hydrocephalus hydrocephalusHydrocephalus (synonym dropsy of the brain) is a disease characterized by the increase in the number of cerebrospinal fluid in the cavity of the skull.
Hydrocephalus develops due to excess education spinal fluid, breach of its suction or mechanical difficulties outflow (for example, tumors, spinach after inflammatory process, etc.,) on some level ventricular system of the brain.
If the message between the ventricles and subarachnoid space, hydrocephalus is called open (communicating). In violation of this message develops closed, or occlusive hydrocephalus. The cavity of the ventricles stretch, their walls become thinner, can occur break the wall of the ventricle.
There are congenital and acquired hydrocephalus. Congenital hydrocephalus develops after intrauterine infection, abnormalities and malformations.
Acquired hydrocephalus develops more often after infectious process of the meninges or brain, after traumatic brain injury, tumors and parasitic diseases of the brain.
In congenital hydrocephalus children are born with a big head (up to 50-70 cm in circumference, while the norm 34-35 cm). The head is shaped like a ball, forehead much is thrown forward and as it hangs over the face (Fig). These filters will wybuchu, no pulse, cranial sutures diverge. A child is difficult to hold his head. Found the fall of view up to blindness. Observed weakness in the limbs and increased muscle tone, delayed mental development. Patients often die in early childhood, if survive and in some cases remain idiots, they observed the paralysis of limbs and epileptic seizures.
Acquired hydrocephalus may be acute or chronic. In severe may suddenly develop motor disorders, and seizures. With the development of occlusion in children found a significant increase in the head, expansion of the venous network in the frontal-temporal areas. In chronic cases, the disease for a long time asymptomatic. With the development of occlusion appear headache attacks with vomiting, the stagnation in the fundus, DLR in the eyes, motor disorders in the extremities and other symptoms, depending on the level of violations of the flow. The diagnosis can be clarified by ventrikulografia (see).
Treatment. Regardless of the forms of hydrocephalus shown treatment dehydrating means: magnesium sulfate - 25% solution 1-5-7 ml intramuscularly at the rate of 10 injections; glucose - 40% solution 15-20 ml intravenously in a day, the course of 10-15 injection; gipotiazid-on 12,5-25 mg (depending on age) 3 - 4 times a week with potassium chloride - 0.5 g 3 times a day (in the days of the acceptance of gipotiazid); novoryt - 0.3-0.5-1 ml injection a day, up to 10 injections per course. In severe forms of hydrocephalus - one-two times a week puncture of the ventricles of the brain through the advanced spring and lumbar puncture with slow excretion of cerebrospinal fluid. When occlusive hydrocephalus - operation.
Surgical treatment. Indications: the growing phenomenon of increased intracranial pressure (stagnation in the fundus, decrease of visual acuity or field of view). Contraindications: idiocy, current inflammatory process, stabilization or reverse the development of hydrocephalus. Make palliative surgery: puncture and drainage for drainage of cerebrospinal fluid, decompressive trepanning. Radical surgery: removal of the causes of blockage, the creation of an internal drainage, removal of vascular plexuses of the ventricles, the creation of new ways of outflow of cerebrospinal fluid.