Hypertensive hydrocephalic syndrome

Hypertension-hydrocephalic syndrome( HGS) is a disease that occurs as a result of too much accumulation of cerebrospinal fluid( CSF) under the membranes and in the ventricles of the brain, which appears due to excessive production, an obstruction to outflow or any failures in the reverse absorption of thisLiquid. This syndrome is one of the most frequent diagnoses in pediatric neurology. It is most common in children with perinatal encephalopathy, especially at an early age. The term GGS is used only in Russia.

Causes of

HGS may occur as a result of the following causes:

• Hypoxic-ischemic brain damage;
• Intracranial hemorrhages;
• Congenital malformations of the brain;
• Unfavorable course of pregnancy and childbirth;
• Severe prematurity;
• Intrauterine infections;
• Neuroinfections.

Diagnosis

The methods of investigation that allow us to make conclusions about the level of pressure of the cerebrospinal fluid are very limited at the moment. The only more or less reliable and accessible of them can be called only the procedure of lumbar puncture of the cerebrospinal fluid for measuring pressure, which is the main criterion of the diagnosis for this disorder.

This pathology may be one of the manifestations of such a disease as hydrocephalus, however, like a host of other neurological diseases. The criteria for diagnosing HGS include symptoms that indirectly indicate an increase in cerebrospinal pressure and that the ventricles of the brain expand. Methods of research, such as neurosonography, axial computed tomography, magnetic resonance imaging, can help in determining how much the ventricles of the brain are widened, where the places of obstruction of the locomotion pathways are located, the multichamber of the ventricles of the brain. At the same time, do not overestimate the information obtained with the help of these techniques.

Often, the diagnosis of GGS can be made unreasonably, turning from a symptom of the disease, that is, one of the many manifestations of the main disease, it is transformed into a basic, leading diagnosis.

It should be borne in mind that children at any age may well have transient( transit) fluctuations in liquor and blood pressure. Such cases do not apply to the GHS, especially if the child is at an older age. Dizziness, headache, nausea and other symptoms can refer to a large number of functional disorders in the brain, and also be a manifestation of various abscesses, inflammatory and infectious diseases, voluminous formations, hematomas, metabolic disorders. Diagnosis of HGS is possible only if the result is obtained by comparing various clinical manifestations with research data that confirm the fact of changes in the size of the ventricles of the brain, that is, neurosonography performed in infants at an early age or KTMRT for older children.

However, at the moment there is a negative trend towards a reassessment of the results of individual methods of brain research in diagnosing GHG.For example, the technique of dehydration therapy( diacarb, acetazolamide, fonurit) can often be prescribed in the presence of increased pulsation of the signal from information obtained by echoencephalography, although there is evidence that such a rise is a nonspecific change that can occur in various diseases such as vegetovascular dystonia, Migraine and others like that. Thus, increased pulsation of signals can not be a sufficient reason for diagnosing GGS.Conversely, if intracranial pressure increases as a result of the appearance of additional volumes, then the ventricular ripple decreases rather quickly, until it disappears completely on the echoencephalogram.

Treatment of

Treatment of the disease is usually done with diacarb, increasing the outflow and reducing the development of cerebrospinal fluid. If the effect of the drug is small and there is a progressive increase in the ventricles, the most frequent hospitalization is for the operation of bypassing the ventricles of the brain.