Outdoor brain hydrocephalus - a neurological disease that develops in the ventricular system, and in the spaces under the lining of the brain due to excessive accumulation of cerebrospinal fluid (CSF) due to increased its formation or impaired outflow.There are congenital (arisen as a result of the unborn fetus) and acquired hydrocephalus.
Pathogenesis distinguish between open, closed and ex vacuo form of the disease.Open external hydrocephalus develops in connection with the violation of the production and absorption of cerebrospinal fluid.It is assumed free message likvoronosnyh spaces.When closed hydrocephalus occurs separation likvoronosnyh spaces on different levels.Hydrocephalus ex vacuo is a consequence of the reduction of brain parenchyma due to atrophy in various pathologies of the central nervous system (Alzheimer's disease), or a result of aging (variant of the norm).
Depending on clinical displays distinguish progressive, stabilizing and regressing form of the disease.
main causes of external hydrocephalus:
- traumatic brain injury;
- various inflammatory diseases of the brain or its membranes (encephalitis, meningitis);
- pathological changes of cerebral vessels;
- disorders of the cervical vertebrae;
- pathology of the central nervous system.
Symptoms of external hydrocephalus
Typical symptoms are:
- general weakness, fatigue;
- headache, accompanied by nausea and vomiting;
- double vision;
- disturbance of gait and coordination of movements;
Very often common signs of external hydrocephalus in adults may not appear so headaches and high blood pressure may not occur for a long time.
One of the insidious forms of the disease is moderate outside the brain hydrocephalus.Characteristic for it is the complete absence of any signs of the disease for even a few years.But there comes a time when the patient's condition is deteriorating as a result of violations of cerebral circulation.More often than not, this form of hydrocephalus is diagnosed incidentally during fundus studies.
symptoms in children
In congenital form of the disease in children, an increase of volume of the head up to 50%, swelling of the fontanelle and skin veins of the head, the difference of bone joints.In addition, the disease is accompanied by a naughty child, which is caused by increased intracranial pressure, lethargy, poor appetite, marbled skin.A characteristic feature is the over-eyed gaze direction and predominantly downward.
external hydrocephalus in older children and adolescents have the same clinical manifestations as in adults.
worth noting that hydrocephalus is more common in premature babies.
should know that the external signs of hydrocephalus may be characteristic of other diseases, so you should not engage in self-diagnostics, and as soon as possible to address to the doctor for a thorough examination and confirm or refute the diagnosis.
Diagnosis and treatment
To date, one of the most effective ways to establish this diagnosis is MRI.In addition, applied studies such as a CT scan, brain ultrasound, X-ray, angiography, as well as laboratory testing for the presence of rubella virus, herpes, syphilis, toxoplasmosis.
The choice of tactics of treatment depends on the type of disease and the patient's age.Patients prescribed diuretics and vasodilators, normalizing the work of the central nervous system and controlling the outflow of cerebrospinal fluid.carbonic anhydrase inhibitors are used at the same time, reducing the production of liquor and saluretiki improving venous return.However, it is understood that the drug treatment only slows down the course of the disease and alleviate the patient's condition, only rarely resulting in complete recovery
In cases where conservative treatment for 2-3 months does not bring positive results and does not manage to stabilize the process, that is, if the diseaseHe continues to progress, resorting to surgical methods.
One such method is bypass surgery, during which excess cerebrospinal fluid is derived.However, this intervention can cause a number of complications:
- blockage in the ventricles of the brain or in the abdominal cavity;
- shunt infection and as a result, the brain and the meninges;
- a variety of mechanical damage to the shunt;
- too fast outflows from the ventricles, which can lead to the formation of hematoma;
- slow the outflow from the ventricles, which makes the operation inefficient;
reached endoscopic surgery of today, of wide application and high efficiency.Its purpose * creation of cerebrospinal fluid outflow tract of the ventricular system in the brain of the tank, through which the absorption of cerebrospinal fluid, the normal physiological range.The indisputable advantages of endoscopy are:
- restore normal likrovotoka;
- absence of a foreign body in the body (shunt system) and its associated complications;
- less traumatic;
- marked improvement in the quality of life of the patient.
skilled is very difficult to give a forecast for the flow of the disease - each individual case is different.However, be aware that external hydrocephalus in adults can lead to physiological as well as to mental disorders.If hydrocephalus is not treated, it may lead to death.But, as practice shows, the majority of patients managed to fully recover after surgery and live a normal life (sometimes - with some restrictions).
Hydrocephalus in children has more positive forecasts.The percentage of the return to normal life have a higher, subject to early treatment and painstaking work as doctors and rehabilitation specialists and parents themselves.