When they talk about this pathology, it so happens that the image of a child with large head sizes comes to mind. Indeed, dropsy of the brain is a disease that is more common for children, although people who have crossed the maturity threshold are not protected from it.
Hydrocephalus in adults is a pathological condition that occurs due to a violation of the circulation of cerebrospinal fluid and without timely treatment, it is rapidly progressing, causing more and more complaints. Basically, their manifestation is associated with an increase in the level of intracranial pressure.
The limits of the norm are in the range from 100 to 180 mm of water. Art. To maintain it, there are a number of factors:
- tone of the vascular wall of the vessels of the brain;
- permeability of the blood-brain barrier (BBB);
- level of perfusion, i.e., blood supply to brain tissue;
- cerebral volumetric blood flow;
- cerebrospinal fluid homeostasis;
- level of cerebrospinal fluid production and absorption;
- adequate ratio of brain structures and CSF in the cranium.
When any of these factors falls out, intracranial pressure changes up or down. For a disease such as brain hydrocephalus in adults, an increase in ICP is characteristic.
This is a leading manifestation of brain pathology, which is characterized by a number of symptoms, including headache, nausea, vomiting, etc.
There are several reasons for the development of this condition: cerebral edema, hematomas, tumor formations, disruption of cerebrospinal fluid circulation – cerebrospinal fluid pressure – leading to an expansion of the brain cavities and pathological compression of its substance.
Compensatory mechanisms designed to maintain intracranial pressure, unfortunately, can not always cope with rapidly developing disorders.
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Types of hydrocephalus
In clinical practice, there is a fairly clear understanding of the types of this disease. A different classification of hydrocephalus is associated, first of all, with the basis on which basis the separation occurs. The first option – the isolation of individual species – is based on determining the localization of the pathological process:
- Internal, or ventricular, hydrocephalus, in which an excess of cerebrospinal fluid is observed only in the ventricles of the brain.
- External when the amount of CSF in the ventricles is normal, but it is too much in the subarachnoid space.
- The mixed form combines both features.
The second option is based on the development mechanism:
- An open, or communicating, form – the circulation of cerebrospinal fluid is not disturbed, but either its hypersecretion or a decrease in the rate of absorption occurs.
- Closed form, or occlusal, – there is a pathology in the way the cerebrospinal fluid moves from secretion sites.
The third way to divide the dropsy of the brain in adults into species is associated with the rate of development of this condition:
- The acute form – from the onset of the disease to formidable complications, only three days can pass.
- Subacute – the duration of the development of pathology up to a month.
- Chronic – the disease proceeds most favorably, from the moment of the onset of the disease to severe clinical signs it takes from one to six months.
There are several other classifications used in hydrocephalus. They are based on the moment of occurrence of this pathology, the nature of the compensation of processes, etc.
Speaking about what are the causes of hydrocephalus, the following pathological conditions should be noted:
- stroke of various etiologies;
- infectious lesions of the central nervous system;
- encephalopathy, both toxic and metabolic;
- developing tumor process;
- traumatic brain injuries, etc.
Classification and characteristic symptoms
Depending on the time of occurrence, hydrocephalus is divided into:
- congenital – diagnosis is possible even in the period of intrauterine development;
- acquired – occurs as a result of traumatic brain injuries or inflammation processes that directly affect the brain.
According to the developmental features, the pathology has the following types:
- open – some parts of the brain are destroyed, which leads to inferior entry of cerebrospinal fluid into the bloodstream;
- closed – characterized by the fact that the liquid begins to spread incorrectly due to obstacles formed as a result of defective changes, which leads to the formation of blood clots or even tumors;
- atrophic – there is a substitution of substances on the fluid of the spinal cord;
- hypersecretory – an excess volume of cerebrospiral fluid is produced.
Depending on the location of the cerebrospinal fluid, dropsy of the brain is divided into:
moderate internal – the formation of flu >
Sciatic nerve inflammation – symptoms of the disease, drug treatment and folk remedies
According to the degree of development of the disease, it is classified into such forms as:
It should be noted that the development of hydrocephalus can be acute and chronic. This determines the main symptoms of the pathology.
Acute dropsy has all the standard features that accompany high intracranial pressure:
- severe headaches in the morning;
- stagnation of the optic nerve disks, which is associated with a disturbed current in the nerves, which provokes high blood pressure, leading to visual impairment;
- axinal dislocation of the brain – is expressed by loss of consciousness, the head acquires a forced position, oculomotor disorders occur; cases of oppressed work of the heart and organs of the respiratory system are not excluded, which leads to death;
- bouts of nausea and vomiting in the morning, after his headaches subside;
- drowsiness – is one of the dangerous signs that indicate the possible development of a more serious neurological disorder.
In the chronic form of hydrocephalus, the symptomatology differs significantly from acute and is expressed in the following manifestations:
Apraxia walk. This syndrome is characterized by a condition when a patient in a prone position easily shows how to walk or r >
Signs of neurosis – diagnosis, treatment and prevention
Fundus changes are not observed.
Depending on the type of hydrocephalus of the brain in adults, the clinic of its manifestations will change. Similar symptoms can progress at different speeds, which will directly affect the outcome of the disease.
Symptoms common to any hydrocephalus can be divided into an syndrome of increased intracranial pressure, or hypertensive hydrocephalic syndrome, and a symptom complex associated with compression of the brain.
As a rule, this is a mild hydrocephalus. It is considered the easiest form. Symptoms increase gradually, without sudden jumps. Most often occurs as a chronic pathology. A factor in the development of this disease is a past meningeal infection.
A characteristic group of signs accompanying hydrocephalic syndrome, which grows gradually and in the early stages is almost invisible:
- Memory impairment
- Sleep cycle disorder.
- Indifference to what is happening, apathy.
- Vomiting of central origin.
- A growing headache, a feeling of fullness in the head, a feeling of pressure on the eyeballs.
- Drowsiness, weakness, yawning, dizziness.
- Mental disorder in the form of nervous conditions.
- Tachycardia, sweating, fainting conditions are in the late stages of hydrocephalus due to the lack of timely treatment.
In addition to PVPD syndrome, there are neurological manifestations associated with incipient compression of the brain and an excess of cerebrospinal fluid:
- Visual impairment.
- Disorder of coordination of movements (cerebellar ataxia).
- Paresis and paralysis.
- The loss of all types of sensitivity.
- Muscle hyperreflexia.
- Emotional instability, aggressive, asocial behavior.
In general, a chronically developing dropsy of the brain has such manifestations as:
- Increasing dementia, i.e., decreased intelligence.
- Disorders of motor function – lower paraparesis.
- Impaired urination
It is considered a serious violation of cerebrospinal fluid circulation. Most often, it proceeds sharply, accompanied by symptoms of increased intracranial pressure and compression of brain structures of a pronounced nature. Possible loss of consciousness up to coma, loss of vision, impaired activity of the cardiovascular and respiratory systems.
Here are just some of the acute symptoms of hydrocephalus in adults:
- a sharp unbearable headache that does not respond to painkillers;
- severe nausea and vomiting, which does not bring relief;
- signs of a dislocation of brain structures, manifested by various cerebral disorders;
- violation of behavior and psyche;
- decrease and loss of sensitivity;
- pronounced weakness – a poor prognostic sign, indicating an increase in symptoms;
- blurred vision.
Moderate hydrocephalus of the brain with timely treatment costs a minimum of consequences. The prognosis for life is favorable.
In cases where the disease is started, the patient may develop serious intellectual and mnestic disorders. He cannot take care of himself; he is losing socialization skills.
With acute hydrocephalic syndrome, especially in cases where adequate therapy has not been carried out, brain compression that occurs with hydrocephalus can lead to serious consequences.
One of the formidable complications of hydrocephalic syndrome is swelling of brain tissue. Due to the limited volume of the cranial cavity, its structures are displaced relative to each other and the bones of the skull, resulting in compression of the cerebral hemispheres, cerebellum and medulla oblongata, where vital centers are located. All this leads to their ischemia and a serious violation of the functions of the central nervous system, which cause characteristic signs of hydrocephalus.
Serious consequences arising from hydrocephalus can be avoided with timely diagnosis and correctly prescribed treatment.
Among the most effective studies in diagnosing dropsy of the brain, computed tomography (CT) and magnetic resonance imaging (MRI) are distinguished. These methods help to determine the shapes and sizes of the ventricles, brain cisterns and subarachnoid space.
To determine the direction of cerebrospinal fluid flow and clarify the type of disease, radiography of the cisterns of the brain base is used.
In some cases, a trial lumbar puncture may be prescribed, as a result of which about 50 milliliters of fluid is excreted, which contributes to a temporary improvement in the condition. This is due to the fact that there is a restoration of blood supply to ischemic tissues against a background of reduced pressure. This is a fairly favorable prognosis for surgical treatment.
It has long been known that just a thorough examination of the patient and a competent collection of anamnesis allow the doctor to make an accurate diagnosis with almost one hundred percent certainty.
When evaluating complaints of a dropsy patient, an experienced specialist will easily suspect he has hydrocephalic syndrome. Additional research methods will only be used to identify the extent of the disaster.
Correctly performed with hydrocephalus diagnostics allows the doctor to determine the treatment methods. This is especially important for acute dropsy of the brain. Diagnostic error can lead to serious consequences of hydrocephalus and even lead to death of the patient.
For more detailed information about the severity of the patient’s condition, you can apply:
- MRI scan;
- CT diagnostics;
The study of symptoms and a visual examination of the patient is not a sufficient condition for determining the external hydrocephalus of the brain. Indirect signs, of course, are important, but professional diagnostics are indispensable here. Today 6 methods of detecting dropsy are used:
- ultrasound examination (ultrasound) of the neck and head to assess the state of blood vessels;
- magnetic resonance imaging (MRI) helps to identify changes in the soft tissues and determine the type of hydrocephalus, the stage of development of the pathology as accurately as possible;
- computed tomography (CT) is designed to determine the degree of damage to brain tissue, the size of subarachnoid cracks, the presence of neoplasms;
- an x-ray with the introduction of a contrast agent is aimed at identifying violations in the outflow of venous blood and damage to the vascular bed;
- spinal puncture is prescribed if there is a suspicion of the development of dropsy after encephalitis or meningitis and you need to find out what level of cerebrospinal fluid pressure;
- Ophthalmologic examination – the ability to determine whether the patient has swelling of the optic nerve and atrophy of the tissues of the ocular apparatus.
IMPORTANT! If the diagnosis of “chronic external hydrocephalus of the brain” has been confirmed, an additional diagnostic examination is preferably carried out after 6 months. The intensity of further visits to the doctor depends on the data received and is determined individually.
Treatment of external dropsy of the brain in adults
First of all, before determining therapeutic measures, it is necessary to identify the root cause of the development of hydrocephalus of the brain. With pathology of a tumorous nature, first of all, the tumor formation itself is eliminated. When choosing a type of treatment, a specialist should be based on such indications as:
- the stage of development of the disease;
- age category of the patient;
- cerebrospinal fluid pressure level and many others.
If the disease is at the initial stage of formation, then the use of medications is not excluded. However, it must be remembered that drugs may not eliminate the pathological process, but only slow down its development.
Among the additional methods of therapy, there are:
- microcurrent reflexology;
- drug treatment.
The main task of neurosurgical surgery is to create an artificial pathway that helps to remove excess fluid in those areas where it will be freely absorbed.
For these purposes, a bypass method is used, which includes three components:
- ventricular crater – its installation is made in the region of the lateral ventricles of the brain;
- valve – regulates flu >
Sciatica: causes and symptoms of the disease, treatment with folk remedies
In modern medicine, there is such a method as endoscopy. Its main goal is to create ways for the outflow of cerebrospinal fluid from the ventricles to the brain cisterns, where fluid will be absorbed. This method has some advantages over shunting, since it eliminates the presence of foreign bodies in the body, contributes to less injuries and reduces the risk of adverse effects.
The choice of treatment strategy for hydrocephalus in adults occurs only after an extensive neurological examination and neuroimaging diagnostic methods. The disease treatment program is selected depending on the type of hydrocephalus, taking into account its severity and the rate of aggravation of symptoms.
In mild forms, conservative treatment of hydrocephalus by prescribing pharmacological agents is possible. As a rule, the patient is prescribed a diuretic called diacarb. The action of this medication is aimed at ensuring the removal of excess fluid from the body. A good therapeutic effect is shown by treatment with a diuretic mannitol (Mannit).
This drug helps to reduce intracranial pressure, helps to increase the excretion of water by the kidneys. In parallel with these funds, it is advisable to take the lasix diuretic (Lasix). To compensate for the calcium deficiency associated with taking diuretics, it is recommended to include Panangin in treatment.
The secondary goal of treatment for hydrocephalus in adults is to improve blood supply and nutrition of brain tissue. For this, drugs of various groups are used. An effective corrector of cerebrovascular accidents is Cavinton. To activate cellular metabolism, Actovegin can be included in the treatment program.
However, drug treatment in acute and severe conditions with hydrocephalus in adults is inappropriate, since the rapid development of symptoms can lead to irreversible changes in the body and cause premature death of the patient. Therefore, if there is a threat to the life of the patient, immediate surgical treatment is necessary.
In the chronic course of hydrocephalus, a variety of bypass operations are performed. This type of surgical treatment is aimed at ensuring the outflow of excess CSF into the natural cavities of the body by placing a variety of shunts. Such surgical treatment is complex and traumatic manipulations, however, with their correct and competent execution, recovery is observed in more than 60% of patients with hydrocephalus.
To date, the most safe and atraumatic method of treating hydrocephalus is endoscopic ventriculocysternostomy of the bottom of the third ventricle. Ventriculocysternostomy is an operation aimed at creating an artificial route between the basal cisterns of the brain and the ventricle.
Treatment methods are selected at the consultation of a neurosurgeon or neuropathologist after diagnosis of the disease. Intervention should be timely, otherwise the risk of various neurological complications increases. It is important to take into account both the type of pathology and the characteristics of the patient’s body.
In the Department of Neurosurgery Clinical Hospital named after Eramishantseva practiced only effective methods of treating external dropsy of the brain. The methods are divided into two large groups: conservative (medication) and surgical (surgical), each of which has its own characteristics and advantages.
Drug treatment is relevant only in the mild stage of the disease. Special drugs accelerate the outflow of fluid from the brain, increase urination, relieve inflammation and swelling, strengthen blood vessels, and normalize the functioning of the cardiovascular system. To combat severe headaches, your doctor may prescribe non-steroidal anti-inflammatory and analgesic drugs.
Common groups of drugs are vascular, neurotropic, venotonic, diuretics. But with an acute disease, they will be ineffective. Mixed hydrocephalus is poorly corrected. In this case, conservative treatment will not relieve the disease, but will only restore or improve the functioning of individual systems and functions of the human body. Often, surgery is indispensable.
If acute external dropsy is diagnosed, in most cases drainage of the ventricles of the brain is prescribed. The main technologies are endoscopy and open surgery.
In the first case, we are talking about manipulations, which are characterized by minimal trauma, a very low risk of complications, and fairly quick postoperative recovery. Methods of endoscopy allow with minor intervention not only to remove excess cerebrospinal fluid, but also to eliminate defects in veins, hematomas, blood clots.
Currently, an open operation is selected only in exceptional cases. Why? It is difficult to imagine an open surgery without craniotomy. And trepanation is always increased risks and a long postoperative recovery period.
Another way to get rid of dropsy of the external type is bypass surgery. Doctors use a system of valves and silicone tubes to remove excess cerebrospinal fluid from the skull. The fluid redirects to other cavities of the body, in particular to the abdominal cavity, right atrium, superior vena cava. According to statistics, the effectiveness of such a technique is 85%.
Is it possible to protect against the occurrence of external hydrocephalus of the brain? This is a very difficult question. But, if you completely abandon bad habits and avoid craniocerebral injuries, there is a high probability that the trouble will bypass you. Another important point is the timely and professional treatment of such serious diseases as encephalitis, polio, meningitis, and other infectious diseases.
The treatment of hydrocephalus has the following goals:
- decrease in intracranial pressure;
- prevention of possible complications;
- restoration of normal cerebrospinal fluid circulation;
- elimination of the consequences caused by compression of brain structures;
- treatment of the main pathology that caused hydrocephalus.
Options for treating hydrocephalus are different.
Chronic dropsy of the brain undergoes conservative therapy. Arising, as a rule, after the infectious diseases, traumatic brain injuries, etc., it stops, after eliminating the consequences of these pathologies.
Such patients are treated inpatiently. The drugs they receive cause a decrease in intracranial pressure due to the removal of excess fluid from the body (diuretics). Drugs such as nootropics, which have a beneficial effect on brain tissue, and drugs that affect the underlying disease are also prescribed.
In the case of occlusal hydrocephalus, it is customary to talk about urgent neurosurgical surgery. It is not possible to cure such a condition with medication. The main methods of surgical intervention are:
- Ventricular puncture.
- Liquor-shunting surgery.
- The use of external drainage.
- Endoscopic surgery.
With acute hydrocephalus, treatment does not delay it. It is then that this type of emergency unloading operation is applied. This is necessary to immediately reduce intracranial pressure and prevent the dislocation of areas of the brain.
Using a special cerebral cannula or catheter, a puncture of the lateral ventricle of the brain is performed, after which spinal fluid is slowly excreted.
Liquid bypass surgery
The most common type of surgery. The essence of this operation is to superimpose a message between the enlarged cavity of the ventricle of the brain and other free space, which may be the chest and abdominal cavities.
Endoscopic surgery for hydrocephalus is by far the most advanced way to treat dropsy of the brain. The method is a priority area of neurosurgery, but it requires high costs and highly qualified specialists.
The most traumatic and most undesirable intervention in hydrocephalus. It is an extreme measure and is applied in case of impossibility of other types of treatment.
The prognosis for the diagnosis of hydrocephalus, as with any other disease, entirely depends on at what stage the treatment began. This factor, in turn, is related to how quickly the patient turned to a specialist, how much the latter is competent in the question and possesses the necessary skills, how well he understands the symptoms typical of hydrocephalus.
Properly performed conservative treatment can have a rather favorable effect on the outcome of the disease. Eliminating the causes that caused hydrocephalus, the doctor greatly facilitates the patient’s condition.
The main thing to understand is that hydrocephalus is not a sentence. Panic and get hysterical is not worth it. Having become acquainted with what is dropsy, what are the types of this disease, having learned the factors that contribute to the development of this disease, a person can protect himself from it.
And knowing the main symptoms of hydrocephalus of the brain, you can suspect it in time and consult a specialist in a timely manner. Hydrocephalus is treated, so you should not delay a visit to a specialist.
Pathological preventive measures
Prevention to prevent the formation of dropsy of the brain includes the following recommendations:
- prevent infection during pregnancy;
- timely treat diseases of a viral nature, which can be complicated by neuroinfections;
- undergo ultrasound screening to detect hydrocephalus;
- during childbearing, use only those drugs that are not negatively able to affect the fetus.
It should be remembered that a disease such as hydrocephalus of the brain is quite dangerous, capable of causing irreversible brain changes or even fatal.
Only timely diagnosis of the disease and correctly selected therapy can return the patient to a normal, normal lifestyle.