Moderate cerebral hydrocephalus
The term “hydrocephalus” consists of two words literally translated from Latin as “water” and “brain”. With this disease, an excessive amount of cerebrospinal fluid - cerebrospinal fluid - is formed in the brain. This liquid serves as a shock absorber that protects the brain from physical influences, transfers nutrients, and removes metabolic products. If the cerebrospinal fluid is formed in excess, the intracranial pressure of the fluid on the brain structures increases. The negative symptoms of the disease significantly worsen the patient's quality of life. Moderate hydrocephalus is one of the varieties of this pathology.
Content:
- Classification of hydrocephalus
- What leads to the development of the disease
- Symptoms and manifestations of the disease
- Diagnosing moderate hydrocephalus
- Medication for moderate hydrocephalus
- Surgical treatment of moderate hydrocephalus
Classification of hydrocephalus
The disease takes the following forms:
- Moderate internal hydrocephalus - the accumulation of cerebrospinal fluid occurs in the ventricles of the brain;
- Moderate external hydrocephalus - CSF accumulates in the subarachnoid space;
- Moderate mixed hydrocephalus - combines the symptoms of both of the above types of the disease;
- Moderate hydrocephalus replacement - cerebrospinal fluid replaces the atrophying substance of the brain, is more often diagnosed in old age, and may accompany Alzheimer's disease.
Any form of moderate hydrocephalus can be either congenital or acquired. Moderate congenital hydrocephalus is the result of birth trauma, infections suffered by the child during intrauterine development. The acquired form of the disease appears as a complication of somatic diseases, as well as as a result of traumatic brain injury.
What leads to the development of the disease
Moderate hydrocephalus is based on impaired outflow of cerebrospinal fluid into the spinal cord canal, where it is normally absorbed into the venous network of the circulatory system.
Factors leading to the onset of the disease:
- Arterial hypertension;
- Stroke;
- Atherosclerosis;
- A cyst or tumor that squeezes the ventricle and interferes with the circulation of cerebrospinal fluid;
- Osteochondrosis;
- Hernia of the cervical spine;
- Neuroinfection - meningitis, encephalitis;
- Alcoholism;
- Traumatic brain injury caused by bruises of the head during a fall from a height, impact, car accident.
Symptoms and manifestations of the disease
for a long time, the main and only symptom of the disease may be headaches, which appear most often in the morning. this symptom is due to a prolonged stay in a horizontal position. headaches, as well as increased intracranial pressure, may not be present at the beginning of the development of the disease. often hydrocephalus is detected only when diagnosing the state of the brain for a completely different reason.
sooner or later, an excessive amount of cerebrospinal fluid still manifests itself as signs of impaired functionality of the brain, oxygen starvation.
Untreated moderate hydrocephalus can lead to stroke, intellectual disabilities.
symptoms of the disease in the development stage:
- Visual and hearing impairment;
- Loss of memory, inability to perform many intellectual operations;
- Violation of fine motor skills, change in gait;
- Impaired concentration of attention;
- Increased fatigue;
- Insomnia, sleep disturbances;
- Irritability;
- Loss of the ability to orientate in space.
In the later stages of the development of the disease, vomiting, urinary incontinence occurs, and cerebral edema develops. These symptoms are a consequence of a complete blockage of the outflow of cerebrospinal fluid, the so-called occlusive crisis.
Diagnosing moderate hydrocephalus
The most reliable data on the state of the brain, on the anatomy of the internal cavity of the cranium, on the amount of cerebrospinal fluid and changes in cerebral structures due to increased intracranial pressure are obtained using MRI (magnetic resonance therapy). An alternative to this study is an X-ray of the skull in two projections.
Additional diagnostic methods:
- Angiography - X-ray with a contrast agent, which allows you to see the stenosis of the cerebral vessels, aortic aneurysm;
- Ultrasound of the brain;
- Examination of the fundus using ophthalmoscopy, which allows to determine the presence or absence of edema of the optic nerve head;
- Analysis of cerebrospinal fluid collected using a lumbar puncture - allows you to detect pathogenic microorganisms in the infectious nature of the disease.
The tactics of the diagnostic examination is determined by the attending physician - a neurologist or neurosurgeon. You may need to consult an endocrinologist, psychotherapist, infectious disease specialist.
Medication for moderate hydrocephalus
In the initial stage of the disease, it is possible to compensate for the symptoms of moderate hydrocephalus with the help of medications.
Most often assigned:
- Diuretics for removing excess fluid from the body - Mannitol, Diacarb, Furosemide;
- Preparations for the prevention of potassium and magnesium deficiency, excreted in significant quantities along with the liquid - Asparkam, Panangin;
- Preparations for improving cerebral circulation - Cavinton, Cinnarizin, Glycine, Piracetam, Cerebrolysin;
- Multivitamins and immunomodulators to strengthen the body's defenses and accelerate recovery.
The appointment of the treatment regimen is carried out by the attending physician; self-administration of drugs can lead to severe complications.
Surgical treatment of moderate hydrocephalus
Although the prognosis of moderate hydrocephalus is quite favorable, with the development of symptoms of the disease, indications for surgical intervention may arise:
- Severe headaches that are not relieved by taking analgesics;
- Seizures;
- Intellectual impairment;
- Movement coordination disorders;
- Loss of control over bowel movements and urination.
Intervention tactics depend on the cause of moderate hydrocephalus, the stage of the disease. Surgical options:
- Removal of a tumor or cyst that disrupts the circulation of cerebrospinal fluid;
- Ventriculo cisterno endoscopy, which creates an artificial pathway for the excretion of cerebrospinal fluid;
- Bypass surgery that allows you to dump excess cerebrospinal fluid.
Most often, bypass surgery is performed - an operation that was worked out to the smallest detail several decades ago. A catheter is installed in the cavity of the ventricle, the valve of which opens after an increased level of intracranial pressure is reached. After restoring normal values, the valve closes.
The withdrawal of cerebrospinal fluid occurs in the patient's body cavity, which is able to transform it and remove it from the body:
- Abdominal cavity (preferred);
- Atrium;
- Gall bladder;
- Large vessels;
- Ureter.
If hydrocephalus is caused by infectious factors, bypass surgery is not performed so as not to provoke inflammatory processes in the tissues of the patient's body. Endoscopic surgery requires qualified specialists and modern equipment. In the bottom of the ventricle, overflowing with cerebrospinal fluid, artificial openings are created for the withdrawal of cerebrospinal fluid into the basal cisterns in the occipital part of the brain.
In some cases, the removal of brain tumors of any etiology, cysts with helminth cysts, scars after a stroke can give a significant relief to the patient's condition. If the formations do not affect large vessels, and have not grown through the brain tissue, the condition is relieved very quickly.
In order not to aggravate the first negative symptoms of the disease, if you suspect moderate hydrocephalus, you should undergo a full examination.
Author of the article: Sokov Andrey Vladimirovich | Neurologist
Education: In 2005 completed an internship at the IM Sechenov First Moscow State Medical University and received a diploma in Neurology. In 2009, completed postgraduate studies in the specialty "Nervous diseases".
