Hydrocephalus of the brain in neonates and infants, photos
Hidrocefalia of the brain – a disease where the brain cannot receive cerebrospinal fluid (CSF) is a clear watery liquid that surrounds and protects the brain and spinal cord. At the same time developing its accumulation in the cranial cavity, which in infants may increase the head, and the older children experience severe headaches in Association with increased intracranial pressure.
Causes of hydrocephalus
Normally, the CSF flows through the ventricles and exits the brain through a small reservoir at its base. Cerebrospinal fluid carries nutrients to the brain, and derives from the metabolic products. In the presence of blockade in any of the ventricles, the CSF collects in the brain, leading to hydrocephalus development. This excess cerebrospinal fluid can also develop in the case where the choroid plexus (the area of the brain that produces CSF) produces it in excessive quantities or when products are not absorbed properly into the bloodstream. Release:
- Congenital hydrocephalus in which babies are born with this disease. Often its development is associated with spina bifida or stenosis Siluianova water (a small passage that connects two large ventricles of the brain).
- Acquired hydrocephalus in which the disease develops after birth. This pathology can affect people of any age. As a rule, acquired hydrocephalus caused by intracerebral bleeding, which can occur in premature infants or people with traumatic brain injury. In some children, hydrocephalus may develop due to tumor or infectious disease of the brain. In some cases, to discover the cause of this disease is not possible.
Symptoms of hydrocephalus in newborns
The clinical picture of hydrocephalus may vary depending on the age of the child. In infants the bones of the skull are connected by fibrous tissue, therefore increasing the number of liquor joints between them stretched. As a result, a baby with hydrocephalus has a head of unusual shape. Its head usually has a much larger size than those of healthy children of the same age. Other signs include:
- Bulging of the fontanelles.
- The joints between the bones of the skull.
- The rapid increase in the head of a child.
- Veins on the head, which can be easily seen with the naked eye.
- Always looking down.
Depending on the severity of the disease, babies may be too sleepy, fussy, they may develop vomiting or seizures. Small children with hydrocephalus may also lag behind in development. In very severe cases the child may be a delay in weight gain and growth.
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The clinical picture of hydrocephalus in older children
In older children there is no clear symptom of increasing head size, because the bones of their skulls are tightly interconnected and cannot be extended by increasing the amount of cerebrospinal fluid. As a result of increased intracranial pressure develop severe headaches that can disrupt sleep of the baby in the middle of the night or early morning. Children can also be:
- Nausea and vomiting.
- Increased sleepiness.
- Problems with balance and motor skills.
- Diplopia (double vision).
- Strabismus, or repetitive movement of the eyes.
In severe cases, there may be changes in personality, loss of certain abilities development (e.g., speech or walking), and memory impairment.
Diagnosis of hydrocephalus
A child with symptoms of hydrocephalus should be immediately subjected to medical examination. The doctor will examine and prescribe the necessary examinations, which may include ultrasound, computed and magnetic resonance tomography.
Treatment of hydrocephalus
In children it is very important to start to treat hydrocephalus treatment immediately after diagnosis. In the absence of treatment, the disease can cause serious problems with the Central nervous system. A method of treatment of hydrocephalus depends on the age of the child, causes accumulation of the cerebrospinal fluid and the General health of the child patient.
Ventriculostomy with coagulation of the choroid plexus
Endoscopic ventriculostomy of the third ventricle of the brain with the coagulation of the choroid plexus is a relatively new technique that is increasingly used in children with hydrocephalus, which required surgical treatment. This minimally invasive method is to place a small video camera with a light (called an endoscope) inside the brain, allowing neurosurgeons to see on the monitor the area of operations. Then use tiny tools they make a small hole at the bottom of the third ventricle. This creates a «emergency exit» that allows CSF to flow from the brain, bypassing the overlap. The body then absorbs CSF back into the bloodstream.
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After ventriculostomy neurosurgeons slightly burned (coagulated) part of the choroid plexus, which produces cerebrospinal fluid. This is done in order that the brain was created less than cerebrospinal fluid. This surgical approach is more effective than bypass surgery (implantation of drainage in the brain for removing CSF), which was previously the standard treatment of children with hydrocephalus. The ventriculostomy can be performed in children older than 1 year, but in the future will be available and at a younger age.
When bypass surgery is needed, through which one end of a shunt (flexible tube) is placed in the ventricle and the other in the abdominal cavity, chambers of the heart or space around the lungs. The cerebrospinal fluid is excreted from the brain in these places and into the bloodstream. A valve in the shunt system regulates the flow of cerebrospinal fluid thus to prevent insufficient or excessive removal of CSF. Currently, bypass surgery was used less as a ventriculostomy with coagulation of the choroid plexus has a greater efficiency and safety.