Dropsy, or hydrocephalus brain, the child is a serious disease that is mostly found in newborn babies. But such a diagnosis is not a sentence – with timely detection of the disease and the right approach the disease can be cured easily, sometimes even without any consequences for the child.
What is the danger of the disease for children how to detect and treat the disease, and what parents upon detection of hydrocephalus in a child?
What is hydrocephalus in a child
Hydrocephalus literally means "water in the brain", therefore, the disease is often called "dropsy". This condition occurs when the meninges inside the skull and the ventricles of the brain: excessive accumulation of cerebrospinal fluid due to certain malfunctions in the body.
Accumulation of fluid leads to increased intracranial pressure disturbed blood supply of the brain, is its compression. As a result of these processes, the child can not develop normally, the nervous system ceases to function properly. Cavity, which accumulates excess fluid increases, which leads to growth of the skull, because the bones of the skull in babies is still very soft.
Please note! Most often, hydrocephalus is diagnosed in newborns, in which the disease begins to develop in the womb. Less frequently the disease affects older children.
Hydrocephalus of the brain in children has several classifications:
- At the time of formation:
- Fetal – appearing during pregnancy (usually at 16-20 week), it may be due to earlier future mommy of viruses, infections, drug and alcohol abuse, genetic predisposition;
- Congenital – may be the kid from the hard labor, while receiving birth trauma, and congenital anomalies of the Central nervous system and brain;
- Acquired – appears in children from one year and older, due to the transfer of certain pathologies or on the background of adverse factors.
- According to the morphological characteristics:
- Open – develops due to violation of production or absorption of cerebrospinal fluid;
- The closed (occlusive) – there are obstacles for the normal circulation of fluid (adhesions, tumors, etc.).
- According to the degree of intracranial pressure:
- Degree of development:
- Acute – develops within 2-3 days and usually requires surgery;
- Chronic – symptoms increase gradually, the latent period can last for 6 months or more.
- On the localization of the accumulation of fluid:
- External (outer) – fluid accumulates between the membranes of the brain
- Internal – cerebrospinal fluid fills the ventricles of the brain;
- Misc – has a clear deployment, fluid may accumulate in the ventricles and in the space between them (is the most dangerous form).
- At the stage of violations:
- Compensated – when the diagnosis of "dropsy" does not manifest any characteristic symptoms;
- Decompensated, has pronounced symptoms and a rapid development.
Please note! Hydrocephalus is most often characteristic of children who were born prematurely or received during childbirth brain injury.
The consequences of the accumulation of fluid in the brain can be quite varied – it depends on the specific sections that are experiencing the pathology and extent of injury. If the disease is detected at an early stage and the baby was promptly and properly given medical help, the consequences can be small or absent.
In severe cases the baby may experience problems with development, speech, mind, experience hearing, vision, motor and vestibular apparatus. In the absence of timely assistance, death can occur.
The causes of hydrocephalus in children
The most common causes of the development of hydrocephalus in children are intrauterine factors that may arise due to:
- Infectious diseases transferred by the mother during pregnancy;
- Genetic malformations;
- Drug abuse, alcohol, tobacco;
- Disorders of the CNS.
Is not excluded the fact that the cause of hydrocephalus may serve as rhesus conflict of mother and fetus. This does not mean that with a negative RH factor of the mother and fetus positive, make sure to have a pathology, but doctors say higher risk of developing abnormalities.
Please note! Especially dangerous for a pregnant woman and her baby during the first trimester of pregnancy, when any infectious disease that may affect fetal development.
The severity and extent of the disease depends on the time when the woman brought the infection: usually in the early stages of pregnancy that leads to abortion, late – developing abnormalities, including hydrocephalus.
What infection is most dangerous? The woman should be afraid of Contracting meningococcal disease, rubella, toxoplasmosis, pneumococcal, mumps, virus herpes, chicken pox, viral sore throat. A role in the development of abnormalities can play anemia the expectant mother and diabetes and preeclampsia.
Important! Most often, the pathology of the child is affected by cytomegalovirus infection.
Congenital forms of hydrocephalus are also in 80% of cases are the consequences of the mother during pregnancy, infections, and only in 20% of cases they cause a difficult birth.
The birth process is a big test for both the mother and the child. Prolonged childbirth, accompanied by fetal hypoxia, birth injuries at the risk of hydrocephalus in the child increases significantly.
At risk are premature babies, which starts the production of CSF in the moment when it in fact did not end in fetal development.
In rare cases, causes a congenital form of hydrocephalus is a brain tumor has brain cancer and education in the ventricles of the brain.
Acquired hydrocephalus occurs less frequently and is inherent to children from one year and older. Provoking factors for its occurrence can be:
- Inflammatory processes involving the meninges (encephalitis, meningitis);
- Bleeding in the brain;
- Brain tumor;
- The consequences of intracranial injuries;
- Pathology of the heart, brain, Central nervous system;
- Genetic factors.
One of the factors contributing to the emergence of "dropsy" in babies older than one year, is weakening immunity and a tendency to frequent diseases. Untreated, the disease can develop into meningitis that will provoke the development of hydrocephalus.
Symptoms and signs
In infants and older children, symptoms of hydrocephalus are manifested in different ways. We are born babies the bones of the skull have not yet grown together and therefore tend to move apart due to increased volume of fluid in the brain. Therefore, the characteristic feature of the development of "dropsy" in children under one year is a disproportionately large volume of the head.
Please note! A newborn baby is very easy to detect outer "dropsy" in the following characteristics: skull large in size, a bulging Fontanelle, the child often and strongly throws back the head back.
Normal newborn has a head circumference at birth at 1-2 cm more chest, but these proportions should be changed to 6 months. If the head continues to be more of the chest and increased in volume, it is an occasion for appointment of a survey.
Pediatricians have special age table that shows the rate of head circumference for a child. Ahead of this rule is not talking about pathology – the doctor should monitor the speed with which the growing head of the baby. If the monthly amount is increased by 3-4 cm is a disturbing symptom, which urgently need advice neuropathologist.
Other signs of hydrocephalus in children under one year and infants:
- Mild weight gain;
- Copious and frequent vomiting;
- The presence of a venous network at the temples, frontal part of the head, the nape;
- The projection of the Fontanelle and the intensity of its pulsation;
- The child is not holding the head (if the child is older than 3 months);
- Visual disorder: strabismus, ptosis of the eyelids, the appearance of white stripes on the sclera;
- Crowding the head in an unnatural way;
- Baby can't smile (ages 3-4 months);
- Delayed development;
- The pupils of the child are not recorded on the subject;
- Causeless tearfulness, irritability, moodiness;
- The reluctance to breastfeed.
With the rapid development of "dropsy" convulsions and vomiting "fountain", the incessant crying, disturbances of consciousness, drowsiness, loss of skills, loss of motor reflexes. If you notice such symptoms, the child should be immediately hospitalized.
Important! In children by year, attention should be paid to symptoms such as irritability, hyperactivity, short attention span, trembling chin and other neurological disorders.
After a year, measure the skull kid makes no sense, because in this period the bones of the skull, has lost its elasticity. The older children in the development of disease can indicate:
- Morning and night headaches;
- Coordination disorder;
- Reduced vision;
- Bleeding from the nose.
- Mood swings;
- Pressure on the eye socket;
- Restless sleep;
- The syndrome of attention deficit and hyperactivity;
- "Blue" under the eyes;
- Nausea and vomiting without any reason;
- Muscle spasms;
- Urinary incontinence or high her selection.
- The gap or growth;
- The decline of intellectual abilities.
Alone, these signs cannot be considered as clear symptoms of hydrocephalus, but they testify to neurologic violations, so seeing a doctor is still necessary.
How to treat hydrocephalus in children
First of all, upon detection of symptoms of hydrocephalus in a child or if you suspect that her parents should consult a pediatrician. The doctor will assess the overall health of the child, to measure the volume of the head and if necessary refer to neurologist.
Please note! Neurologists tend to find in young children the disease, which is not really. Therefore, parents should clearly be able to determine when to fear for the health of the baby, and when the doctor's diagnosis is far-fetched, and not to panic ahead of time.
Neurologist evaluates the baby's reflexes and then forwards for examination to the optometrist, who evaluates the condition of the fundus. Based on these data, doctors can make a preliminary diagnosis, but the full confirmation of the disease comes only after the ultrasound of the brain (newborn babies), MRT and CT (children two years old and more).
After a complete examination, the decision on further treatment is taken by the neurologist or neurosurgeon.
Treatment medicines prescribed for external and compensated form of hydrocephalus and also mild form of the disease.
Children with conservative treatment prescribe diuretics, which reduces the production of cerebrospinal fluid and its circulation is getting better. When you open forms of hydrocephalus such treatment is usually sufficient.
Than treat hydrocephalus in children:
- Diuretics – Diakarb, Furosemide, Mannitol;
- Potassium supplements – asparkam, Panangin (to replenish potassium that is leached from the body when diuretics);
- Nootropic drugs – Kogitum (for the better functioning of the brain).
Additionally, the complex treatment includes massage, microcurrent therapy, physical therapy.
Usually conservative treatment is 3-5 months. If after this period the child's condition is not improving, but MRT and CT show the ineffectiveness of drug treatments, the decision on surgical intervention.
The most effective methods of surgical intervention in hydrocephalus in children are:
- Bypass surgery – the withdrawal of excess fluid from the ventricles into the abdominal cavity with a special catheter;
- Endoscopy – a small cuts in the skin introduces the endoscope for removal of cerebrospinal fluid in the cavity of the subarachnoid space.
Bypass surgery – most common treatment for hydrocephalus, however, the method has disadvantages, because in 50% of cases after surgery there are complications. The rest of the "shunted" is generally not different from their peers and live a normal life, if the hydrocephalus had not already caused irreversible effects in the body.
Endoscopy is less traumatic than bypass surgery and less likely to cause complications, so it is often assigned to a newborn and one year old kids, because it minimizes the risks of negative consequences. However, this method is applicable for all forms of hydrocephalus.
After surgical interventions the child remains on the account at the neurologist, in most cases – for life.
Forecast and consequences
Given the high mortality in children with "water on the brain", parents often wonder – how many children live with hydrocephalus. But the universal predictions for this disease does not exist, all cases are unique and the consequences of pathology are dependent on many factors.
The most positive forecasts and open when communicating hydrocephalus, but when the occlusive forms of negative effects even after the treatment can not be avoided.
The most easily treatment of congenital forms of the disease, if they are timely detected and matched correct therapy. When acquired and severe forms of hydrocephalus, the majority of children feel the consequences of the disease – delays in physical and mental development, disorders of coordination of movements, vision and hearing. After operations not excluded complications such as epileptic seizures, inflammatory and infectious pathologies of the brain.
Hydrocephalus is a treatable, but the effects in most cases are irreversible and can greatly affect the quality of life of the baby.
Tips for parents
First of all, when you install a diagnosis of "hydrocephalus" do not despair, and to panic – the baby at this stage need the support of parents to help to successfully cope with the disease. On the Internet a lot of forums where moms share their successes in the fight against "dropsy".
During pregnancy be sure to pass all the necessary tests and examinations to determine the possible risk factors in advance. If the period of carrying a child the woman suffered a serious communicable disease, she should undergo further examination and may make the decision about terminating the pregnancy.
If the child was born prematurely, it should be protected from infections and have to do with it all medical examinations. Older kids should be protected from head injury, and viral and infectious diseases do not start the disease and in time to see a doctor.
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