Hydrocephalus of the brain
General characteristics of the disease
Hydrocephalus of the brain or dropsy is a neurological disorder caused by the accumulation of fluid in the ventricular system and the subarachnoid parts of the brain. Hydrocephalus of the brain develops as a result of excessive production or poor outflow of cerebrospinal fluid (CSF).
Injuries, infectious and parasitic diseases, tumors or adhesions in the brain lead to disturbances in the circulation of cerebrospinal fluid. As a result, cerebrospinal fluid accumulates, increases the volume of the ventricles of the brain and leads to a general increase in the size of the skull, thinning of the walls and rupture of the ventricles, as well as vision problems, paralysis, epileptic seizures and other complications of cerebral hydrocephalus.
Congenital hydrocephalus of the brain
Hydrocephalus of the brain in children is more often congenital. In this case, the most formidable complications of the disease, which developed during the prenatal period, are observed.
Congenital cerebral hydrocephalus in children is accompanied by an increase in head size up to 50% of the standard volume. Frequent causes of congenital cerebral hydrocephalus in children are pathologies of fetal development and anomalies in the structure of the brain, intrauterine meningitis, hemorrhage, etc.
Signs of congenital hydrocephalus of the brain in children are:
- moodiness caused by increased intracranial pressure;
- poor appetite
- lethargy,
- marbling of the skin,
- eyelid retraction (excessive opening of the eye),
- the preferred direction of looking down.
Acquired hypertensive hydrocephalus of the brain
The disease is caused by a tumor, cyst, inflammation, or pathological bone changes in the posterior cranial fossa. Hypertensive cerebral hydrocephalus in adults is manifested by bilateral frontal and occipital pain, nausea and vomiting caused by the accumulation of cerebrospinal fluid and increased intracranial pressure. At the same time developing:
- edema of the optic disc,
- slowness of movements,
- weakening of intelligence
- violation of reflexes.
Acquired normotensive hydrocephalus of the brain
With this type of disease, relatively normal indicators of intracranial pressure are observed. The provoking factors of normotensive hydrocephalus of the brain are complications after meningitis, subarachnoid hemorrhage, trauma or aneurysm.
The accumulation of fluid in the head leads to pressure on the white matter of the brain, and as a result develop:
- gait disturbances
- headache
- dementia,
- urinary incontinence.
Non-communicating and communicating types of cerebral hydrocephalus
Non-communicating or closed cerebral hydrocephalus in adults or children develops when fluid from the ventricles of the brain cannot enter the subarachnoid space. If there are no obstacles to the circulation of cerebrospinal fluid, the disease is called communicating or open cerebral hydrocephalus. In children, both types of the disease are caused by congenital organic causes, in adults - by acquired tumors and intracranial cysts.
General, internal and external hydrocephalus of the brain
Depending on the localization of cerebrospinal fluid, it is customary to distinguish internal (ventricular), general and external hydrocephalus of the brain in adults and children.
With the internal form of the disease, cerebrospinal fluid mainly accumulates in the ventricles of the brain. External hydrocephalus is characterized by the accumulation of cerebrospinal fluid in the subarachnoid space. And the general or mixed form of cerebral hydrocephalus develops when the cerebrospinal fluid is localized in all cavities of the brain.
Diagnostics of the cerebral hydrocephalus
In the diagnosis of the disease, computed and magnetic resonance imaging, examination of the fundus, and lumbar puncture are used. Diagnosis of cerebral hydrocephalus in children under 3 years of age is complicated by the need for general anesthesia.
Neurosonography is an alternative to CT and MRI in the diagnosis of cerebral hydrocephalus in children under 1.5 years of age. Visualization of the ventricles and subarachnoid space with the help of NSG is possible only before the closure of the large fontanelle.
Treatment of cerebral hydrocephalus
Treatment of cerebral hydrocephalus is mainly surgical. With the help of medical methods, it is possible to achieve only a slowdown in the development of the disease or to lower the intracranial pressure with hydrocephalic syndrome. The latter is characterized by indirect signs of the accumulation of cerebrospinal fluid against the background of increased intracranial pressure and increased head volumes.
Surgical treatment of cerebral hydrocephalus is successful in more than 85% of cases. With the help of bypass surgery, it is possible to completely remove excess cerebrospinal fluid in case of cerebral hydrocephalus in adults. The patient is completely healed and returns to normal life. However, after some time, he may need a complete or partial replacement of the shunt. With hydrocephalus of the brain in children due to the growth of the head, the shunt is revised 2-3 times.
In addition, with the congenital form of the disease, the treatment of cerebral hydrocephalus in children is longer and is aimed at maximizing the correction of congenital complications of the disease.
Minimally invasive endoscopic surgery is a priority in the development of methods for treating cerebral hydrocephalus. With the help of them, it is also possible to install a shunt system, remove a cyst or tumor that blocks the outflow of cerebrospinal fluid.
In the endoscopic treatment of cerebral hydrocephalus, endoscopic ventriculocisternostomy, septostomy and aqueductoplasty are most often used. They have a minimal percentage of postoperative complications and a faster rehabilitation period.
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The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
