HYDROCEPHALIA

Innovative methods of modern medicine with timely treatment give most patients with hydrocephalus a chance for a normal and long life.

Hydrocephalus - what is it?

The literal translation of the term "hydrocephalus" implies that this disease is manifested by the presence of an excessive amount of water in the head. This interpretation is not entirely correct. We are not talking about water, but about cerebrospinal fluid.

Unlike the heart, the brain is not a muscle. It is a soft substance consisting of nervous tissue. Cerebrospinal fluid is a kind of protective "safety cushion" for her, which provides:

• delivery of nutrients to the brain and return of metabolic products;
• stability of intracranial pressure.

Similar to blood circulation in the cardiovascular system, this fluid, which is vital for the proper functioning of the brain, circulates in the cranial cavity. The place of its formation is the ventricles, connected to each other by special channels. After washing the surfaces of the spinal cord and brain, the cerebrospinal fluid, the composition of which is constantly renewed, is absorbed into the bloodstream. Hydrocephalus is an excess amount of cerebrospinal fluid in the head. It is formed due to a violation of the balance between the amount of cerebrospinal fluid produced and its absorption.

Types of hydrocephalus

There are currently several classifications of hydrocephalus. The etiology of hydrocephalus implies the existence of two forms: congenital or acquired.

According to the mechanism of occurrence, there are main types of hydrocephalus:

• closed (occlusive) hydrocephalus - there are natural barriers in the form of cysts, adhesions, hemorrhages;
• open (combined) hydrocephalus – for example, with previously transferred infectious meningitis, the very mechanism of absorption of cerebrospinal fluid into the bloodstream is disrupted;
• hypersecretory – a rare form of hydrocephalus that occurs with excessive production of cerebrospinal fluid.

The speed of the course of the pathological process assumes the presence of three forms: acute (development of the disease within a few days from the moment of symptoms), subacute (forms within a month) and chronic (progresses over several months).

Localization increased in the volume of liquid determines:

• external hydrocephalus - between the meninges;
• internal hydrocephalus – affects the ventricles and is divided into unilateral and symmetrical;
• mixed hydrocephalus.

Depending on whether the nerve structures of the brain are compressed by the increased volume of cerebrospinal fluid or not, compensated or decompensated hydrocephalus is observed.

Causes of hydrocephalus

Most patients who develop hydrocephalus are children. As a rule, in adolescents and adults, hydrocephalus is a secondary result, a complication of some disease. The list of such pathologies is quite large:

• neuroinfections - meningitis, encephalitis;
• craniocerebral injuries;
• brain tumors, sarcoidosis;
• ischemic stroke, hemorrhages;
• severe forms of cardiovascular diseases – heart failure, hypertension, aneurysms.

In addition, a significant number of cases of hydrocephalus are determined, when the cause remains undetected - an idiopathic factor.

Congenital hydrocephalus

Hydrocephalus, which is observed before the birth of a child, is defined as congenital hydrocephalus. Reasons that can lead to this pathology:

• brain malformations;
• inflammatory diseases of the central nervous system;
• birth injuries;
• intrauterine infection with infectious diseases of the mother (rubella, mumps, toxoplasmosis, etc.).

Symptoms of hydrocephalus

Depending on the development of hydrocephalus and the patient's age, the symptoms of the disease have their own characteristics.

Hydrocephalus in children

The bones of the skull of newborn children are still separated from each other, so the increase in the volume of cerebrospinal fluid pushes them apart and leads to a disproportionate change in the shape of the head. At the same time, an "explosive" protrusion of the fontanelle is observed. In addition, the child's scalp is transformed - it becomes thin, with a noticeable network of blood vessels. When hydrocephalus develops in newborns, the symptoms of this disease are supplemented by disorders of a neurological nature:

• convulsions;
• bad sleep and appetite;
• shrill cry;
• change in muscle tone;
• difficulties with holding the head and vertical position of the body.

Ophthalmological signs of hydrocephalus in babies are eye rolling, involuntary eye tics, etc. p.

In children older than two years of age, increased intracranial pressure is manifested by vomiting, headache, movement coordination disorders, and memory problems.

Hydrocephalus in adults

The main signs of hydrocephalus in adults are expressed in symptoms of increased intracranial pressure. The acute form is accompanied by:

• paresis;
• headache that cannot be stopped by painkillers (analgesics), most pronounced in the morning;
• nausea and vomiting;
• drowsiness;
• oculomotor disorders.

In the case of a chronic form, the main manifestations of hydrocephalus are:

• dementia;
• enuresis;
• uncertainty, impaired gait.

Diagnosis of hydrocephalus

The choice of hydrocephalus diagnostic methods depends on the clinical picture and individual characteristics of the patient. Several types of hardware diagnostics are used to make an objective diagnosis:

• magnetic resonance imaging (MRI) is the most informative method;
• computed tomography (CT);
• X-ray.

If necessary, ultrasound, angiography of brain vessels, ophthalmoscopy, etc. can be performed. p.

Treatment of hydrocephalus

Today, the only effective method of treating hydrocephalus is surgery. Its essence is to eliminate the cause of accumulation of excess cerebrospinal fluid in the skull. If for some reason this option is not possible, then CSF shunting is performed.

Shunting for hydrocephalus

The main purpose of shunting is to remove excess fluid from the ventricles of the brain to other body cavities (peritoneum, pleural cavity, atrium). The modern shunting system is equipped with valves that allow you to adjust the pressure of the cerebrospinal fluid in the cerebral vessels. As the child grows, the catheters are lengthened or changed.