Intracranial hypertension ( increased intracranial pressure ) , hydrocephalus - Causes, Symptoms and Treatment .MF .
brain tissue is very sensitive to mechanical stress.Therefore, nature has placed the human brain in addition to bone boxes (skull) in a protective liquid medium (liquid subarachnoid space) and has provided its internal liquid cavities (ventricles).Thus, the brain is actually suspended in fluid - cerebrospinal fluid (other names - cerebrospinal fluid, or CSF).Cerebrospinal fluid in the cranial cavity is under a certain pressure.It is the pressure of cerebrospinal fluid in the brain called intracranial pressure .
normal level of intracranial pressure is very important for human health.Increased intracranial pressure - this is not an independent disease, but a symptom of many neurological diseases.
Causes of increased intracranial pressure
All liquid space and ventricles are connected by channels.The liquor is continuously circulated.In some parts of the brain, it is highlighted, and then flows through the cerebrospinal fluid ducts to other parts of the brain, which is absorbed into the bloodstream.
Excessive accumulation of cerebrospinal fluid causes an increase in pressure on his brain substance.This is referred to as increased intracranial pressure (intracranial hypertension).
Three common causes of chronic increased intracranial pressure:
1. liquor stands out too much;
2. CSF not fully absorbed;
3. impaired patency of cerebrospinal fluid circulation paths.
To increase intracranial pressure and hydrocephalus result:
- craniocerebral trauma (even very long, up to the birth trauma, concussions, contusions of the brain);
- meningitis or encephalitis;
- congenital structural features of the central nervous system (Arnold Chiari malformation, idiopathic intracranial hypertension, and others.); poisoning
- (including medication and alcohol);
- circulatory disorders in the vessels of the brain (eg, ischemia, encephalopathy, osteochondrosis of the cervical spine);
- intracranial volumetric processes (tumors of the brain, meninges, brain hemorrhage, and intracranial hematoma).
If intracranial pressure is raised considerably, and quite a long time, fluid cavities of the brain can expand - this extension is called hydrocephalus .Since the cranial cavity - closed space, the expansion of fluid cavities of the brain occurs due to weight reduction of the medulla.This process can have a negative impact on health.
MR tomography of a normal brain.The gray matter of the brain shown, white - liquor.The normal value of the fluid spaces of the brain (they are slotted).The ventricles within the brain visible.Subarachnoid spaces - white border around the brain.
MR tomography with intracranial hypertension and hydrocephalus.The result of inadequate treatment of elevated intracranial pressure.We see excessive accumulation of cerebrospinal fluid within the brain (butterfly) and outside the brain (broad white border).The amount of brain matter decreased - brain atrophy from the fluid pressure.
symptoms of increased intracranial pressure
increased pressure on the substance of the brain is able to disrupt the central nervous system.Hence, the characteristic symptoms:
· Heaviness in the head or headaches, growing in the morning or in the second half of the night;
· In severe cases, possible nausea and / or vomiting in the morning;
· Vegetative-vascular dystonia (sweating, a drop or increase in blood pressure, palpitations, presyncopal status, etc..) - Almost obligatory symptom;
· Fatigue, "dullness", easy exhaustion through a load of work or study;
· "Bruises" by gases (if to tighten the skin under the eyes in "bruise" visible dilated small veins);
· Possibly a decrease in sexual desire, potency;
· If a person's body is in a horizontal position, liquor stands actively and absorbed more slowly, so the intracranial pressure and the symptoms tend to reach a peak in the second half of the night or in the morning;
· Intracranial pressure is higher, the lower the atmospheric pressure, so the deterioration is due to the change of weather.
diagnosis of intracranial hypertension and hydrocephalus established physicians based on characteristic symptoms and on the basis of special research data, such as brain imaging.
Diagnosis of suspected increased intracranial pressure (intracranial hypertension), hydrocephalus
directly measure the intracranial pressure can only by introducing a liquid cavity of the skull or spinal canal a special needle with a pressure gauge attached to it.Therefore, direct measurement of intracranial pressure due to the invasiveness of the procedure does not apply.
Signs of changes in intracranial pressure in children and adults are found under the following procedures Survey:
- neurological examination
- MRI brain
- fundus examination
- conduct lumbar puncture
- X-ray of the skull bones
- REG (rheoencephalography)
increased intracranial pressure can say with confidence based on the following data:
- Expanding, curl veins fundus - indirect but reliable sign of increased intracranial pressure;
- Expansion of fluid cavities of the brain and medulla vacuum on the edge of the brain ventricles, clearly visible under X-ray computed tomography (CT) or magnetic resonance imaging (MRI);
- Violation of the outflow of venous blood from the cranial cavity, to be ascertained by means of ultrasound vascular studies.
- decrease in pulse wave at REG study (on reoentsefalogramme)
extent from increased intracranial pressure suffers brain can be measured by EEG.
gold standard instrumental examination of patients - is an assessment of symptoms, these brain imaging and fundus picture and EEG.
Echoencephalography (Echo EG) provides indirect and not always reliable data about the increased intracranial pressure, it is less reliable than CT and MRI, so this method is rarely used.
intracranial hypertension.Hydrocephalus - Treatment
human brain under the influence of excess pressure is normal may not work, in fact, there is a slow atrophy of the white brain matter, and this leads to a slow decrease in intellectual ability, disturbance of the nervous regulation of the internal organs (hormonal disorders, hypertension, and others.).It is therefore necessary to take all measures for the speedy normalization of intracranial pressure.
in the treatment of increased intracranial pressure is important to reduce isolation and increase the absorption of CSF.Traditionally made for this purpose designate diuretics.However, the constant use of diuretics is not always acceptable to the patient.
apply treatments to normalize intracranial pressure without medication.This special exercises to reduce intracranial pressure (applied by the patient alone), individual drinking regime, and small changes in diet, unloading venous head using soft methods of manual therapy, acupuncture and physiotherapy.
thus achieved steady decrease intracranial pressure without the continuous use of diuretic drugs, and then gradually decrease the unpleasant symptoms.Commonly occurs in the first week of treatment.
Elevated intracranial pressure can be cured only if the treatment of a disease, the symptom is caused.
Surgical treatment of hydrocephalus
In very severe cases (eg, cerebrospinal fluid flow after brain surgery or congenital cerebrospinal fluid flow), surgical treatment.For example, the technology developed by implanting tubes (shunts) to drain excess cerebrospinal fluid.
PS: To decrease the intracranial pressure (hypotension), cause dehydration (vomiting, diarrhea, high blood loss), chronic stress, vascular dystonia, depression, neurosis, diseases associated with impaired blood circulation in the vessels of the brain (such as ischemia, encephalopathy,cervical osteochondrosis).