half after the birth of the child, an ultrasound of the brain is prescribed. This is done today for almost all children, even without any special indications from the nervous system. First of all, the doctor looks for ventriculomegaly, since this disease is most common in both newborns and unborn babies. What is this disease?

Ventriculomegaly (or ventricular expansion) is the expansion of the ventricles of the brain, which are cavities filled with cerebrospinal fluid.

There are the following ventricles of the GM:

lateral (left and posterior) - the largest formations in the entire ventricular system, consisting of the body, anterior horn, lower and posterior horns;
third ventricle - located between the visual tubercles and connected to the lateral ventricles and cerebral aqueduct of the midbrain;
fourth ventricle - located in the region of the medulla oblongata and cerebellum, has communication with the aqueduct of the midbrain and the central canal of the spinal cord.

The main function of the ventricular system is liquor production, which, in the absence of pathology, enters the spinal canal. If for some reason the outflow of CSF is disturbed, ventriculomegaly develops.

Ventriculomegaly: the main characteristic of the disease

The causes of this pathology are very different. Among them, hemorrhage, obstructive hydrocephalus, traumatic and infectious factors are in the first place. As you know, during pregnancy, planned ultrasounds are made, and even then you can notice any violations of the structure of the brain in the fetus. If ventriculomegaly is detected, treatment in this case is aimed at reducing the risk of certain consequences of such an expansion.

When determining ventriculomegaly in newborns, a neurologist may prescribe diuretics (for example, diacarb) and agents that prevent excessive excretion of potassium from the body (the same asparkam). In principle, if the child does not have any developmental disorders, you can especially not focus your attention on the fact that the baby has been diagnosed with ventriculomegaly. In other cases, additional symptomatic treatment may be needed in addition to the above.

It is important to note that ventricular dilatation is present in many adults. This became clear after the introduction of computed tomography into practice. But in such cases, this is considered a variant of the norm, since ventriculomegaly does not interfere with a normal life at all.

By the way, a few years ago, ultrasound of the brain was not routinely done, only according to indications.

For the first time I read about this, as I understand it, if you don’t do an ultrasound, then you won’t know if you are sick or not.

Ultrasound, as far as I know, can be done once a year. But other tests can be taken much more often.

This is a very interesting article for me. they did it to us in the birth house when the ultrasound was born .. and everything was fine ..

the disease is really very serious. but if nothing bothers me, it seems to me that you should not just do an ultrasound.

But it seems to me that it is necessary to check from time to time. For yourself, it will be quieter.

I am in favor of everyone having a complete examination once a year, for peace of mind. but often I would not do an ultrasound, all the same, this procedure is not so harmless

I completely agree, in Europe every year they do tests and are examined, but we won’t go until we get hot!

That's for sure, and the most interesting thing is when that very time comes, well, when it gets hot, it may already be too late.

Yes, and most of the time it happens

I take it this is high intracranial pressure?

Contact and observe strictly to and from a medical specialist.

We all do not do ultrasound of the brain. Only for certain indications.

we also don’t do ultrasound so simply, only as directed by a doctor!

Do all children need to do an ultrasound, probably, certain indications are needed for this?

A very serious disease that requires careful examination, observation and treatment. Choosing the right clinic is important.

Hydrocephalus in adults

Hydrocephalus, or, as it is also called ventriculomegaly, can manifest itself acutely within a few days (with subarachnoid hemorrhage - SC), subacutely - within a few weeks, chronically - within several months, years. It is generally accepted that hydrocephalus can be symptomatic (with certain symptoms) and asymptomatic.

According to Black (1996), among 935 patients with hydrocephalus, in 315 (34%) it was due to KS, in 314 (34%) it was idiopathic, in 102 (11%) it was caused by trauma to the skull and brain, in 54 cases (6% ) - with brain tumors, as well as with stenosis of the Sylvian aqueduct, meningitis and other diseases.

Patients complain of headache, nausea, blurred vision, unsteadiness when walking. As with tumors, the headache is localized in the forehead, in the temples and is often morning, later, with the development of the process, it becomes generalized. Nausea or vomiting are noted at the height of the headache.

Eye symptoms are characterized by a decrease in visual acuity, double vision, and paresis of upward gaze is often noted during examination. There are congestive discs in the fundus. Uncertainty when walking, unsteadiness, conduction and cerebellar symptoms are noted.

Of the additional research methods, the most informative are CT of the brain and MRI. Angiography is irrelevant. Under certain conditions, ventricuography or even pneumoencephalography can be used (in the absence of stagnation in the fundus).

Treatment of hydrocephalus in adults. Dehydration therapy is carried out. With its inefficiency - various bypass operations.

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ventriculomegaly

Ventriculomegaly is a disease that occurs in the fetus and is associated with an increase in the ventricles of the brain. Most often, the lateral ventricles of the brain are affected.

The ventricles are cavities in the brain that are filled with cerebrospinal fluid. It is their increase beyond the established normal size that leads to the development of ventriculomegaly.

Disease classification

Depending on the causes of development, ventriculomegaly is divided into 2 main groups:

Symptomatic ventriculomegaly;
Idiopathic ventriculomegaly

Idiopathic ventriculomegaly

This is a type of ventriculomegaly where the cause is unknown and the pregnancy proceeds normally without complications. At the same time, there are no hereditary prerequisites for the occurrence of the disease in the fetus.

Types of ventriculomegaly disease

There are three main types of ventriculomegaly disease:

With a mild type of ventriculomegaly, no serious changes occur and this type of disease does not require special therapy.

The average type of the disease is accompanied by a moderate increase in the size of the ventricles (they reach a size of mm) and a slight violation of the outflow of cerebrospinal fluid.

In a severe course of the disease, there is a strong increase in the size of the ventricles of the brain and a violation of the outflow of cerebrospinal fluid from them. Additional deviations and pathologies of the brain and nervous system also appear.

In addition, the following types of ventriculomegaly are distinguished:

isolated (when only the lateral ventricles are affected);
extensive (covers various groups of the ventricles of the brain);
heredity.

Causes of the disease

The causes of symptomatic ventriculomegaly are as follows:

chromosomal changes in fetal development;
fetal hypoxia;
infectious diseases during pregnancy;
Hemorrhage (hemorrhage);
Physical injury.

Symptoms of ventriculomegaly

Symptoms of the disease, as a rule, begin to be detected by ultrasound in the weeks of pregnancy.

It's important to know! With a rapid increase in the size of the ventricles of the fetal brain, there is a high risk of developing fetal hydrocephalus.

The main symptoms and manifestations of this disease are enlarged cerebral ventricles in the fetus. It is during the weeks of pregnancy that ultrasound clearly shows signs of ventriculomegaly.

The diagnosis of ventriculomegaly is made when the ventricles reach a width of more than 10 millimeters!

In addition to an increase in the size of the ventricles in the fetus, the symptoms of the disease may include the following:

changes in the structure of the heart;
violations in the structure of the bone apparatus;
changes in the structure of the brain;
hydrocephalus (cerebrospinal fluid retention) in the fetal brain.

Depending on the degree of increase in the size of the ventricles of the brain and the presence of additional pathologies, the geneticist diagnoses the risk of dangerous diseases of the nervous system. If the fetus has only ventriculomegaly against the background of a slight increase in the ventricles of the brain, then the outcome of the disease is favorable in most cases.

Features of the course of ventriculomegaly in pregnant women after 35 years

Most often, this pathology occurs in pregnant women after 35 years. The following factors contribute to the occurrence of ventriculomegaly in later pregnancy:

increased risk of genetic disorders;
high probability of the so-called "breakage of chromosomes". This factor increases the risk of chromosomal abnormalities in the fetus, which lead to the occurrence of ventriculomegaly;
a high probability of developing fetal hypoxia (scientists have established more frequent cases of fetal hypoxia during pregnancy after years);
infectious complications during pregnancy. The younger the woman, the less likely it is to develop serious complications and infectious diseases.

Thus, in pregnant women, the risk of developing fetal ventriculomegaly is minimal.

Complications of the disease

Complications of ventriculomegaly include the likelihood of serious diseases of the nervous system. Such diseases include:

Down syndrome;
Edwards syndrome. This is a chromosomal pathology in which there are many malformations of the child;
Turner syndrome. This syndrome is characterized by severe physical developmental anomalies and sexual infantilism.
Severe fetal hydrocephalus. A serious condition in which cerebrospinal fluid accumulates in large quantities in the ventricles of the brain.

Diagnosis of the disease

Methods for diagnosing fetal ventriculomegaly include the following:

fetal ultrasound. The earliest time at which it is possible to determine the signs of ventriculomegaly is 17 weeks. The most informative ultrasound at 25 weeks of gestation. With this method of diagnosis in the fetus, an increase in the size of the ventricles of the brain is determined. If the width of the ventricle is more than 10 millimeters, the diagnosis of ventriculomegaly becomes possible. In addition, ultrasound examination determines violations in the structure of the heart, bone apparatus, and nervous system. The frequency of this study is once every 3-4 weeks (depending on the complexity of the disease and the severity of symptoms).
Fetal MRI. It is carried out in the presence of severe symptoms of ventriculomegaly.
Neurosonography. This method is used in a newborn immediately after birth and at the age of 1 month. According to the dynamics of the process, a conclusion is made about the need for further research and treatment of the disease. This method is very informative and provides detailed information about the course and dynamics of the disease.

Neurosonography (NSG) is an ultrasound examination of the brain.

Treatment of ventriculomegaly

The treatment of this disease is conservative. Such methods of treatment are used that are aimed at preventing the development of severe diseases of the nervous system. For this purpose, the following methods of treatment are used:

administration of antihypoxants. They prevent and prevent the onset and progression of brain hypoxia. Among such agents, such as piracetam, actovegin, oliven, riboxin and others are widely used.
administration of diuretics. Used to remove excess fluid and reduce intracranial pressure (furosemide, diacarb).
vitamins. Vitamins of group B are prescribed, which contribute to the restoration of the child's nervous system.
massage and physiotherapy. Massage used in children with ventriculomegaly is relaxing and strengthening (alternating load and relaxation). Recommended courses of 10 sessions every 2 months (depending on the age of the child. The older, the shorter the interval between courses). Physiotherapy exercises are aimed at strengthening the muscular apparatus of the child and maintaining the body in good shape. Particular attention in this pathology is recommended to be paid to the muscles of the pelvis and collar zone of the head (in order to normalize blood circulation in this section).

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ventriculomegaly

Ventriculomegaly is a pathological change in which an increase in the size of the ventricles of the brain is observed in the fetus, leading to brain diseases, neurological disorders.

The reasons

The disease may be isolated, or may be the result of a defect that is associated with other developmental pathologies. The fetus is characterized by an increase in the size of the ventricles of the brain up to millimeters.

The main causes are chromosomal abnormalities observed in women who have pathologies during pregnancy. The cause may be past physical trauma, obstructive hydrocephalus, infectious diseases, hemorrhage, hereditary factors. Fetal ventriculomegaly is the cause of Down, Turner and Edwards syndrome. Pathology affects changes in the heart, brain structures, and the musculoskeletal system.

Ultrasound can help identify symptoms. Symptoms begin to appear as early as the week of pregnancy. There are cases of detection of pathology at the beginning of the third trimester.

It occurs in pregnant women who give birth after 35 years. Young women in labor are less susceptible to making this diagnosis. According to statistics, the disease occurs in 0.6% of cases.

There are three main types of pathology:

the light type is singular. This type of serious treatment does not require;
the middle type is characterized by an increase in the ventricles, their size reaches 15 millimeters. The disease proceeds with slight changes in the outflow of cerebrospinal fluid;
the severe type is characterized by a significant increase in the ventricles of the brain of a newborn in combination with other pathologies of the brain;

Diagnostics

Diagnosis of ventriculomegaly is carried out in the week of pregnancy using ultrasound, spectral karyotyping of the fetus. The examination includes a complete study of the anatomical structures, especially the ventricular system of the brain.

A more accurate diagnosis is carried out on the basis of a scan of the fetal head with the obligatory determination of the threshold value of the lateral ventricles of the brain. The disease occurs if the size of the ventricles is more than 10 millimeters.

Treatment

Treatment of ventriculomegaly is aimed at preventing the consequences that this pathology can cause. The most dangerous is the occurrence of severe diseases of the brain, the central nervous system.

Drug treatment involves taking diuretics, antihypoxants, vitamins. The doctor also prescribes massage, physiotherapy exercises, which focuses on the static loads of the pelvic floor, pelvic muscles.

Taking medications, the action of which is aimed at preventing the development of neurological disorders, is necessary to retain potassium in the body.

If a disease is detected in a newborn, it is very difficult to predict how it will develop. In most cases, if there is an isolated defect, the outcome of treatment will be normal. When the disease in the fetus is combined with chromosomal abnormalities, there is a high probability of developing severe neurological disorders.

This article is posted for educational purposes only and does not constitute scientific material or professional medical advice.

When using materials from the site, the active reference is obligatory.

The information provided on our website should not be used for self-diagnosis and treatment and cannot be a substitute for consulting a doctor. We warn about the presence of contraindications. Specialist consultation is required.

Ventriculomegaly Causes Symptoms And Treatment

It is well known that the foundations of the future health of each person are laid even before he is born. Therefore, any violations of intrauterine development of the fetus can lead to serious consequences in the future: mental retardation, neuropsychiatric disorders, and even premature death. In particular, sometimes during a routine ultrasound examination at 20-25, and sometimes even at the 17th week of pregnancy, doctors find in the fetus a pathological expansion of the lateral cavities of its brain (ventricles), which contain cerebrospinal fluid (CSF). In such cases, ventriculomegaly is diagnosed. The causes, symptoms and treatment of this disease are very similar to another, more severe disease called hydrocephalus, characterized by excessive accumulation of CSF in the cerebral ventricular system. Therefore, inexperienced doctors often make mistakes when making a diagnosis, thereby bringing most parents to a real hysteria. Of course, there are reasons for concern with ventriculomegaly, but unlike dropsy of the brain, the question of artificial termination of pregnancy in this pathology is rarely raised.

The reasons

First of all, doctors remind that the lack of medical control during pregnancy does not make it possible to correct the existing deviations in the health of the expectant mother and child. According to most experts, the main reason for the development of this disease is abnormal changes in the chromosomes of a pregnant woman, which can occur due to genetic predisposition, infectious diseases suffered during the period of childbearing, prolonged medication, physical injuries. Ventriculomegaly often occurs after a cerebral hemorrhage or hypoxia (oxygen starvation) in the fetus. According to statistics, the risk of developing this pathology increases in women who have reached the age of 35.

Complications

Fortunately, an increase in the ventricles of the brain in the fetus is most often moderate in nature, not requiring serious therapy. Treatment measures are resorted to only when the brain lobes are expanded by more than 15 millimeters, which causes difficulties with the outflow of cerebrospinal fluid. In such cases, the lack of treatment can lead to various neurological and physical problems in the development of the child: cerebral palsy, mental retardation (Down syndrome), disproportionate head shape of the newborn (Edwards syndrome), short stature and sexual infantilism (Turner syndrome).

Symptoms

As already noted, the main symptom of ventriculomegaly, expressed in an increase in the cerebral ventricular cavities of the fetus, is detected during a planned ultrasound scan during the period of bearing a child. Along with this, anatomical changes in other structures of the brain, heart and bone apparatus can be detected. After birth, the child may be excessively whiny, overly excited, or vice versa, too apathetic. Sometimes the newborn has convulsions, bulging veins and a slight increase in the size of the head. Of course, such symptoms require urgent intervention by pediatricians, pediatric neurologists, neonatologists, who, after magnetic resonance imaging and neurosonography (ultrasound of the brain) of the baby, will decide on appropriate therapy in each case.

Treatment

As a rule, the fight against this pathology begins even before the birth of the child. The first step is prenatal therapy, which involves the treatment of the fetus in the womb. The main tasks facing doctors are: to remove excess fluid from the body, to reduce intracranial pressure in the fetus, to prevent hypoxia of his brain, to prevent the development of neurological disorders. For this purpose, a pregnant woman is prescribed antihypoxants (Riboxin, Actovegin, Piracetam and others), diuretics (Diakarba, Furosemide and others), B vitamins. collar zone of the head.

Finishing the conversation about ventriculomegaly, the causes, symptoms and treatment of this childhood pathology, one cannot fail to note the latest achievements of modern medicine, which allow restoring the health of newborns with the help of an expensive but very effective neurosurgical operation, in which a shunt is installed to remove excess cerebrospinal fluid from the cerebral ventricles.

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The information on our website is informative and educational in nature. However, this information is by no means a self-medication guide. Be sure to consult your doctor.

Ventriculomegaly is a pathological change in the fetus, in which there is a slight or significant increase in the size of the ventricles of the brain, which leads to neurological disorders and diseases of the brain.

Causes and symptoms of ventriculomegaly

Pathological ventriculomegaly in the fetus can be either isolated or be a defect associated with other developmental pathologies. With this disease, the fetus has a large size of the ventricles of the brain, reaching up to 12-20 mm.

In modern medicine, among the main causes of ventriculomegaly, chromosomal abnormalities are distinguished, which are observed in 17-20% of women with pathologies during pregnancy.

Causes of ventriculomegaly include obstructive hydrocephalus, physical trauma, infectious disease, hemorrhage, and hereditary factors. Pathology is enhanced in the presence of other developmental anomalies.

Fetal ventriculomegaly can lead to the development of Down syndrome, Turner and Edwards syndrome in the child. This disease affects changes in the structures of the brain, heart and musculoskeletal system.

Symptoms of ventriculomegaly can be clearly identified by ultrasound, and their appearance is noticeable at 20-23 weeks of gestation. In some cases, the pathology is fixed at the beginning of the third trimester of pregnancy, the best period for diagnosing and identifying symptoms of the disease is 25-26 weeks.

If ventriculomegaly is a single pathology in the fetus, then the likelihood of severe chromosomal abnormalities is low. The attending physician determines the risk of developing brain diseases in a child in accordance with the increase in the width of the ventricles.

Medical studies have found that the risk of ventriculomegaly is high in pregnant women over the age of 35 (the incidence of the disease is 0.5-0.7%), and in young women in labor it is significantly reduced.

In pediatrics, there are three main types of ventriculomegaly:

severe type with the presence of large enlargements of the ventricles of the brain of the fetus or newborn, as well as combined with other pathologies of the brain;
medium type with an increase in the ventricles up to 15 mm and slight changes in the outflow of cerebrospinal fluid;
mild type, which has a single character and does not require serious treatment.

Diagnosis of the disease

Ventriculomegaly is diagnosed during pregnancy (from 17 to 33 weeks) using ultrasound and spectral karyotyping of the fetus. Perinatal examinations should include the study of all anatomical structures of the fetus, especially the ventricular system of the brain.

To establish an accurate diagnosis, a transverse scan of the fetal head is performed to determine the threshold value of the lateral ventricles of the brain. Ventriculomegaly is determined when the size of the ventricles is more than 10 mm.

Treatment of ventriculomegaly

The main treatment of ventriculomegaly is aimed at preventing the consequences of this pathology, which can be severe diseases of the brain and central nervous system.

A pediatrician and a neurologist prescribe antihypoxants, diuretics and vitamins as a drug therapy.

For the treatment of ventriculomegaly, massage and physiotherapy exercises are prescribed (static exercises with loads on the pelvic muscles and pelvic floor).

As medicines intended to prevent the development of neurological disorders in a child, drugs are prescribed aimed at retaining potassium in the body.

What processes in a woman's body during pregnancy can cause ventriculomegaly in the fetus? Is it possible to endure and give birth to a healthy baby, despite the frightening diagnosis? Is ventriculomegaly treated and at what stages? The answers to these and other questions will help expectant mothers to understand the current situation.

What is this disease

A pathological process affecting the fetal brain, in which the ventricles of the brain swell (change their shape), is called ventriculomegaly. Pathology has a negative impact on the developing nervous systems of the body (central and peripheral). As a result of ventriculomegaly, the fetus suffers from:

spinal cord;
brain brain;
nerve processes and roots;
autonomic nervous system.

Not only individual organs, but also entire body systems suffer from excess fluid.

The cerebral ventricles communicate with each other through canals. They perform a very important function for the body - they synthesize cerebrospinal fluid (cerebrospinal fluid). Normally and in the absence of anomalies, this fluid flows into a certain space called the subarachnoid. If an anomaly is present, then the outflow stops, fluid (liquor) accumulates in the ventricles, creating many problems for the baby.

There are three degrees of severity of ventriculomegaly:

light;
average;
heavy.

With a mild degree of damage, they are single in nature, quickly respond to treatment and pass without consequences for the baby. Complex preparations are not required, the ventricles quickly return to normal.

The average degree implies an increase in the ventricles (one or more) up to 15 mm inclusive. This happens because the natural outflow of fluid is disturbed. The functionality of the ventricles is also impaired.

With a severe degree of ventriculomegaly, there is a strong increase in the ventricles (up to 21 mm) due to the accumulation of cerebrospinal fluid in them. Serious treatment and monitoring of the condition and intrauterine development of the baby is required.

Causes of ventriculomegaly in the fetus

Ventriculomegaly is a rather dangerous disease that can provoke the death of the fetus even in the womb, or manifest itself in the form of anomalies (mental and physical disorders), as a prospect - disability in the future. In order, if possible, to protect the baby from the harmful effects of ventriculomegaly, it is necessary to choose the most effective treatment, identifying the real causes of this pathology. These causes may be associated with genetic abnormalities of the parents, or they may appear on their own. Fetal ventriculomegaly can be caused by:

the age of the pregnant woman is over 35;
abnormal genes and chromosomes in expectant mothers;
the presence of pathological processes during pregnancy;
all kinds of infections (including intrauterine);
obstructive fetal hydrocephalus;
physical injury;
strokes;
periventricular leukomalacia;
lissencephaly.

You can identify the threat as early as the 17th week of pregnancy with the help of ultrasound screening. Starting from weeks 17 to 34, the doctor pays special attention to the development of the brain, as well as the size of its ventricles. Ventriculomegaly is indicated by an increase in one or more ventricles, ranging from 12 mm to 20 mm. If ventriculomegaly is suspected, the doctor recommends undergoing additional studies and repeating the ultrasound in another 2 weeks. It is also obligatory for the expectant mother to visit a geneticist, who will determine whether it is a congenital pathology or caused by injuries or infections. A karyotyping procedure for a baby in the womb is also shown.

Consequences of ventriculomegaly

Fetal ventriculomegaly - the consequences of this disease, which began in the womb, can be very severe, starting with the death of a child in the womb (due to malformations), premature birth (up to 4% of all known cases), severe and disability.

If a genetic factor played a role in the appearance of ventriculomegaly, then the following deviations and syndromes are possible:

Down syndrome;
hydrocephalus;
Patau;
Edwards;
Turner (with gonadal dysgenesis);
vascular malformations of the brain;
mental retardation;
lagging behind in physical development.

It is noted that female infants are more susceptible to anomalies and defects as a result of ventriculomegaly, in comparison with infant boys.

Despite everything, children born with such a diagnosis have a lot of chances for a further normal life. So, in 80% of cases out of a hundred, babies outgrow this condition and further develop fully without deviations.

Among all known cases of ventriculomegaly, 10% of infants are subject to serious pathologies. Deviations of moderate severity were observed in 8% of children born with this diagnosis.

Ventriculomegaly in the fetus, methods of its treatment

Treatment of pathology is the timely elimination of the causes that caused this disease. If the cause of the identified pathology was an intrauterine infection, then the first task of doctors is to eliminate this infection, which they do with the appropriate drugs.

Goal of treatment for ventriculomegaly:

eliminate the causes that caused the disease;
prevent negative consequences that may occur later.

Since the disease is found in the fetus in the womb, the treatment is prescribed to the expectant mother. Mild degrees of the disease generally do not require medical intervention. In such cases, constant monitoring and monitoring of the condition of the mother and fetus is indicated.

Serious pathological phenomena in the fetus require immediate intervention, so expectant mothers are prescribed the following groups of drugs:

antihypoxants;
diuretics;
vitamins.

Shown massage, exercise therapy.

Ventriculomegaly in the fetus is a pathological change in which there is an increase in size. This pathology can cause various brain diseases and neurological disorders.

It should be noted that normally each person should have four ventricles of the brain. Two of them are located in the thickness of the white matter, they are called the lateral ventricles of the brain. Each of them has a back, front and bottom horn.

With the help of the interventricular opening, a connection is made with the third ventricle, which, through the cerebral aqueduct, is connected to the fourth ventricle, located at the bottom of the rhomboid fossa. In turn, the fourth ventricle is connected to the central canal of the spinal cord. This system consists of vessels with cerebrospinal fluid. Normally, the size of the lateral ventricles should be no more than 10 mm at the level of the posterior horn.

The main function of the ventricular system is the production of cerebrospinal fluid, which, in the absence of pathologies, enters the spinal canal. In the event that for some reason its outflow is disturbed, a disease such as ventriculomegaly develops. It is accompanied by the expansion of the ventricles of the brain.

This disease can be isolated, but in some cases it is the result of a defect associated with other developmental pathologies. It should be noted that ventriculomegaly is characterized by an increase in the ventricles in the fetus in sizes from 12 to 20 millimeters.

The main causes of this disease include chromosomal abnormalities present in women whose pregnancy is accompanied by various pathologies.

In addition, the causes of ventriculomegaly can be:

infectious diseases;
physical injury;
obstructive hydrocephalus;
hemorrhage;
hereditary predisposition.

This disease in the fetus can cause the appearance of Down syndrome, Turner and Edwards. Ventriculomegaly in the fetus affects changes in the heart, disruption of the musculoskeletal system, brain structures.

To detect this disease, an ultrasound examination is performed. Symptoms may appear as early as 20 to 23 weeks of pregnancy. Sometimes pathology is detected at the beginning of the third trimester.

According to scientists, this disease is most often diagnosed in women who give birth to a child after thirty-five years. At a young age, such a diagnosis is not so common. According to statistics, the disease is diagnosed in 0.6% of cases.

Types of ventriculomegaly

This pathology has three main types:

Light type. It is isolated and does not require any serious treatment.
Medium type. It is characterized by an increase in the ventricles, the size of which can reach 15 mm. This disease is accompanied by certain changes in the outflow of cerebrospinal fluid.
Heavy type. This form of the disease is characterized by a significant increase in the cerebral ventricles of the fetus in combination with other pathological changes in the brain.

Diagnosis of the disease

Ventriculomegaly in the fetus is diagnosed during pregnancy - from the seventeenth to the thirty-third week. They do it with . Spectral karyotyping of the fetus can also be used. It is very important that perinatal examinations include the study of all the anatomical structures of the fetus, especially the ventricular system of the brain.

To establish an accurate and reliable diagnosis, it is necessary to conduct a transverse scan of the fetal head. This should include determining the threshold value of the lateral ventricles. Ventriculomegaly in the fetus is diagnosed if the size of the cerebral ventricles exceeds 10 millimeters.

Treatment Methods

In the event that this disease is associated with some kind of infection, then the main treatment should be aimed at eliminating the cause of the pathology. After that, the doctor prescribes a second ultrasound examination.

It should be noted that if the expansion of the ventricles of the brain is isolated and moderate, then special therapy is not required. Such deviations from the norm in no way affect the development of the fetus. The task of specialists in this case is to monitor the state of the ventricles until the very birth.

In the event that the disease is accompanied by cerebral hypertension, drug therapy is indicated. In some cases, surgery may even be needed.

If the width of the ventricles is no more than twelve millimeters, then therapy is carried out by prescribing antihypoxants and static loads on the pelvic muscles. As drugs designed to prevent the occurrence of neurological disorders in a child, agents are prescribed to retain potassium in the body.

If ventriculomegaly was detected in a newborn, then its consequences are quite difficult to predict. The isolated form of the disease in most cases is not associated with any problems. If the expansion of the ventricles of the brain is accompanied by other chromosomal abnormalities, severe neurological disorders may appear.

Consequences of ventriculomegaly in the fetus

Moderate ventriculomegaly with lateral ventricles less than 15 millimeters, especially if treated appropriately, is usually not associated with any negative consequences. If the size of the ventricles exceeds 15 millimeters, in addition, there is an increase in fetal hydrocephalus, then the consequences can be the most severe. They include congenital diseases of the central nervous system, and even fetal death.

It must be understood that the earlier and faster this pathology grows and passes into, the worse the forecasts are. In the case of defects in other organs, the threat of the birth of a child with a chromosomal abnormality increases - this may be Edwards, Patau, Down syndrome.

In addition, it should be noted that the probability of intrauterine fetal death or death during childbirth is approximately 14%. After childbirth, the normal development of the child without disruption of the central nervous system is observed in 82% of cases. At the same time, 8% of children have mild disorders of the nervous system. In 10% of cases of this disease, gross disturbances in the functioning of the nervous system and severe disability of the child are observed.

fetal ventriculomegaly- This is a rather dangerous pathology that can have serious consequences for the health of the child. Therefore, it is so important to pass all the necessary examinations in a timely manner and monitor your health. In no case should you neglect planned ultrasound examinations during pregnancy. Timely treatment will help prevent or significantly reduce the negative consequences of this pathology.

It should be noted that the expansion of the ventricles of the brain is diagnosed in many adults. This became apparent after the introduction of computed tomography into practice. However, in such situations, this is considered a variant of the norm, since ventriculomegaly absolutely does not interfere with the usual way of life.