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December 21, 2011
Hydrocephaly is a state which is shown owing to accumulation of too large amount of liquid in a brain. As a rule, it happens because of obstruction (that is obstruction) which, in turn, breaks normal process of drainage of liquid. Too large amount of liquid which is in a brain can press its brittle fabrics to a skull because of what at the person damage of a brain begins. If in time treatment was not begun, as a result there can occur the death. Hydrocephaly is also called "brain dropsy". She is an inborn disease, however in certain cases develops later. According to statistical data, with an edema every 500th child is born. Treatment perspectives from brain hydrocephaly directly depend on whether in time the illness was diagnosed and treatment is begun. It is also important whether there are accompanying diseases.
Symptoms and symptoms of this disease directly depend on about what age group there is a speech. Extent of progressing of an illness is important. At newborns the most common symptoms is a number of features. That, children for whom brain hydrocephaly is diagnosed afterwards are born with very big head. Further the circle of the head increases very quickly and exceeds norm indicators. On parietal part of the head of the child the convex fontanel is found. At the children having this illness vomiting, irritability, a bad dream is often shown, convulsions and rolling of eyes can be shown. Such children, as a rule, develop with a delay.
At hydrocephaly at adults, and also at children of advanced age the following symptoms of a disease can be shown: headaches which are followed by vomiting, doubling attacks in eyes and impossibility to focus sight, rolling of eyes, manifestation of problems during the movement – bad balance, impossibility to coordinate the movements, fatigue. Also at hydrocephaly there can periodically be memory losses, an incontience of urine, change of the personality, strong irritability.
Depending on what reasons became a basis for display of hydrocephaly, there are certain symptoms and symptoms of an illness. At people at different age hydrocephaly arises for various reasons. So, for example, normotensive hydrocephaly is characteristic generally of people of advanced age. At such illness first of all problems with walking are shown. Very often the person has an urine incontience, and also dementia of which slow processes of thinking, and also difficulties in perception of information are characteristic.
The brain of the person has the consistence reminding jelly, being in the skull filled with cerebrospinal fluid. This liquid fills also ventricles which are in a brain more deeply. Liquid at first passes through ventricles, then it appears in the closed spaces which are located between a skull and a brain. From there liquid gets to a blood stream. At normal balance in the course of development, circulation and a conclusion of liquid at the person normal intracranial pressure is observed. But when for certain reasons outflow of cerebrospinal fluid is broken, begins development of hydrocephaly of a brain. Similar pathology arises if the channel between ventricles is narrowed, or in case of problems with liquid absorption by a human body. In the latter case at the person normotensive hydrocephaly at which excess liquid expands ventricles, however pressure which affects a brain develops, remains normal. This state is often shown as a result of diseases, injuries. However the exact reasons manifestation of this type of hydrocephaly are for certain not known.
At newborns hydrocephaly is shown because of infectious diseases which the woman had to pregnancy time. Diseases which break afterwards process of functioning of ventricular system of a brain of a fruit are the most dangerous. As a result cerebrospinal fluid badly circulates, or it is heated up too much. Inborn hydrocephaly at children can be shown also in the first months of their life.
Owing to various diseases (meningitis, an encephalomeningitis, intoxications, injuries) the acquired brain hydrocephaly can develop.
Risk factors at hydrocephaly
Children who are born premature have a high risk of heavy bleedings in cerebral cavities, hydrocephaly can turn out to be consequence of what. Also the risk of developing of this disease at the child increases existence of an infection in a uterus. Sometimes at the child inborn defects of development which do not notice at the birth take place. Afterwards they can also provoke display of hydrocephaly at children at at advanced age. Other risk factors are tumors or other changes of a head and spinal cord, an infection of TsNS, bleeding in a brain.
Types of hydrocephaly
The general of symptoms for all types of hydrocephaly is accumulation of cerebrospinal fluid. Because of its accumulation pressure upon a brain increases, respectively, in view of injury of a brain also disfigurations can develop intellectual. However at high-quality diagnosis and the correct treatment of an effect of hydrocephaly it is possible to minimize.
It is accepted to distinguish the following types of hydrocephaly:
Hydrocephaly is inborn which is diagnosed in the childhood. It can be shown owing to physical problems with circulation of cerebrospinal fluid. As the reasons of this state the infection or an injury in development of an embryo, influence of a teratogen is defined. Hydrocephaly at children is shown also owing to existence of other defects, such as defects of a brain tube.
The hydrocephaly acquired can arise as at the child's birth, and later. Meningitis, wounds, hemorrhage, a malignant new growth are its reasons.
Hydrocephaly normal – arises at people of advanced age. She successfully recovers, however becomes frequent the manifestation reason at the patient of dementia. This form of hydrocephaly is often shown as a result of injuries of the head, infections, hemorrhages.
Hydrocephaly vacuolar — a consequence of blows, wounds and other injuries of a brain. Often similar phenomenon not hazardously to health and, respectively, treatment does not demand.
If the child has listed symptoms, it has to guard at once parents and to become a reason for the address to the specialist. So, at children at hydrocephaly problems at suction of a breast can be observed very often or when feeding from a small bottle. Such child is a lot of and stridently cries, does not wish to incline the head or to move a neck, it is difficult for it to breathe, periodically there are attacks of spasms. The head of the kid grows very quickly, the fontanel has the convex form. Also at the child eyes and a face can externally change.
People of advanced age who note emergence of the problems with walking which are not connected with arthritis or other diseases also have an occasion to address the specialist.
Diagnosis of hydrocephaly
The doctor can diagnose hydrocephaly for children even during pre-natal development. Data of ultrasonography of the pregnant woman are for this purpose used. Also this illness comes to light at early age in the course of regular measurement of a circle of the head. In the presence of doubts in correctness development the doctor can appoint in addition carrying out ultrasonic research of the head of the baby. In the presence of pathologies which are found at ultrasonography to the child the complex of further researches is appointed.
At the address to the specialist of adult patients or children of advanced age first of all careful inspection, collecting the anamnesis, inspection of physical and neurologic character is performed. Further if necessary the doctor appoints to the patient carrying out a computer tomography or magnetic and resonant tomography. These methods of research provide to the doctor of the image of a brain of the patient. At suspicion on hydrocephaly at adults of the patient goes for consultation to the specialist neurosurgeon.
Complications of hydrocephaly
Depending on at what age the disease begins to develop, its weight is defined. So, at detection of hydrocephaly at the newborn child, most likely, rather serious injury of a brain and, as a result, physical incapacity will take place. If disease severity not so high, then on condition of timely and correct treatment of people can lead almost full-fledged life.
Treatment of hydrocephaly
If for the patient it is diagnosed early disease stages, then medicamentous therapy will effectively work. However at too rapid progress of an edema of a brain it is important to make immediate surgical intervention. Till recent times operation on carrying out ventrikulo-peritoneal shunting was considered as the most eurysynusic method of surgical treatment of an edema of a brain. To the patient special shunts on whom liquid was removed from a brain in an abdominal cavity were entered. However in this case in view of imperfection of shunts time in several years was required to replace system.
The operation called by ETV is applied to treatment of hydrocephaly also. In this case the specialist does an opening in a cerebral cavity, and through it cerebrospinal liquid flows down. This operation is applied in case of development of hydrocephaly owing to obstruction between cerebral cavities. In case of inborn hydrocephaly this method is applied if shunting was unsuccessful, or there was an infection. In due time the given method was the only surgical way of treatment of hydrocephaly. However now it is considered less effective, than other methods. Such operation is appointed only to children who already were six months old.
Today new methods of treatment of hydrocephaly are applied in the surgical way. So, the neuroendoscopic method is low-traumatic. Operation is performed by means of a neyroendoskopom with the mini-camera. Being guided by the received image, doctors recover liquid outflow.
Prevention of hydrocephaly
Careful and regular supervision is important during pregnancy for the purpose of the child's birth in time. In the course of a growing it is important to protect the child from head injuries, ensuring it due safety.
It is also necessary to avoid inflammatory diseases of infectious character of TsNS which very often provoke development of hydrocephaly.