In such cases, urgent treatment is necessary. Up to a year, a complete restoration of the ventricular system and the recovery of the baby are possible.

What it is

For storage and collection of CSF in the human brain, there are 2 paired and 2 unpaired ventricles. Each of them has a reservoir for cerebrospinal fluid. Features of each of the elements of the ventricular system:

First (left) ventricle and second (right) ventricle. They consist of three pairs of horns and a body, interconnected. Dilatation of the lateral ventricles is often diagnosed in newborns. Fluid accumulates in the horns or body of the cerebrospinal fluid collectors.

The third ventricle is connected to the paired ventricles and is located between their anterior and inferior horns.

The fourth ventricle (rhomboid fossa) collects all the fluid from the three previous elements. From it, the fluid is distributed through the spinal or central canal.

The growth of the ventricles occurs gradually, consistent with the linear dimensions of the cranium. However, in the presence of provoking factors, dilatation of the third or fourth CSF collector occurs. Sometimes the presence of the 5th ventricle may be noted on an ultrasound examination of a future mother. This is the norm.

Ventricular system

The ventricular system is designed to store and secrete cerebrospinal fluid. With proper operation in the tanks of its collectors, cerebrospinal fluid is collected from the surrounding veins. From there, the cerebrospinal fluid is distributed to the subarachnoid space.

Enlargement of one of the ventricles in infants is not always pathological. Minor deviations in their size are due to the large head of the child at birth. There is an expansion of the elements of the ventricular system up to one year of age. If pathology is detected, it is recommended to measure the entire CSF apparatus.

Violation of the outflow from the ventricles of the brain occurs due to the appearance of a barrier to the removal of cerebrospinal fluid. With prolonged accumulation of fluid, an increase in the head and a hydrocephalic state of the baby are observed. Which leads to brain dysfunction. These violations occur in pathological or premature birth, trauma to the head of the newborn.

Indicators of normal sizes

The size of the ventricles is determined by ultrasound of the brain of the baby. At the slightest deviation, there is a risk of stagnation of the cerebrospinal fluid.

Normal indicators of the elements of the ventricular system in newborns:

• Side (first and second): 4 mm. Features of paired elements: anterior horns - up to 4 mm, rear horns up to 15 mm, lateral bodies 4 mm each.
• Third: 5 mm.
• Normal indicators of the fourth ventricle range from 3 to 6 mm.

Brain structures in healthy children should grow symmetrically and gradually. The indicators are calculated depending on the linear dimensions of the cranium. If one of the ventricles is larger than normal, it is necessary to examine the entire cerebrospinal fluid apparatus and verify the asymmetry of the paired or pathological increase in unpaired elements.

With fluid retention in the ventricles of the brain, their volume increases and intracranial pressure increases. With hydrecephalic-hypertensive syndrome, there is a malfunction and atrophy of the hemispheres.

The causes of pathology are as follows:

Congenital hydrocephalus: fetal hypoxia, pathological childbirth, childbirth before 35 weeks, infection or virus of the mother during pregnancy, genetic pathologies of brain development.

Acquired hydrocephalus: infection, neoplasms in the ventricles, head trauma, violation of the integrity of the bones of the skull and brain.

A newborn with this syndrome is characterized by tearfulness, impaired motor skills and a lag in physical and psycho-emotional development. There is a gradual or sharp increase in the head, the bones of the skull diverge, the fontanel protrudes.

It is also necessary to pay attention to the baby who has strabismus, he often burps, is naughty in the morning, reacts negatively to bright lights and loud sounds.

If dilatation of the left ventricle is diagnosed in newborns up to six months, inpatient treatment is possible. The child is prescribed sedative, diuretic and nootropic drugs. Be sure to appoint massage and gymnastic exercises.

Enlarged and dilated ventricles affect the functioning of the central nervous system. If the changes evenly affected each element of the liquor structure, this is the norm. There are types and degrees of severity of the ventriculomegalic condition.

By localization, the following types of pathology are distinguished:

Enlargement of the rear or side (left, right) element.

An increase affecting the visual tubercles and the frontal region of the brain.

An expansion of the fourth ventricle that affects the cerebellum and the medulla oblongata.

The main causes of such a congenital condition are the abnormal development of the fetus due to violations in the chromosome series. Other factors are associated with pathological childbirth, head trauma or infections affecting the brain.

After ultrasound diagnosis of the brain in newborns, diuretic, potassium-containing and vitamin medicines are prescribed. Lack of adequate treatment leads to the development of Down syndrome, Turner syndrome, Edwards genetic mutation.

The child will not be able to fully live, as the enlarged ventricles will negatively affect the brain and heart.

Causes of dilation

Dilation may occur in utero or develop gradually after pathological births or head injuries. Even the smallest changes in the size of CSF structures can lead to serious consequences. Their increase leads to an increase in intracranial pressure, which provokes hydrocephalus.

The main causes of enlarged paired or unpaired ventricles of the brain in infants:

• Pathological pregnancy: lack of oxygen, early placental abruption.
• Early labor, prolonged labor, lack of labor activity.
• Head injury during childbirth, due to a fall, impact, accident.
• Benign and malignant tumors in the brain that prevent the outflow of fluid.
• The formation of cysts.
• Entry into the brain of foreign bodies.
• Transferred infectious diseases.
• Subdural and subarachoid hemorrhages leading to ventricular asymmetry.

Dilation in infants leads to diseases of the nervous system and developmental disorders. It is possible to identify the pathology in the first days of the stay of the child and mother in the neonatal unit. Therefore, it is possible to prevent the development of serious complications.

Expansion Symptoms

Manifestations of enlarged ventricles are not noticeable with minor changes. With a gradual accumulation of fluid, disturbances in the work of the central nervous system, heart, organs of vision and hearing are observed.

By the presence of the following signs, doctors may suspect dilatation in a newborn:

• lack of appetite and frequent regurgitation;
• tremor of the chin, arms and legs;
• epileptic seizures;
• motor disorders;
• lag in mental and physical development;
• strabismus and other visual impairments;
• pallor of the skin;
• the appearance of enlarged veins on the forehead, temples and head;
• the head increases, the bones of the skull diverge.

If ventricular enlargement occurs at an older age, the child may complain of nausea and headache. Coordination disorders, hallucinations, memory loss are also noted. The presence of certain symptoms may depend on the degree of dilatation of the ventricles of the brain and the localization of the pathology.

Diagnostics

Identification of the disease includes instrumental examinations. Such diagnostic measures allow you to accurately determine the size and depth of the ventricles and the degree of accumulation of fluid in them. In the presence of external changes in the outlines of the skull or with characteristic symptoms, the doctor prescribes the following procedures:

Examination of the fundus to examine the condition of the vessels and identify visual impairment.

Neurosonography to determine the size of each of the paired ventricles.

Magnetic resonance therapy for older children. It is prescribed for difficult diagnosis of the child's condition using other methods.

Computed tomography to detect the slightest changes in the size of the ventricles.

Ultrasound examination of the child's brain to identify echo signs of ventricular expansion. In addition to accurate measurements of CSF structures, it is possible to determine the volume of accumulated CSF.

Puncture of cerebrospinal fluid to determine its composition and nature.

Only after the examination, the doctor can prescribe adequate treatment. If the changes are minor and symmetrical, constant monitoring of the child's condition is prescribed. Identified cysts can resolve on their own during the first year of life.

How is a breast ultrasound performed?

Ultrasound examination is carried out through an unovergrown fontanel of the child. Therefore, after a year, when the bones of the skull grow together, computed tomography or MRI is prescribed.

The procedure is carried out according to the following algorithm:

1. Treatment of the spring with a special gel that promotes the penetration of ultrasonic rays.
2. Setting up the device based on the age of the child being examined.
3. Examination of the brain and fixing the results.

According to the presented conclusion, it is not necessary to make a diagnosis on your own. After studying the results, examining the child, fixing the accompanying signs of impaired brain development, treatment will be prescribed.

Interpretation of ultrasound results

The attending physician deals with the interpretation of the results, sometimes a consultation with a neurosurgeon is required. If the examination reveals that the baby's ventricles are dilated, but there are no pathological symptoms, it is necessary to undergo an examination again.

In addition to the size and depth of the elements of the liquor apparatus, which were mentioned above, the following indicators are provided: the interhemispheric gap should be no more than 3 mm;

subarachnoid space about 3 mm.

These measurements indicate the state of the ventricles and the degree of dilatation. If they are greatly enlarged, there is a violation in the structures of the brain. The lateral ventricles should not exceed 4 mm, otherwise hydrocephalus is diagnosed.

Treatment of the disease

Dilation therapy includes medication and physiotherapy.

For the treatment of expansion of the lateral and unpaired ventricles of the brain of newborns, the following is prescribed: diuretics to reduce the production of cerebrospinal fluid; nootropics to improve blood circulation; agents that calm the central nervous system; gymnastics and massage of the child to improve the condition of the child and relieve muscle tone; vitamin complexes to prevent rickets.

If the enlargement of the ventricles has become a consequence of an infectious disease, antibiotics and antiviral drugs are prescribed. In case of violations of the integrity of the skull and brain, surgical treatment is performed.

Consequences and complications

The consequences of an increase in the ventricle of the brain can be different. It all depends on the degree of expansion and localization of the pathology. The main complications that can occur if medical recommendations are not followed:

• loss of vision and hearing;
• lack of coordination, lack of physical and mental activity;
• lagging behind peers;
• paralysis;
• constant growth of the head, deformation of the bones of the skull;
• epileptic seizures and loss of consciousness;
• hallucinations;
• hemorrhagic shock;
• paralysis;
• fatal outcome.

If the ultrasound revealed a slight increase in the ventricles, but the baby is not capricious and develops according to the norm, a second examination is prescribed. To avoid the development of possible complications, do not ignore medical prescriptions. Pass all the necessary examinations and treat the child.

To imagine why the ventricles of the brain are enlarged, you need to know the anatomical side of the problem. The ventricles, located in the brain zone of a small baby, are represented by many cavity formations necessary to preserve cerebrospinal fluid.

Ventricles of the brain

The capacitive structure of the brain for CSF storage is the lateral ventricles. In terms of size, they are larger than all the others. The left ventricular formation of the brain is the first, and located on the right side is the second.

The third ventricular element is closely interconnected with the two located laterally due to the hole located between the column of the fornix and the anterior thalamus ending, connecting the third ventricular element with the lateral (interventricular). The corpus callosum (corpus callosum) has sides, and these cavity formations in the form of ventricles are localized on the sides, slightly below this body. The composition of the lateral ventricles is presented in the form of anterior, posterior, lower horns, as well as the body.

The fourth ventricular component is very important, located near the cerebellum and medulla oblongata. It looks like a rhomboid shape, which is why it is called a rhomboid fossa, in which the spinal cord canal is located with a canal where there is a communication between the fourth ventricular component and the plumbing.

It is worth noting that if the 5th ventricle is present, located in the brain region during ultrasound diagnosis during pregnancy, then this is the norm.

Together with the function of accumulation by the ventricles, the secreting function of the cerebrospinal fluid is performed. In the normal state, this fluid drains into the region of the subarachnoid space, but sometimes this process is disturbed, the various ventricles located in the brain region of a helpless baby are enlarged. This indicates a disturbed outflow of cerebrospinal cerebrospinal fluid from the ventricular zone, a hydrocephalic state develops.

What does this mean

Do not panic if some of the ventricles are dilated, located in the brain region of a helpless baby. After all, the dilatation of some ventricles located in the brain region is not always pathological. A slight increase in any ventricle located in the area of ​​\u200b\u200bthe brain in the baby is due to physiology due to the large head of the baby.

An increase in the ventricles of the brain in newborns is not rare until the age of one. In this situation, it is required to find out not only how dilated some of the ventricles located in the brain zone of a small baby are, but also to measure the entire cerebrospinal fluid apparatus.

An excess of cerebrospinal fluid is considered the main root cause of what, in fact, is why this expansion of the ventricles of the brain is carried out. The cerebrospinal fluid does not flow due to an obstruction in the place where it departs, resulting in dilatation of the existing ventricular system located in the brain region.

The expansion of the lateral ventricles of the brain occurs in those babies who appeared prematurely. When dilatation of some of the lateral ventricles located in the region of the brain in newborns is suspected, or their asymmetry, it is necessary to measure them, to set a qualitative parameter. This is what happens when the existing lateral ventricles of the human brain are expanded, and what this means is already clear. Conditions where many ventricles are dilated require careful description.

Ventriculomegalic condition

With it, the cavitary system of the ventricular apparatus is enlarged, as a result of which dysfunction of the central nervous system will manifest itself.

Ventriculomegalic types

Depending on the burden, the pathology occurs in mild, moderate and severe; location defines the following types:

• lateral, in which there is an increase in some of the ventricles in a small child, such as the posterior and lateral;
• another view, where the location of the pathology is in the area near the visual tubercles and the frontal region;
• in the next case, the focus affects the cerebellar region with the medulla oblongata.

What are the causes of pathology

The main root cause why pathology is possible in newborns is considered to be a chromosomal abnormality in pregnant women. Other circumstances that determine why certain ventricles of the brain area in a small child are enlarged are infectious diseases, physical trauma, hydrocephalic obstruction, hemorrhagic manifestations, and aggravated heredity.

Symptoms of the disease

Expanded some ventricles of the brain zone in a small child serve as the root cause of the syndrome states of Down, Turner, Edwards. In addition, some enlarged ventricles of the brain area in a small baby affect cardiac activity, brain structures and the musculoskeletal system.

Diagnostic measures

This condition in children is diagnosed with an ultrasound examination of the head.

How is it treated

In a state where the lateral ventricles of the brain in a child are dilated, the main thing is to prevent complicated conditions of the body. Diuretic, vitamin preparations, antihypoxants are prescribed. Additional methods of treatment for this condition are massage procedures with special physiotherapy exercises. Potassium-sparing agents are used to prevent complicated conditions.

Hydrocephalic-hypertensive syndrome

Another course of the disease cannot be excluded, in which increased ventricular cerebral components are observed in newborns ─ hydrocephalic hypertension syndrome.

With it, cerebrospinal cerebrospinal fluid is excessively produced, accumulating under the meninges and the ventricular system of the brain. This pathology is rare and requires diagnostic confirmation. This syndrome is classified according to the age of the child.

Causes

The root causes are divided into those that were before birth and those that have already been acquired. Congenital occurs due to:

• complicated course of the woman's condition, in which she is pregnant, complicated childbirth;
• intrauterine cerebral hypoxia, trauma during childbirth, developmental anomalies;
• early labor activity;
• intrapartum trauma with hemorrhage in the subarachnoid space;
• intrauterine infectious pathology;
• brain anomaly;
• protracted labor activity;
• a long period between the departed amniotic fluid and the expelled fetus;
• maternal chronic pathology.

Acquired root causes include:

• neoplasms of an oncological or inflammatory nature;
• foreign body located in the brain;
• condition after a skull fracture with penetration of bone fragments into the brain;
• infectious pathology;
• cause of unclear etiology.

All the root causes of this syndrome lead to the development of an expansion of the ventricles of the brain in infants.

Manifestation of pathology

The clinical syndrome manifests itself:

• high intracranial pressure;
• increased volume of ventricular fluid.

The symptoms boil down to:

• the baby refuses to breastfeed, is whiny, capricious for no apparent reason;
• he has a decrease in activity in muscle fibers;
• reflexive activity is poorly expressed: it is difficult to grasp and swallow;
• often spit up;
• strabismus is observed;
• on examination, the iris is half-covered by the lower eyelid;
• the seams of the skull diverge ─ this also indicates that there is an increase in some of the lateral ventricles of the brain region in a child;
• tension with bulging fontanelles shows that the ventricles of the brain are dilated in a child;
• month after month, the head circumference increases, this is also an important sign that some of the lateral ventricles of the brain are slightly dilated in the baby;
• the fundus of the eye shows that the visual discs are edematous, also an indicator that there is dilatation of the lateral ventricles located in the brain region of a small baby.

These manifestations indicate that the ventricular system of the enlarged brain in a small child, or the fifth ventricle of the brain, is enlarged, the consequences may be severe. Children of the older age category acquire this syndrome sometimes immediately after they have had an infectious pathology or damage to the skull with the brain.

A characteristic feature of this problem is considered to be morning soreness in the region of the head, squeezing or bursting nature, localized in the temporal and frontal zone, with the manifestation of nausea with vomiting.

The complaint, in which some ventricle of the brain region of a small child is enlarged, is the impossibility of raising the eyes upward with the head lowered downward. This is often accompanied by a feeling of dizziness. With the observed paroxysm, the skin is pale, lethargy, lack of activity are expressed. The child is annoyed by bright light and loud sound effects. Based on this, it is already possible to assume that the left ventricle of the brain in a child is enlarged.

Due to the high muscle tone in the legs, the child walks on toes, he has a pronounced strabismus, he is very drowsy, psychomotor development is slow. This is what the enlarged ventricles of the diseased brain in a small child at 3 years old lead to.

Diagnostic measures

High-precision diagnosis of hydrocephalic syndrome with hypertension, it is not easy to find out whether the ventricle of the brain is really enlarged in infants. Using the latest diagnostic methods, it is impossible to establish an accurate diagnosis, in which the syndrome leads to the development of a slight expansion of the ventricular system of a small area of ​​the brain in a child, or the 3rd ventricle, located in the brain area, is enlarged, or dilatation of the left ventricle, located in the area brain in a child.

The diagnostic parameters of the newborn are the circumference of the head region, the activity of reflexes. Other diagnostics include:

• ophthalmological examination of the fundus;
• neurosonographic examination in order to see how enlarged the ventricle of a certain part of the brain in a newborn is;
• conducting a computed tomographic study and MRI will help to accurately determine that this may be a slight dilatation of the lateral ventricles of the brain in a child;
• lumbar puncture study, which determines the degree of pressure of the cerebrospinal cerebrospinal fluid. This method is accurate and reliable.

Therapeutic measures

Neurological and neurosurgical specialists are obliged to treat this disease. The sick are constantly monitored by doctors, otherwise the dilated ventricles of the brain in a child will bring serious consequences.

Until the age of six months, when there is dilatation of the left lateral ventricle of the brain in newborns, outpatient treatment. The main treatment is:

• diuretics together with drugs that reduce the reproduction of cerebrospinal fluid;
• nootropic group of drugs that improves cerebral circulation;
• sedatives;
• special gymnastic exercises with massage.

Therapeutic measures of the syndrome, in which an increase in the left ventricle of the brain in newborns, are long-term, take more than 1 month.

Children of the older age group are treated for hydrocephalic syndrome, depending on the pathogenesis, depending on the root cause of the pathology. When the syndrome arose due to an infectious disease, drugs are prescribed against bacteria or viruses. With a cranial injury or oncology, surgical intervention is indicated. If left untreated, the enlarged ventricular system of the brain in newborns will cause serious consequences.

Complicated conditions

The manifestation of hydrocephalic syndrome with hypertension causes complicated conditions of the body, in which the child will have the following consequences:

• psychomotor baby develops slowly;
• blind completely or partially;
• auditory dysfunction, possibly completely deaf;
• may fall into a coma;
• completely or partially paralyzed;
• the fontanel bulges abnormally;
• epileptic seizures are manifested;
• involuntarily urinates, performs an act of defecation;
• may die.

This is what the increased state of the ventricular elements of the brain in newborns will lead to, what are the possible consequences, if the treatment is not completed in time.

In the infantile period, the prognostic course is the most favorable due to the periodicity of the arterial type of pressure and intracranial pressure, which over time, the older the baby, to normal values. In the older children's age category, the prognosis is unfavorable, depending on the root cause of this syndrome, the characteristics of treatment.

The information on the site is provided for informational purposes only, does not claim to be reference and medical accuracy, and is not a guide to action. Do not self-medicate. Consult with your physician.

Enlargement of the ventricles of the brain in infants

Quite often, babies have enlarged ventricles of the brain after birth. Such a condition does not always mean the presence of a disease in which treatment is certainly required.

Ventricular system of the brain

The ventricles of the brain are several interconnected collectors in which the formation and distribution of cerebrospinal fluid occurs. Liquor is washed by the brain and spinal cord. Normally, when a certain amount of cerebrospinal fluid is always in the ventricles.

Two large collectors of cerebrospinal fluid are located on both sides of the corpus callosum. Both ventricles are interconnected. On the left side is the first ventricle, and on the right - the second. They consist of horns and a body. The lateral ventricles are connected through a system of small holes with the 3rd ventricle.

The fourth ventricle is located in the distal region of the brain between the cerebellum and the medulla oblongata. It is quite large in size. The fourth ventricle is diamond-shaped. At the very bottom there is a hole called the rhomboid fossa.

Proper functioning of the ventricles ensures the penetration of cerebrospinal fluid into the subarachnoid space when necessary. This zone is located between the hard and arachnoid membranes of the brain. This ability allows you to save the required volume of cerebrospinal fluid in various pathological conditions.

In newborn babies, dilatation of the lateral ventricles is often observed. In this condition, the horns of the ventricles are dilated, and there may also be an increased accumulation of fluid in the area of ​​\u200b\u200btheir bodies. This condition often causes both left and right ventricular enlargement. In differential diagnosis, asymmetry is excluded in the region of the main brain collectors.

The size of the ventricles is normal

In infants, the ventricles are often dilated. This condition does not mean that the child is seriously ill. The dimensions of each of the ventricles have specific values. These indicators are shown in the table.

First and second ventricles (lateral)

To assess normal indicators, the definition of all structural elements of the lateral ventricles is also used. The lateral cisterns should be less than 4 mm deep, the anterior horns 2 to 4 mm, and the occipital horns 10 to 15 mm.

Causes of ventricular enlargement

Premature babies may have dilated ventricles immediately after birth. They are arranged symmetrically. Symptoms of intracranial hypertension in a child with this condition usually do not occur. If only one of the horns increases slightly, then this may be evidence of the presence of pathology.

The following reasons lead to the development of ventricular enlargement:

Fetal hypoxia, anatomical defects in the structure of the placenta, the development of placental insufficiency. Such conditions lead to disruption of the blood supply to the brain of the unborn child, which can cause an expansion of the intracranial collectors.

Traumatic brain injury or falls. In this case, the outflow of cerebrospinal fluid is disturbed. This condition leads to stagnation of water in the ventricles, which can lead to symptoms of increased intracranial pressure.

pathological childbirth. Traumatic injuries, as well as unforeseen circumstances during childbirth, can lead to disruption of the blood supply to the brain. These emergency conditions often contribute to the development of ventricular dilatation.

Infection with bacterial infections during pregnancy. Pathogenic microorganisms easily cross the placenta and can cause various complications in the child.

Prolonged childbirth. Too long a time between the discharge of amniotic fluid and the expulsion of the baby can lead to the development of intrapartum hypoxia, which causes a violation of the outflow of cerebrospinal fluid from the dilated ventricles.

Oncological formations and cysts that are in the brain. The growth of tumors puts excessive pressure on intracerebral structures. This leads to the development of pathological expansion of the ventricles.

Foreign bodies and elements that are in the brain.

infectious diseases. Many bacteria and viruses easily cross the blood-brain barrier. This contributes to the development of numerous pathological formations in the brain.

How is it manifested?

The expansion of the ventricles does not always lead to adverse symptoms. In most cases, the child does not experience any discomfort that would indicate the presence of a pathological process.

Only with severe violations begin to appear the first adverse manifestations of the disease. These include:

Gait disturbance. Toddlers begin to walk on tiptoe or step heavily on their heels.

The appearance of visual disturbances. They often manifest themselves in babies in the form of strabismus or insufficiently good focus on various objects. In some cases, the child may develop double vision, which increases when looking at small objects.

Behavioral disorders. Babies become more lethargic, drowsy. In some cases, even apathetic. It is very difficult for a child to captivate with some games or recreational activities.

Headache. Manifested with an increase in intracranial pressure. At the height of the pain, vomiting may occur.

Decreased appetite. Babies in the first months of life refuse breastfeeding, eat poorly. In some cases, the child spit up more.

Sleep disturbance. Babies may have difficulty falling asleep. Some kids sleepwalk.

The disease can be of varying severity. With minimal symptoms, they talk about a mild course. With the appearance of headache, dizziness, and other symptoms indicating high intracranial hypertension, the disease becomes moderately severe. If the general condition of the child is severely disturbed and treatment is required in a hospital, then the disease becomes already severe.

Effects

Untimely diagnosis of pathological conditions that led to the appearance of dilations in the region of the ventricles of the brain can affect the further development of the child. The first persistent symptoms of ventricular dilatation are observed in babies at 6 months.

Violation of the outflow of cerebrospinal fluid can lead to a persistent increase in intracranial pressure. In severe cases of the disease, this contributes to the development of impaired consciousness. Disorders of vision and hearing lead to the development of hearing loss in the child and weakening of vision. Some babies have epileptic seizures and seizures.

Diagnostics

In order to determine the exact dimensions of the ventricles, as well as to find out their depth, doctors prescribe several examination methods.

The most informative and reliable are:

Ultrasound procedure. Allows you to accurately describe the quantitative indicators of the ventricles, as well as calculate the ventricular index. With the help of ultrasound, it is possible to estimate the volume of cerebrospinal fluid that is present in the brain collectors during the study.

CT scan. With high accuracy allows you to describe the structure and size of all the ventricles of the brain. The procedure is safe and does not cause pain in the baby.

Magnetic resonance imaging. It is used in complex diagnostic cases, when establishing a diagnosis is difficult. Suitable for older children who are able to remain still for the duration of the study. In small children, MRI is performed under general anesthesia.

Fundus examination.

Treatment

Therapy of pathological conditions that led to dilatation and asymmetry of the ventricles of the brain is usually carried out by a neurologist. In some cases, when volumetric formations or the consequences of craniocerebral injuries become the cause of the disease, a neurosurgeon joins.

To eliminate pathological symptoms, the following methods of treatment are used:

Prescribing diuretics. Diuretics help reduce the manifestations of intracranial hypertension and improve the well-being of the baby. They also contribute to the normalization of the formation of liquor.

Nootropics. They improve the functioning of the brain, and also contribute to good blood filling of blood vessels.

Medications with a sedative effect. They are used to eliminate increased anxiety and agitation.

Potassium preparations. Positively affect the excretion of urine. This helps to reduce the increased amount of cerebrospinal fluid in the body.

Multivitamin complexes. They are used to compensate for all the necessary trace elements involved in vital processes. They also help to strengthen the body and contribute to a better resistance to disease.

Soothing and relaxing massage. Allows you to reduce muscle tone, and also helps to relax the nervous system.

Physiotherapy. Helps to normalize the outflow of cerebrospinal fluid and prevents its stagnation in the cerebral ventricles.

Appointment of antibacterial or antiviral drugs according to indications. They are used only in cases where viruses or bacteria have become the cause of the disease. Appointed for coursework.

Surgery. It is used in the case of the presence of various volumetric formations or to remove fragments of bone tissue as a result of a skull fracture due to craniocerebral trauma.

Forecast

If the condition develops in infancy and early infancy, then the course of the disease is usually favorable. With appropriate treatment, all uncomfortable symptoms quickly pass and do not bother the baby. High intracranial pressure normalizes.

In older children, the prognosis is somewhat different. Adverse symptoms are much more difficult to treat. The long course of the disease can lead to persistent visual and hearing impairments. If the treatment was started out of time, then in most cases the child has persistent disorders that negatively affect his mental and mental development.

Dr. Komarovsky will tell about the expansion of the ventricles of the brain in infants and its consequences.

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What is "asymmetry of the lateral ventricles of the brain"? First you need to figure out what the ventricles of the human brain are.

"The ventricles of the brain" is a system of special anastomizing cavities that communicate with the subarachnoid space, as well as the human spinal cord canal. The ventricles contain something called cerebrospinal fluid. The reverse surface of the walls of these ventricles is covered with ependyma.

Types of cerebral ventricles

As mentioned earlier, the lateral ventricles of the brain are some containers in the brain, inside of which there is CSF. These ventricles are the largest in the entire ventricular system. The ventricle on the left is called the first, and on the right - the second. It is important to note that the lateral cerebral ventricles communicate with another (third) ventricle using Monroy's foramina. They are located on both sides of the midline, below the corpus callosum, symmetrically. Each such ventricle has a posterior horn, an anterior horn, a lower horn, and a body.

The third cerebral ventricle is located between the visual tubercles. This ventricle has an annular shape, because visual intermediate tubercles grow into its body. The edges of the ventricle are filled with gray matter. This substance has vegetative subcortical centers. The third ventricle communicates with the aqueduct of the midbrain and this happens through a special opening with the lateral ventricles.

Another (fourth ventricle) is located between and the medulla oblongata. This ventricle is shaped like a tent, with a bottom and a roof. It should be noted that the base and bottom of this ventricle is similar to a rhombus, it can be said to be pressed into the pons located behind and the medulla oblongata. For this reason, it is commonly referred to as the rhomboid fossa. In the posterior lower corner of this fossa is the canal of the spinal cord. Also, in the upper anterior corner, the fourth cerebral ventricle communicates with the conduit.

The lateral angles end in two pouches curving ventrally near the inferior cerebellar peduncles.
In addition, the lateral ventricles of the brain are quite large in themselves and have a C-shape. CSF (cerebrospinal fluid) is synthesized in the ventricles, after which this fluid enters the subarachnoid space. In the event that the outflow of cerebrospinal fluid from the cerebral ventricles worsens, the person receives a diagnosis. Among other things, the spinal ventricles are one of the largest elements in the entire ventricular system.

Dilatation of the ventricles

Expansion (dilatation), or "asymmetry of the lateral ventricles of the brain" occurs as a result of an excessive amount of CSF (cerebrospinal fluid) located in these ventricles. The result is that this fluid does not always have time to exit quickly (for example, due to obstructions in the way the cerebrospinal fluid exits).

This disease can very often be found in premature babies, since the size of their lateral ventricles is much larger than in babies born at term. If the child has "enlarged ventricles of the brain" or "asymmetry of the ventricles of the brain", the size of the lateral ventricles is determined, as well as their qualitative and quantitative characteristics. There are various methods for diagnosing this. Also, when conducting a study, one should directly measure the depth of the ventricles and the size of the transparent septum, which is located in the third ventricle. "The ventricles of the brain dimensions" must correspond to the norm. Normally, their depth should be in the range from 1 to 4 mm. If these figures are more than 4 mm, as a result of which their lateral curvature disappears and the shape turns into a round one, one can speak of the beginning of their expansion of the lateral ventricles.

What does it threaten?

Diseases in which there is an expansion of the lateral ventricles

A large accumulation of CSF often occurs as a result of a disease such as hydrocephalus. Hydrocephalus is considered a very serious pathology of the brain. As a result of this pathology, there is a change in the process of absorption of cerebrospinal fluid, as a result, cerebrospinal fluid can accumulate in the lateral ventricles, which provokes their dilation. A large amount of cerebrospinal fluid can also appear with lesions of the central nervous system. As a result of CNS lesions, the cerebral ventricles can also increase in size due to insufficiently rapid release of cerebrospinal fluid. Violation of the circulation of cerebrospinal fluid also occurs due to the appearance of tumors, cysts and other neoplasms.

In addition, a violation of the circulation of cerebrospinal fluid can be caused as a result of a traumatic brain injury, hemorrhages and inflammatory processes in the human brain. A frequent cause of the expansion of the lateral ventricles is a defect in the Sylvian aqueduct. This pathology occurs in 30-35% of cases of hydrocephalus. A common cause of dilatation or asymmetry of the lateral ventricles may be a subdural hematoma of the posterior cranial fossa. It is important to remember that hydrocephalus can provoke, "bleeding into the ventricles of the brain."

Other causes of cerebral ventricular dilatation

The expansion of the lateral ventricles of the brain is the cause of many malformations in newborns. Even despite the fact that the expansion of the cerebral ventricles has practically no effect on the health of the newborn, medical supervision is required. Basically, the expansion of the lateral ventricles of the brain, not provoked by serious diseases, rarely leads to noticeable consequences. Also, the expansion of the head ventricles may be a consequence of rickets, or it may appear as a result of an unusual structure of the skull.

With regard to diagnosis, asymmetry and dilatation of the lateral ventricles can be detected during the passage of an ultrasound examination. In case of doubt, after a certain period of time, a second ultrasound may be prescribed.

An increase in the ventricles of the brain in the fetus is a pathology that is observed with ventricular megaly. This disease is characterized by the impossibility of the correct outflow of cerebrospinal fluid due to the altered size of the cerebral ventricles. Pathology, which can lead to serious consequences for the nervous system, occurs both in the fetus of an unborn child, and in children and adults.

Ventriculomegaly: Ventricular Size Matters

In the brain of a person not yet born or already born, small or adult, there are four cavities that communicate with each other, which are filled with cerebrospinal fluid. They are called cerebral ventricles.

Each of them ideally should correspond to certain sizes at which the inflow or outflow of liquid (liquor) can be carried out without problems. If there is an increase in the ventricles of the brain, then the circulation process is disturbed. This can lead to various pathologies of the peripheral and central nervous system.

Important! The most common diagnoses for such symptoms are hydrocephalus and, although these are extreme degrees of complications in ventriculomegaly.

Cases when an increase in the ventricles of the brain with timely diagnosis and proper treatment does not affect the quality of health of a small patient are very common.

Why do cerebral ventricles enlarge?

The reasons for the increase in the ventricles of the brain can be both hidden, when the diagnosis of ventriculomegaly is made to the fetus without obvious deviations from the norm during the pregnancy of a healthy mother, and obvious. The latter include:

• genetic abnormalities in complicated pregnancy, which are most often observed in expectant mothers aged 35 years and older;
• heredity;
• infections that were transmitted from mother to unborn child during fetal development (including toxoplasma and cytomegaloviruses);
• injuries that the expectant mother and her child could have received during pregnancy;
• internal bleeding in the fetus caused by thinning of the vascular walls;
• in an unborn child;
• incorrect formation of the convolutions of the brain and other anomalies in the development of the central nervous system.

An increase in the cerebral ventricles can be both an independent, isolated disease, and one of the symptoms of a third-party pathology.

How to detect an increase in cerebral ventricles?

An increase in the ventricles of the brain in newborns is detected during the second planned ultrasound, which is performed approximately at the fifth or sixth month of pregnancy. By this time, the child's nervous system is already practically formed. But one conclusion on ultrasound is not enough, therefore, for an accurate diagnosis, the expectant mother, after consulting with a geneticist, needs to undergo several more procedures:

• repeated ultrasound a few weeks after the previous one to assess the dynamics of a possible pathology in the fetus;
• take a blood test for spectral karyotyping, which will allow you to assess the degree of possible damage to the chromosomes of future parents;
• transverse scan of the fetal head.

Only after a comprehensive diagnosis can we talk about any type of ventriculomegaly. Recently, in difficult cases, it is proposed to do an MRI of the fetus.

The main types of ventriculomegaly

Normally, the size of the cerebral ventricles should not exceed 10 mm. This indicator is considered borderline. Its excess is a reason for concern for the health of the unborn baby. However, not all cases of ventriculomegaly lead to irreversible consequences in the development of his nervous system. It is no coincidence that this disease is divided into three types:

• mild, in which the increase in the cerebral ventricles varies within 10-12 mm;
• medium, if the size of the pathology is up to 15 mm;
• severe if the increase in the lateral ventricles of the brain in the fetus exceeds 15 mm.

Depending on the type of disease, a treatment strategy is developed.

Treatment of ventriculomegaly

With ventriculomegaly, treatment performs two tasks: firstly, it is necessary to eliminate not the symptom itself in the form of enlarged ventricles of the brain, but the cause that caused such a pathology, and secondly, it is necessary to neutralize the consequences of the disease for human development as much as possible.

If the doctor is dealing with a mild type of disease in the fetus, if an increase in the ventricles of the brain in newborns in an isolated form is recorded, which is not associated with deep chromosomal disorders, then he prescribes drug therapy designed to stimulate the development of the nervous system. It is possible to use diuretic drugs against, drugs that prevent oxygen deficiency in the body, vitamins. Massage and therapeutic exercises can also help.

In severe form of ventriculomegaly with changes in the brain and genetic pathologies, termination of pregnancy is not excluded. That is why it is so important to detect an increase in the ventricles of the brain in a child or fetus as early as possible in order to prevent the pathology from progressing.

Why is ventriculomegaly dangerous?

Down and Edwards syndromes, cerebral palsy, pathologies in the development of the brain and heart, fetal death are the most severe consequences of the disease. But they are possible only with an increase in the cerebral ventricle over 15 mm in combination with other pathologies and with chromosomal abnormalities. But in most cases, with the timely detection of a problem in its isolated form and proper treatment, it does not affect the development of the child.

An increase in the ventricles of the brain in adults is also diagnosed quite often. But it is not considered dangerous and does not affect the normal life of an already formed person. Early diagnosis is the key to successful treatment. Therefore, pregnant women need to carefully undergo all examinations in order to identify the problem at its initial stage and ensure a healthy future for their baby.

However, certain deviations from the norm can cause the development of neurological pathologies. One of these conditions is the asymmetry of the lateral ventricles of the brain. This disease may not cause clinical symptoms, but in some cases it indicates the presence of a number of diseases.

What are the ventricles of the brain, their role

The ventricles of the brain are strips in the tissue necessary for the deposition of cerebrospinal fluid. External and internal factors can lead to their increase in volume. The lateral ventricles are the largest. These formations are involved in the formation of cerebrospinal fluid.

Asymmetry is a condition in which one or both cavities are enlarged to varying degrees.

1. Side. The most voluminous ventricles, and it is they that contain cerebrospinal fluid. They connect to the third ventricle through the interventricular foramen.
2. The third. It is located between the visual tubercles. Its walls are filled with gray matter.
3. Fourth. Located between the cerebellum and the medulla oblongata.

Causes of dilation

Enlargement or dilatation of the lateral ventricles of the brain occurs due to increased production of cerebrospinal fluid. This leads to the fact that it cannot be displayed normally.

This, in turn, leads to a violation of the output of cerebrospinal fluid. This disease most often occurs in premature babies, but is observed in people of any age.

What causes a disorder in newborns

This is how the dilatation of the lateral ventricles looks schematically

Dilatation of the lateral ventricles of the brain in infants is often a sign of hydrocephalus, and can also be caused by a number of other reasons.

In newborns, asymmetry is caused by trauma or volumetric formations of the brain. Regardless of the possible cause, an urgent consultation with a neurosurgeon is required.

Mild asymmetry may be a congenital disorder that does not cause symptoms. In this case, only constant monitoring is required so that the difference between the ventricles does not change.

The main causes of dilatation include:

• viral and other diseases of a woman during pregnancy;
• oxygen starvation of the fetus;
• premature birth;
• birth trauma;
• malformations of the CNS.

Ventricular asymmetry can also result from hemorrhage. This pathology occurs due to compression of one of the ventricles with an additional volume of blood. Due to hemorrhage, the ventricles of the brain in infants can be enlarged for the following reasons:

• various diseases of the mother, for example, type I diabetes or heart defects;
• intrauterine infections;
• a long time between the break of the waters and the birth of the child.

The most common cause of dilatation is hypoxia. Other causes account for less than 1% of cases. It is hypoxia that leads to the accumulation of cerebrospinal fluid, which, in turn, increases intracranial pressure. This leads to the expansion of the cavity of the lateral ventricles.

Risk zone for adult patients

A change in the size of the lateral ventricles leads to a violation of the CSF circulation. Asymmetry of the lateral ventricles of the brain in adults occurs for the following reasons:

Provocative diseases

The main disease that causes this pathology is hydrocephalus. It can interfere with the absorption of cerebrospinal fluid. This leads to its accumulation in the lateral ventricles.

Excessive formation of cerebrospinal fluid is also observed in severe CNS lesions. Impaired circulation has also been associated with the formation of cysts, tumors, and other neoplasms.

A common cause of hydrocephalus is a defect in the Sylvian aqueduct. If this defect was detected even in the prenatal period, termination of pregnancy is recommended. At the birth of a child, complex systematic treatment will be required.

Another cause is an aneurysm of the vein of Galev and Arnold-Chiari syndrome. However, in children, the disease can be caused by rickets or due to the specific structure of the skull, so it is important to see a specialist if there is a predisposition to the disease.

Symptoms and diagnosis of the disorder

In an adult, ventricular asymmetry rarely causes symptoms. However, in some cases, this anomaly can cause the following symptoms:

In addition to these symptoms, the picture of the disease can be supplemented by symptoms of diseases that caused ventricular asymmetry.

Such symptoms include cerebellar disorders, paresis, cognitive or sensory disturbances.

In infants, symptoms depend on the severity of the pathology. In addition to general discomfort, symptoms such as head tilting, regurgitation, increased head size, and others may occur.

Symptoms of pathology can also include strabismus, refusal to breastfeed, frequent crying, anxiety, tremor, decreased muscle tone.

However, quite often the pathology does not cause characteristic symptoms, and can only be detected after an ultrasound scan.

Health care

By itself, dilatation of the lateral ventricles of the brain does not require treatment. It is prescribed only in the presence of symptoms characteristic of the pathology. Treatment is aimed at eliminating the disease, which is caused by dilation.

For the treatment of ventricular asymmetry, the following agents are used:

• diuretics;
• nootropic substances;
• anti-inflammatory drugs;
• vasoactive drugs;
• neuroprotectors
• sedatives;
• if the disease is caused by infections, antibacterial agents are prescribed.

If the pathology is caused by a cyst or tumor, their removal is required. In the event that the patient's condition deteriorates rapidly, an operation is performed to form a new connection of the ventricular system, which will bypass the anomaly.

Most often, the expansion of the ventricles occurs in infants. In the absence of timely and competent therapy, dilatation can persist and even worsen. With mild dilatation and the absence of obvious symptoms, the condition does not require special treatment. It is only necessary to constantly monitor the size of the asymmetry, as well as the general condition of the child.

In the event that the disease is caused by trauma, impaired intrauterine development, infection or tumor, constant monitoring of the patient, treatment of symptoms, and, if possible, elimination of the causes of the pathology is required.

The child is treated by a neuropathologist together with a neurosurgeon. To minimize the risk of complications, a child with such a diagnosis should be constantly under the supervision of doctors. Most often, diuretics are prescribed for treatment, which contribute to the production of cerebrospinal fluid, which puts pressure on the lateral ventricles.

Additionally, it requires taking drugs to improve the blood supply to the brain, and sedatives are also prescribed.

Be sure to prescribe massage, therapeutic exercises and other methods of physiotherapy. Infants with this diagnosis are observed on an outpatient basis. Treatment of pathology can take several months.

Older children are treated depending on the cause of the pathology. Antimicrobials are prescribed if the cause of the asymmetry is a brain infection. In the case of tumors, cysts and other formations, an operation is prescribed.

Mild pathology most often does not cause any symptoms. In rare cases, a slight delay in the motor sphere may occur, however, it completely disappears with time. A severe form of pathology can lead to cerebral palsy as a result of high intracranial pressure.

Asymmetry of the lateral ventricles of the brain is not the most dangerous, but requires attention, a pathology that occurs in people of any age.

If this problem is found, you should visit an experienced specialist who will prescribe the appropriate tests to confirm the diagnosis. Treatment consists in eliminating the cause of dilation, as well as reducing intracranial pressure.

This section was created to take care of those who need a qualified specialist, without disturbing the usual rhythm of their own lives.

Hydrocephalus of the brain in adults: causes, symptoms, treatment

Hydrocephalus in adults (“dropsy of the brain”) is a pathological condition characterized by excessive accumulation of cerebrospinal fluid (CSF) in the cerebrospinal fluid spaces of the brain. Hydrocephalus can be an independent nosological unit, or it can be the result of various brain diseases. It requires mandatory qualified treatment, since the prolonged existence of the disease can lead to disability and even death.

The disease in children is significantly different from the manifestations of the disease in the adult population due to the fact that in the child's body the brain is still being formed. In this article, we will look at the causes, symptoms and treatment of cerebral hydrocephalus in adults.

Causes

Each person in the brain has special spaces containing a special fluid - liquor. Inside the brain itself, this is a system of ventricles of the brain that communicate with each other; outside the brain, this is the subarachnoid space with brain cisterns. Liquor performs very important functions: it protects the brain from shocks, shocks and infectious agents (the latter thanks to the antibodies it contains), nourishes the brain, participates in the regulation of blood circulation in the closed space of the brain and skull, and provides homeostasis due to optimal intracranial pressure.

The volume of cerebrospinal fluid in an adult is ml, it is updated several times a day. The production of cerebrospinal fluid occurs in the choroid plexuses of the ventricles of the brain. From the lateral ventricles of the brain (containing approximately 25 ml), the CSF enters through the foramen of Monro into the third ventricle, the volume of which is 5 ml. From the third ventricle, the cerebrospinal fluid moves to the fourth (also contains 5 ml) along the Sylvius aqueduct (brain aqueduct). At the bottom of the fourth ventricle there are openings: a median unpaired Magendie and two lateral Luschkas. Through these openings, cerebrospinal fluid enters the subarachnoid space of the brain (located between the pia and arachnoid membranes of the brain). On the basal surface of the brain, the subarachnoid space expands, forming several cisterns: cavities filled with CSF. From the tanks, the cerebrospinal fluid enters the outer (convexital) surface of the brain, as if “washing” it from all sides.

Absorption (resorption) of CSF occurs in the venous system of the brain through arachnoid cells and villi. The accumulation of villi around the venous sinuses is called pachyonic granulation. Part of the CSF is absorbed into the lymphatic system at the level of the nerve sheaths.

Thus, the liquor produced in the vascular plexuses inside the brain washes it from all sides and is then absorbed into the venous system, this process is continuous. This is how normal circulation occurs, the amount of fluid produced per day is equal to that absorbed. If at any stage there are "problems" - either with production or with absorption, then hydrocephalus occurs.

Causes of hydrocephalus can be:

• infectious diseases of the brain and its membranes - meningitis, encephalitis, ventriculitis;
• brain tumors of stem or near-stem localization, as well as brain ventricles);
• vascular pathology of the brain, including subarachnoid and intraventricular hemorrhages as a result of aneurysm rupture, arteriovenous malformations;
• encephalopathy (alcoholic, toxic, etc.);
• brain injury and post-traumatic conditions;
• malformations of the nervous system (for example, Dandy-Walker syndrome, stenosis of the Sylvian aqueduct).

Types of hydrocephalus

Hydrocephalus can be congenital or acquired. Congenital, as a rule, manifests itself in childhood.

Depending on the mechanism of development, there are:

• closed (occlusive, non-communicating) hydrocephalus - when the cause is a violation of the CSF flow due to the overlap (block) of the CSF pathways. More often, a blood clot (due to intraventricular hemorrhage), part of a tumor, or adhesion interferes with the normal flow of cerebrospinal fluid;
• open (communicating, dysresorbtive) hydrocephalus - based on a violation of absorption into the venous system of the brain at the level of arachnoid villi, cells, pachyon granulations, venous sinuses;
• hypersecretory hydrocephalus - with excessive production of cerebrospinal fluid by the vascular plexuses of the ventricles;
• external (mixed, ex vacuo) hydrocephalus - when the content of cerebrospinal fluid is increased both in the ventricles of the brain and in the subarachnoid space. In recent years, this form has ceased to be attributed to hydrocephalus, since the reason for the increase in the content of cerebrospinal fluid is the atrophy of the brain tissue and the reduction of the brain itself, and not the violation of the circulation of cerebrospinal fluid.

Depending on the level of intracranial pressure, hydrocephalus can be:

• hypertensive - with an increase in the pressure of the cerebrospinal fluid;
• normotensive - at normal pressure;
• hypotensive - with reduced pressure of the cerebrospinal fluid.

According to the time of occurrence, they are distinguished:

• acute hydrocephalus - the period of development of the process is up to 3 days;
• subacute progredient - develops within a month (some authors consider the period to be 21 days);
• chronic - from 3 weeks to 6 months and above.

Symptoms

The clinical picture depends on the period of formation of hydrocephalus and the level of pressure of the cerebrospinal fluid, the mechanism of development.

In acute and subacute occlusive hydrocephalus, a person complains of a headache that is more pronounced in the morning (especially after sleep), accompanied by nausea and sometimes vomiting, which brings relief. There is a feeling of pressure on the eyeballs from the inside, there is a burning sensation, "sand" in the eyes, the pain is bursting. It is possible to inject vessels of the sclera.

As the CSF pressure increases, drowsiness joins, which serves as a poor prognostic sign, as it indicates an increase in symptoms and threatens with loss of consciousness.

Perhaps blurred vision, a feeling of "fog" before the eyes. Congestive discs of the optic nerves are revealed in the fundus.

If the patient does not seek medical help in time, then the continued increase in the content of cerebrospinal fluid and intracranial pressure will lead to the development of dislocation syndrome, a life-threatening condition. It manifests itself as a rapid depression of consciousness up to coma, paresis of upward gaze, divergent strabismus, and inhibition of reflexes. These symptoms are characteristic of compression of the midbrain. When compression of the medulla oblongata occurs, symptoms of swallowing disorders appear, the voice changes (up to loss of consciousness), and then cardiac activity and respiration are inhibited, which leads to the death of the patient.

Chronic hydrocephalus is more often communicating and with normal or slightly increased intracranial pressure. It develops gradually, months after the causative factor. Initially, the sleep cycle is disturbed, either insomnia or drowsiness appears. Memory deteriorates, lethargy, fatigue appear. Characterized by general asthenia. As the disease progresses, mnestic (cognitive) impairments worsen up to dementia in advanced cases. Patients cannot take care of themselves and behave inappropriately.

The second typical symptom of chronic hydrocephalus is impaired walking. Initially, the gait changes - it becomes slow, unstable. Then uncertainty joins when standing, difficulty in starting to move. In the supine or sitting position, the patient can imitate walking, cycling, but in an upright position this ability is instantly lost. The gait becomes "magnetic" - the patient seems to be glued to the floor, and, having moved from his place, he takes small shuffling steps on widely spaced legs, marking time. These changes are called "apraxia of walking". Muscle tone increases, in advanced cases, muscle strength decreases, and paresis in the legs appears. Balance disorders also tend to progress to the point of being unable to stand or sit on their own.

Often patients with chronic hydrocephalus complain of frequent urination, especially at night. Gradually, imperative urges to urinate are added, requiring immediate emptying, and then urinary incontinence at all.

Diagnostics

The main role in establishing the diagnosis belongs to computed tomography (CT) and magnetic resonance imaging (MRI). These methods make it possible to determine the shape and size of the ventricles, subarachnoid space, and brain cisterns.

Radiography of the cisterns of the base of the brain makes it possible to assess the direction of the CSF flow and clarify the type of hydrocephalus.

It is possible to conduct a trial diagnostic lumbar puncture with the removal of cerebrospinal fluid, which is accompanied by a temporary improvement in the condition. This is due to the restoration of blood supply to ischemic brain tissues against the background of a decrease in intracranial pressure. This serves as a favorable prognostic sign in predicting the surgical treatment of hydrocephalus. You should know that in acute hydrocephalus, lumbar puncture is contraindicated due to the high risk of hernia of the brain stem and the development of dislocation syndrome.

Treatment

The initial stages of hydrocephalus can be treated with medication. For this, the following drugs are used:

• to reduce intracranial pressure and remove excess fluid (provided that the outflow of CSF is preserved) - diacarb (acetazolamide), mannitol and mannitol in combination with furosemide or lasix. Mandatory in this treatment is the correction of the level of potassium in the body, for this they use asparkam (panangin);
• to improve the nutrition of the brain tissue, cavinton (vinpocetine), actovegin (solcoseryl), gliatilin, choline, cortexin, cerebrolysin, semax, memoplant, etc. are indicated.

Clinically developed hydrocephalus is subject to surgical treatment, drug methods improve the condition for a short time.

Acute hydrocephalus, as a life-threatening condition, requires urgent neurosurgical treatment. It consists in trepanation of the skull and the imposition of external drainage, providing an outflow of excess fluid. This is called external ventricular drainage. In addition, through the drainage system, it is possible to administer drugs that thin blood clots (since intraventricular hemorrhage is one of the most common causes of acute hydrocephalus).

Chronic hydrocephalus requires CSF shunting operations. This type of surgical treatment is the removal of excess cerebrospinal fluid into the natural cavities of the human body using a complex system of catheters and valves (abdominal cavity, pelvic cavity, atrium, etc.): ventriculoperitoneal, ventriculoatrial, cystoperitoneal shunting. In the cavities of the body, unhindered absorption of excess cerebrospinal fluid occurs. These operations are quite traumatic, but if performed correctly, they can achieve recovery of patients, their labor and social rehabilitation.

To date, the less traumatic neuroendoscopic technique has taken the first place among invasive methods of treatment. It is still more often performed abroad due to the high cost of the operation itself. This method is called as follows: endoscopic ventriculocisternostomy of the bottom of the third ventricle. The operation takes only 20 minutes. With this method of treatment, a surgical instrument with a neuroendoscope (camera) at the end is inserted into the ventricles of the brain. The camera allows you to demonstrate an image using a projector and accurately control all manipulations. At the bottom of the third ventricle, an additional hole is created that connects to the cisterns of the base of the brain, which eliminates the cause of hydrocephalus. Thus, the physiological liquor flow between the ventricles and cisterns is restored, as it were.

Effects

Hydrocephalus is a dangerous disease, ignoring the symptoms of which is fraught with disability or even a threat to life. The fact is that the changes that occur in the brain as a result of the long-term existence of hydrocephalus are irreversible.

Untimely treatment can turn into a tragedy for a person: loss of ability to work and social significance. Mental disorders, movement problems, urination disorders, decreased vision, hearing, epileptic seizures - this is the list of possible consequences of hydrocephalus if its treatment is not started in a timely manner. Therefore, at the slightest suspicion of hydrocephalus, it is necessary to seek qualified medical help.

TVC, program "Doctors" on the topic "Hydrocephalus"

The system that fits into the brain of a newborn is filled with fluid from the spinal cord, which performs protective functions. It also includes the ventricles, which contain the cerebrospinal fluid. Consider what caused the expansion of the ventricles in the brain and what is the danger of this condition for human health.

The lateral ventricles are used to store CSF. They should not differ from each other and have the same dimensions. The lateral ventricles can be called a container for storing cerebrospinal fluid. They are large compared to the rest. The left formation is the first, and the right side is the second. The third is connected with two lateral openings located between the column of the fornix and the thalamic ending, located in front and attached to the third element of the interventricular body. The fourth ventricle is located near the cerebellum and has an oblong appearance, similar in appearance to a rhombus. Hence the name rhomboid fossa. The lateral ventricles consist of the body, as well as the posterior, anterior and lower horns.

There are 4 ventricles in total:

• two of them are lateral, which are symmetrical and arranged in pairs;
• two, located in series along the midline.

The fourth ventricle through the cistern is directed to the central canal, which ends with the terminal cistern.

According to the standards, they must have the following parameters:

• the horns located in front should have a depth of no more than 2 mm;
• if we consider the area of ​​\u200b\u200bthe body, then their depth should be twice as large and be 4 mm;
• the dimensions of the tank should be within 3 - 6 mm.

The ventricles of the brain grow in proportion to the growth of the baby and are combined with the size of the skull bone, provided that this is a normal process. An increase in the ventricles of the brain is possible at any age, but this will be assessed as a pathology. According to medical terms, this phenomenon is called "occlusive hydrocephalus". This happens due to a violation of the liquor flow. The intervention of specialists is necessary here.

But when the ventricles of the brain are enlarged, this causes great alertness in parents. Is there really reason to worry? To do this, it is worth understanding the reasons for this manifestation.

If the fifth ventricle is found during an ultrasound examination of the fetus, then do not worry: this is normal.

The function of the ventricles is not only the accumulation of cerebrospinal fluid, but also the secretion of CSF. If everything is normal, then the cerebrospinal fluid goes into the subarachnoid space. If this process fails, it is noted that the ventricles of the brain are dilated. If this function is impaired, dropsy develops or, according to medical indications, this is called hydrocephalus.

Cause of pathology

Dilatation of the lateral ventricles of the brain, or ventriculomegaly, should be especially carefully studied if asymmetry is present. With symmetrically located lateral ventricles of the brain, this can be diagnosed both as hydrocephalus and as a normal condition. With asymmetry, it turns out that the ventricles are of different sizes and are disproportionate relative to each other. Perhaps these are the consequences of trauma to the skull. For a newborn in this case, a neurosurgical operation is necessary so that there are no unexpected consequences. Also, asymmetrically located ventricles can be a normal condition, but if all this is noted in a mild form. As a rule, their difference in size should not exceed 2 mm. Although this variant is not recognized as a pathological condition, dynamic monitoring is still necessary so that this number does not increase.

An increase in the horns in the back of the head is considered abnormal. In order to recognize this in a timely manner, screening, ultrasound examination of the brain, as well as neurosonography are carried out. All examinations are carried out through the fontanel of the newborn. Moreover, if the ventricles are not clearly visible, this does not mean that the expansion of the ventricles of the brain has occurred.

For newborns, the expansion of the ventricles of the brain is fixed only when the dimensions of the sections diagonally at the level of the foramen of Monro exceed 0.5 cm, and the smoothness of the contour of the bottom is completely excluded.

The causes of this phenomenon can be congenital and acquired over time. List of congenital causes:

• abnormal course of pregnancy;
• difficult childbirth;
• acute fetal hypoxia while in the placenta;
• deviations from the normative indicators of the central nervous system;
• lack of development;
• early birth;
• perinatal injury.

Specialists pay special attention to hemorrhages, both external and internal. For this reason, a deviation from the symmetry of the ventricles often occurs. Filling with blood, changing in volumes, causes a change in their size. Also, the category of acquired pathology includes:

• viral infections that affected the fetus;
• septic complications;
• a long period of time spent on the birth of a child and the departure of waters;
• pathologies of the mother (for example, the prophets of the heart, as well as diabetes).

The accumulation of fluid in the brain of a newborn causes symptoms that affect the entire brain and can lead to negative conditions.

Hydrocephalus does not contribute to an increase in CSF cavities in a short time. It is possible that at first intracranial pressure may rise, followed by expansion of the lateral ventricles. The latter are not located relative to the center, as a result of which they experience great pressure.

What could be the consequences?

To recognize by external signs whether the baby has intracranial pressure, you should pay attention to:

• lack of appetite and lethargy;
• protrusion of blood vessels on the forehead, because venous blood flow is difficult;
• a change in muscle tone, while the tendons become more active;
• trembling of the limbs;
• decrease in sucking and swallowing reflexes;
• frequent regurgitation;
• swelling and protrusion of the fontanel;
• an increase in the size of the head, disproportionate to the body.

It is not excluded the occurrence of headaches, nausea, and in some cases vomiting due to compression of some parts of the brain.

Perhaps the above points are not associated with ventriculomegaly, however, parents should monitor the changes taking place.

Diagnosis of pathology

After the fontanelles are completely overgrown, and this usually happens in a year or two, the disease can be monitored using an x-ray or tomograph.

MRI is much better at this task. With its use, you can clearly see the contours of soft tissues, as well as the ventricles of the brain in all projections. But there is one caveat: it is necessary to stay in the topographer's magnetic field for at least 20 minutes, and it is unlikely that every child will withstand such a load. For an adult, it is not always possible to cope with such a task, and even more so for a small person. Therefore, medical sleep is used for children, unless, of course, it is contraindicated for them.

If for a number of reasons it is impossible to conduct an MRI, then tomography is used. Thus, it is possible to determine the expansion of the ventricle of the brain. However, this survey also has its drawbacks:

the dose of radiation enters the body of the baby;

poor quality survey.

However, in this case, anesthesia is not required. With subarachnoid hemorrhage, the topographer will be able to more accurately determine the place of accumulation of blood than a magnetic tomograph.

Treatment of the disease

When the ventricles in the head are dilated, the question arises before the parents: is it possible to treat this pathology? Maybe it will go away on its own with time?

If there are no changes in the development of the child and he eats, sleeps and develops perfectly, then this means that there is no need for treatment, everything will go away on its own. That's what experts say. Treatment will be required only if the pressure of the cerebrospinal fluid increases. This is checked using a tomograph, and the diagnosis is clarified when taking a puncture. But doing the latter is an extreme case. Manipulation is indicated for meningitis, although they do not cause ventricular dilatation.

For the treatment of pathology, vitamin, diuretic agents and antihypoxants are prescribed. As an addition to the main treatment, as a rule, massage and physiotherapy exercises are prescribed. In order to avoid complications caused by treatment, preparations saturated with potassium should be used.

Other cases of pathology

In some cases, pathology is observed when the ventricles of the brain are enlarged in adult relatives, that is, the disease is inherited. Also, do not panic if there are dilated ventricles in the brain compartment. Perhaps this phenomenon is due to the fact that the baby has a large head. For children under the age of one year, this pathology is typical. In this case, the content of the entire cerebrospinal fluid in their cavity should be diagnosed.

If the cerebrospinal fluid is produced in excess, then for this reason the ventricles can also be expanded. With poor outflow of cerebrospinal fluid due to an obstruction in its path in the form of dilatation of the system. Also, the pathology becomes noticeable in newborns who were born ahead of time. If a change in the parameters of the ventricles is suspected, such a condition is assessed by specialists, and the indicators are compared with normal sizes.

When the ventricles in the human brain are expanded, this requires decoding and description by doctors.