1 Causes of the disease
Officially, according to medical terminology, cerebral hydrocephalus is a pathology associated with an increase in ventricular volume due to excessive outflow of liquor, which is the basis of cerebrospinal fluid and is used to facilitate nutrition of all parts of the central nervous system. Sometimes the disease is also called dropsy, since the same cerebrospinal fluid filling the ventricular cavity is absolutely transparent, odorless, and similar in all physiological parameters to ordinary water. But in fact, it contains a whole range of nutrients and minerals that are used to work in certain areas of the brain.
But what causes cerebral hydrocephalus? There are several reasons for this, and they cover a variety of combined pathologies, ranging from excessive production of CSF, ending with the obstruction of the output channels. And this may be a consequence of both the physical pathology of the brain and the actions of certain bacteria. Until now, doctors can not describe all the reasons for which there is hydrocephalus of the brain in an adult. Literally every year several new culprits of the disease are found.
2 Fluid accumulation
So, the cerebrospinal fluid, as we have already found out, is a cerebrospinal fluid, which is washed by the subarachnoid cavity. In the same place, there are cells that suck it, supply it to the ventricles, and then bring it back. As a rule, in a normal state, when there are no pathologies in the brain, there are always about 150 ml of such fluid in it. Liquor within 24 hours flows through the brain 3 times. In newborns - significantly more. But if there are any inflammatory processes in the base of the skull, which leads to edema of the tissues, the withdrawal of the cerebrospinal fluid is disturbed. Accordingly, it accumulates in the ventricles, and they, in turn, sharply increase in size. And so on, until the channels are opened( at least partially).In this state, the volume of the cavity increases up to 1 liter, which affects the sharp increase in intracranial pressure. In such cases, hydrocephalus of the brain without surgical treatment leads to irreparable pathologies, which can result in a fatal outcome for the patient.
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3 Classification of the disease
The following types of dropsy are distinguished by pathogenesis:
- is hypersecretory.
Earlier in medicine, such a concept as external hydrocephalus( mixed type) was used, but now it is attributed to brain pathologies that lead to complex tissue atrophy with a decrease in their volume. That is, this disease is treated in other ways, and the consequences from it can be drastically different. And moderate mixed hydrocephalus is quite rare in adults, but it is diagnosed in almost every baby after birth. It does not carry danger for him and passes by itself as the natural volume of the brain increases.
The rate of edema differs from acute to acute and chronic. There is still such a thing as subacute hydrocephalus, which is a combination of acute and chronic. It is considered the most dangerous, but it is rare enough.
Even hydrocephalus of the brain is conventionally divided by the pressure of cerebrospinal fluid, however for each person the critical parameter is individual. That is, the description of this symptom is just a note for the doctor.
4 Symptoms of internal hydrocephalus
What symptoms accompany internal hydrocephalus? The basis is a sharp increase in intracranial pressure, which affects the size of the skull. More precisely, only the interlayer increases visually, but it looks like a mutation of bones. In newborns, everything is somewhat different - the size of the open area of the temechka increases, since the skull in them is not completely fused at this time( this is a physiological feature that simplifies the birth of the baby).
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How does the patient feel at this moment? It is accompanied by a constant headache, a feeling of nausea, a violation of the main receptor functions( hearing, vision, smell, chewing reflex).Over time, the symptoms become more pronounced, as the pressure on the tissue only increases, and they themselves atrophy. All this slowly flows into a chronic stage, when the disease causes irreparable harm to human health. In many cases the hydrocephalus of the brain ends precisely with the death of the patient. A person is simply paralyzed, although he continues to breathe, sweat, digest food. In rare cases, more often in children, internal hydrocephalus retreats independently. In this case, doctors talk about the so-called temporal pathology, which is a consequence of mechanical damage to the head( concussion, hematoma).
5 Symptoms of external form of the disease
Mixed replacement hydrocephalus of the external type occurs in 95% of cases without symptoms for the patient. The volume of the head increases slightly, most often speaking in the forehead. Intracranial pressure remains normal, so there is no visual or auditory impairment. This type of hydrocephalus is mostly found only in the elderly, in whom the disease is accompanied by atherosclerosis and a slight natural increase in blood pressure.
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6 Other pathological manifestations of
When the volume of the ventricles increases, doctors can diagnose the disease, based on the following symptoms:
- gait violation;
- persistent drowsiness( considered the most dangerous symptom, since it speaks of a patient's risk of falling into a coma);
- urinary incontinence( dysfunction of sphincters, even without apparent problems in the work of the urinary system);
- inhibitory reactions;
- pupils can move asymmetrically( the patient does not even know about it);
- lower paraparesis;
- asymmetrical smile( a certain part of the lips does not move).
Here only it is necessary to consider, that the reasons of all these signs mixed, that is can speak about presence of other diseases of a neuronal system. If you suspect a hydrocephalus directly, the doctor must prescribe an MRI, after which the treatment is prescribed.
7 Discirculatory course of the disease
It is also in adults that discirculatory hydrocephalus also occurs, which differs from the others not by problems with the outflow of cerebrospinal fluid, but by the fact that its natural circulation is disturbed. Because of this, the period that is necessary for the withdrawal of CSF is increasing. Accordingly, the brain dramatically increases in volume( sometimes up to 50%), exerting pressure not only on soft tissues, but also on the skull itself. All this also leads to a partial disruption of auditory and visual functions, headaches, and lack of coordination in space. Often discirculatory hydrocephalus causes dysfunction of some groups of pelvic organs( including the reproductive group).
Conditionally discirculatory hydrocephalus is divided into three categories. Already with the second patient gets a disability, because partially or completely loses its efficiency. Over time, the dystrophy of the vascular channels develops, therefore, surgery can not be avoided.
8 Therapeutic actions of
In the early stages, the treatment of hydrocephalus is medicamentous. Those drugs are used that can quickly reduce intracranial pressure, as well as accelerate the outflow of liquor. Sometimes hormonal components are prescribed, with the help of which the secretion of cerebrospinal fluid is regulated.
In more severe situations, surgical intervention and bypass surgery are performed. That is, a valve and a special bunch of silicone tubes are installed in the skull box, through which the liquor is transported back to the abdominal cavity, and thence to the spinal cord. However, such a procedure is quite dangerous, since there is a risk of physical damage to some parts of the brain.
The most modern option for eliminating hydrocephalus is endoscopic surgery.
In this case, the outflow of liquor is controlled directly from the ventricles, and not from the cavity around the brain. Thanks to this procedure, the patient will be permanently freed from hydrocephalus and will be able to continue his life.
If the cause of the disease lies in the infectious lesion of the neuronal system, after stabilizing the pressure inside the cranium, the main problem is eliminated, which led to the accumulation of cerebrospinal fluid. As a rule, the patient takes antibiotics and immunocorrectors for a certain time. All this happens necessarily under the constant supervision of the doctor, since shunting the skull can provoke internal hemorrhage.