DISEASES OF THE NERVOUS SYSTEM : DROPSY OF THE BRAIN (HYDROCEPHALUS) (HYDROCEPHALIA) - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
Dropsy of the brain can be congenital, due to abnormal development of the fetus, illness of parents (syphilis, tuberculosis, alcoholism, trauma during pregnancy) and fetal diseases of the fetus. Especially often hydrocephalus occurs as a consequence of infection of the meninges (meningitis of different etiologies, most often epidemic, pneumococcal pneumonia and tuberculosis) and the brain (encephalitides and meningo-encephalitis). Children should be aware of meningitis because of their common infections (intestinal disease, pneumonia, measles). Hydrocephalus can also be a symptom of some diseases of the brain (tumor, tubercule, parasites, residual effects of injuries). Hydrocephalus can be divided into two main groups:
In determining the form of hydrocephalus should be possible to identify more precisely the causes and level of impairment messages liquor (the ventricles, cellview water, the spinal canal) and to determine the cause of its accumulation.
You should distinguish between acute and subacute period, when hydrocephalus continues to grow, and the period of stable hydrocephalus, when finished with the underlying disease. However, in recent cases under the influence of different reasons can be the further accumulation of fluid. Hydrocephalus, depending on its extent, nature, localization and damage to various parts of the brain are musculoskeletal disorders (paresis or paralysis of the limbs and cranial nerves), damage to the optic nerve (vision loss, sometimes complete blindness), hearing impairment (a reduction or, more rarely, total loss). Due to the destruction of vegetative centers and pituitary gland may experience autonomic dysfunction with metabolic disorders, such as disorder of thermoregulation, obesity or cachexia. There are persistent or paroxysmal headaches, sometimes with vomiting. A frequent symptom are epileptic seizures, which can be identified as focal, generalized. Marked mental disorders as mental retardation of varying degrees.
Recognition is often based on the presence of large head sizes. However, we must bear in mind diseases such as rickets (square-shaped head, softening of the occipital bone) and congenital syphilis (elongated shape of the head), but without dropsy. In the study of intracranial pressure is often found to increase to about 300 - 400 mm volanaro post and above. On radiographs of the skull are changing as arch (spherical shape) and the base (the flattening of the cranial Yam), thinning of the cranial bones, gaping, strengthening of finger impressions. When electroencephalography with the introduction of 200 - 300 ml of air or ventriculography with the introduction of 50 - 100 ml of air you can install the passage of air into the subarachnoid space, the nature of changes in ventricular and designated anatomical irregularities, if any. The amount of protein can be reduced to 0.01%, less it increased to 0,4 - 0,45% (at the rate of 0.15 - 0.3%0); the composition of cellular elements is not changed.
Depending on etiology, in the period of growth of the hydrocephalus is anti-infective treatment (against syphilis, against meningitis of different etiologies). Dehydration therapy in the form of intravenous infusions of 40% glucose solution (30 - 50 ml), 25% solution of magnesium sulfate (intramuscularly and intravenously 10 ml). In some cases, effective radiotherapy. In some cases surgical intervention in the form of palliative operations (lumbar and ventricular puncture, decompressive trephination) and radical interventions.