Malformations of the brain

The most frequent causes of various malformations of the brain are wrong tab of the nervous system or its defeat in the period of embryonic development due to changes in genetic information (see Genetics), some infections, transferred by the mother during pregnancy (toxoplasmosis, rubella, influenza, infectious hepatitis), radiation injuries, and harmful effects of certain chemicals. There are the following defects of the brain. Anencephaly is the absence of the big hemispheres and the roof of the skull. Cyclopia - odnoglazoe, often combined with anencephaly. These lesions incompatible with life. Porencephaly - development in the brain cavities, which are typically reported with lateral ventricles. Microgyria - small brains. Microcephaly is a reduction of cerebral cranium. Congenital hydrocephalus (see Hydrocephalus) - excessive accumulation of cerebrospinal fluid. Congenital cerebral hernias - partial swelling of the brain and its meninges through various holes and defects of the skull, mainly at the root of the nose (front hernia) and in the occipital region (rear hernia). Malformations of the brain (except cerebral hernias), usually accompanied by mental retardation (see).
Damage - see Traumatic brain injury.

Violations of cerebral circulation

developing hypertension, atherosclerosis of brain vessels, vasculitis, blood diseases, injuries, and diseases of the heart. By the severity distinguish between transient disturbances (see Crises) and stroke (see).
When passing the cerebral circulation disorders, there are headache, noise in the head, dizziness, cyanosis of the mucous membranes and people sometimes swelling of your face, often there is a faint cold weather and cyanosis of the extremities. May be numbness and weakness in the limbs (hemiparesis), light speech disorders, functional disorders of the cranial nerves, epileptiformnye syndromes, disorders of consciousness.
Sometimes under the guise of transient disorders of blood circulation flow in a mini recognition which in this case is difficult. During malignant hypertension may occur swelling of the brain, with sharp headache, increased coughing and sneezing, nausea, vomiting, dizziness, slow pulse (bradycardia), meningeal symptoms. Frequent violations of coordination. Intracranial pressure is increased, sometimes in the spinal fluid is increased amounts of protein. In the fundus of the phenomenon of edema disk of optic nerve.
Circulatory disorders in various cerebral arteries are accompanied by specific symptoms that depend on the insufficiency of blood supply to the appropriate area of the brain. When cervical osteoarthritis (degenerative changes of bone and cartilage tissue of the spine, leading to compression of blood vessels) with blood circulation in the system of vertebral arteries patients complain of dizziness, nausea, headaches, mainly in the occipital region. At the height of the attacks occur vomiting. Were impaired coordination, nystagmus (see), eye disorders, speech becomes slurred. Tendon reflexes increased, there are pathological reflexes. When the transient poor circulation in the system of the carotid artery may appear briefly on the opposite side hemiparesis the lesion side of the body.
Due to blockage of the arteries of the brain in the vein thrombosis, when the vessels and other reasons develop severe disorders of cerebral circulation with a permanent disability (see Stroke).
Subarachnoid hemorrhage occurs when the blood burst beneath the arachnoid membrane of the brain. In this case, there deschisa headache ("kick in the head"), vomiting, agitation, meningeal symptoms, seizures apnoea, aetiology, skin person. During a lumbar puncture of spinal fluid and blood; in the fundus - retinal edema, hemorrhage, vasodilatation.
Bleeding under Dura (subdural hematoma) more often in the skull injuries (see Traumatic brain injury). Gradually increasing hematoma accompanied publemozgova and meningeal symptoms, and various focal symptoms. Typical is the pupil dilation side hematoma, increase of tendon reflexes and the Babinski reflex on the opposite side.
In severe cases of atherosclerosis of cerebral vessels and hypertensive disease develop chronic insufficiency of brain blood circulation with various organic symptoms (atherosclerotic encephalopathy). Marked decrease intelligence, memory, attention, irritability, emotional instability, bilateral pyramid reflexes and other pathological symptoms.
The prognosis depends on the nature and severity of dyscirculatory phenomena. If vascular crises it is usually favorable. Worsen the prognosis acceding pneumonia, gastrointestinal disorders, weakening of the heart activity.


Treatment. Acute disorders of cerebral circulation it is necessary to provide the patient calm, free breathing: remove mucus and vomit from his mouth and upper respiratory tract, to free the patient from unnecessary service, compression bandages. Check the condition of the heart activity (pulse, blood pressure), depending on what should be used cardio-vascular equipment. When transporting patients, carried out under strict conditions, be careful.
After rendering first aid to a patient with stroke should consult a doctor to conduct a differentiated treatment. Apply on the testimony of hypotensive and antispasmodic, anticoagulants, distracting (mustard), bromides, dehydration remedies, heart drugs. Paralyzed limbs need to give physiological position: arm is bent at the elbow joint and brought to the body, leg straightened. You need to follow the activities of the pelvic organs (if the delay urine catheterization, in the absence of bowel - cleansing enema), to conduct the prevention of bedsores (wipe the skin with camphor spirit, put the patient on a rubber circle, covered with clean sheets, and so on). When passing the cerebral circulation disorders in patients with essential hypertension on the back of high blood pressure appoint antispasmodic and antihypertensive drugs in different combinations: Dibazol (1-2% solution 1-2 ml under the skin 1-2 times a day or on 0,02-0,05 g 2-3 times a day in powders); eufillin (5-10 ml of 2.4% solution in 10-15 ml of 40% solution of glucose intravenously or 0.1 - 0.2 g 2-3 times a day tablets); papaverine (0,04 g 2-3 times a day with diuretekom and phenobarbital inside); spazmolitin (0,01-0,05 g 2-3 times a day inside or 0.5% solution 1-2 ml intramuscularly); and reserpine (0.1-0.25 mg 3 times daily inside). Recommended dehydrating therapy (intravenous infusion of 40% glucose solution or intramuscular injection of 25% solution of magnesium sulfate). When bleeding in the brain - leeches, bloodletting. In the fall of arterial pressure should be applied norepinephrine, mezaton, cardiotonic tools and analeptiki by a doctor. Cm. also patient Care (neurological).