Hydrocephalus of the brain in an adult: treatment of mixed hydrocephalus

Hydrocephalus of the brain in an adult: treatment of external and moderate forms

A cerebral vesicle or hydrocephalus is a disease that affects not only small children, but also adults.

It is very dangerous and can lead to extremely serious consequences.

It will be helpful for you to know what specific symptoms there are in hydrocephalus and what are the methods of treating the ailment.

What is edema of the brain in adults

Hydrocephalus is a disease in which spinal fluid accumulates in the head. It means not ordinary water, but liquor.

If children have a dropsy, it is usually congenital, in which the head is enlarged in size, as seen in the photo, then in adults it appears as a result of the transferred diseases. The disease is very difficult to detect and some even die from it.

The effectiveness of treatment of brain hydrocephalus in an adult depends entirely on the degree to which it was revealed. The dropsy of each type has its own characteristic manifestations.

Mixed hydrocephalus implies a decrease in the brain, in which the accumulation of fluid takes place both in the space of the ventricles and in the subarachnoid.

If it is moderate, then the patient has almost no complaints and can live with it for a very long time. In more serious cases, manifestations of hydroencephalopathy in adults are as follows:

1. Headache. It almost does not pass, but in the morning stronger than in other periods.
2. Nausea. Like the headache, it is especially acute in the morning.
3. Drowsiness. This symptom signals that hydrocephalus is accompanied by other neurological disorders.
4. Speech disorders, memory problems.

This is non-occlusive hydrocephalus substitution. The subarachnoid space is widened, and fluid accumulation is carried out in it. An adult with such a disease has the following symptoms:

• constant feeling of fatigue;
• nausea, vomiting;
• minor visual impairment;
• sweating;
• double vision in the eyes;
• changes in sexual behavior;
• walking disorders.

Internal

If an adult triventricular occlusive hydrocephalus, in which the cerebrospinal fluid fills the spaces of the ventricles, he may suffer from:

• increased intracranial pressure;
• nausea, vomiting;
• severe headaches;
• problems with eyesight, hearing.

The causes of hydrocephalus in adults

A huge number of factors can provoke a dropsy of the brain. The disease occurs because of:

• a stroke;
• infectious diseases of the brain and membranes (meningitis, encephalitis, ventriculitis, tuberculosis);
• tumors;
• vascular pathologies, including ruptures of aneurysms;
• head trauma and post-traumatic conditions (normotensive hydrocephalus);
• disorders of the development of the nervous system;
• disturbances in production, circulation, absorption of cerebrospinal fluid;
• low density of the medulla.

Treatment

The brain hydrocephalus in an adult is diagnosed by such methods:

1. MRI. It helps not only to make sure the diagnosis is correct, but also to determine its causes.
2. CT scan.
3. Cisternography. Diagnosis is used to determine the type of hydrocephalus.
4. Neuropsychological examination.
5. X-ray with contrast medium.

If, as a result of one or more of these studies, the prognosis is confirmed, the following treatment methods are used:

1. Drug therapy. The option is suitable if the hydrocephalus is moderate. An adult patient is prescribed medications that lower intracranial pressure (Lasix, Mannitol), diuretics. In the course of therapy, a light therapeutic massage is also used. All this will help to stabilize the condition of an adult patient, but not cure it, but to achieve a subcompensated stage.
2. Shunting the brain. It is not performed with chronic hydroencephaly, inflammation, vision problems, but it is effective in asymmetric form. An adult patient is given a drainage, in which excess cerebrospinal fluid goes to other areas of the body. Operation in the vast majority of cases gives a positive result. After a while, an adult man completely returns to his normal life. Periodically, a secondary shunt is needed.
3. Endoscopy. Effective in mixed, substitutional, symmetric hydrocephalus. The endoscopic operation is carried out by microinstruments. With their help, remove the liquid and the cause that disrupts its circulation, for example, a tumor.
4. Folk remedies. They are effective only in order to suppress the symptoms with which the hydrocephalic syndrome manifests itself. It is recommended to use diuretic herbal decoctions (oregano, bearberry, parsley), juniper berries, spirituous root solution of ayr.
5. Diet. In the case of brain hydrocephalus in an adult, it is necessary to follow the rules of nutrition, aimed at improving the exchange of water-salt balance. It is necessary to refuse categorically products, because of which the body accumulates liquid. This is fresh bread, fat meat and poultry, smoked products, sausages, sweets. Instead they need to eat more fresh vegetables and fruits, cereals. Dishes are best cooked for a couple.

Consequences of the disease

The disease can be cured with the timely detection and selection of the correct method of therapy. Nevertheless, in an adult this does not always happen so quickly.

If hydrocephalus is not treated, then the condition will worsen, and the symptoms will progress. As a result, an adult man is threatened with complete dementia.

In particularly severe cases, hydrocephalus leads to a lethal outcome.

about hydrocephalus

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Symptoms and treatment of hydrocephalus of the brain (dropsy) in adults

Hydrocephalus of the brain is a serious pathology characterized by the accumulation of cerebrospinal fluid in the head. It often develops in young children, but adults are also no exception. They have acquired hydrocephalus, and any external signs of it are not visible.

If the disease is not detected in time, then a person may even die. The effectiveness of hydrocephalus therapy depends on when it was detected. The fluid accumulates in the subarachnoid divisions, as well as the ventricular system.

General description of pathology

The human brain has a complex structure. It consists of a large number of departments, which are protected by a cobweb, hard and soft shell.

The space between the first and the last shell is called "subarachnoid". These tissues are interconnected by means of membranes that create the ventricular system.

It consists of tanks, connected by holes and channels. It is in them that the circulation of the cerebrospinal fluid takes place.

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Likvor flows through the ventricles, and then it enters the cisterns located at the base of the brain. Further, the liquid washes the surface tissues, and then absorbed into the blood.

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The ventricular system of the brain and the flow chart of the cerebrospinal fluid in it

The cerebrospinal fluid performs several important functions:

1. It is a kind of shock absorber for the tissues of the brain and spinal cord, protecting them from accidental damage.
2. Delivers nutrients to the brain, and then removes waste from it.
3. Regulates the amount of blood inside the skull.

Types of the disease

Classification of hydrocephalus is very important for the purpose of proper treatment. Dropsy can be of these types:

• Internal. For it is characteristic that the cerebrospinal fluid accumulates directly in the ventricles. The reason for such a pathological condition is a violation of the process of absorption of excess quantity of cerebrospinal fluid. And his outflow is disturbed by a thrombus or a tumor that blocked the path.
• Outer hydrocele. In this case, excess fluid accumulates in the subarachnoid space, since it is not absorbed into the circulatory system. In this case, there are no disturbances in the ventricles of the brain. This form of hydrocephalus is extremely rare. If such a diagnosis is made, it indicates the atrophy of the most important organ in the human body. A very severe form of external edema of the brain is considered to be hydrocephalus substitution in adults. It is characterized by the fact that the brain volume decreases, and the free space is filled with CSF.

• Mixed hydrocephalus. Here the fluid accumulates in all parts of the brain. Most often this form of the disease develops in adults who have reached the advanced age. Mixed type is quite heavy for a person.
• Moderate type of edema of the brain. It is characterized by the fact that any symptoms and signs may be absent for years. However, at one point the disease manifests itself very sharply and the patient's condition is rapidly deteriorating.

In addition, edema can be classified by origin:

1. Congenital. This dropsy develops from birth and is provoked by a hereditary predisposition to impaired brain function. The main reason for the appearance of pathology is the developmental defect.
2. Acquired. It is more typical for adults and develops due to traumatic brain damage, as well as an infectious disease. Treatment of such pathology occurs more quickly.

And hydrocephalus is acute, subacute or chronic.

Fayad Akhmedovich Farhat, the neurosurgeon of the highest qualification category, tells about the causes and treatment of the disease in this video, MD, assistant professor of surgical surgery at the Moscow State Medical University:

Hydrocephalus of the brain: symptoms and signs

So, the presented pathology in adults in moderate form can be asymptomatic. Signs largely depend on the age of the patient. In more complex cases, dropsy has these symptoms:

Mixed:

• Headache, which practically does not pass. In the morning, it is marked with greater intensity.
• Nausea. It also manifests itself most often in the morning.
• Drowsiness. This suggests that hydrocephalus has already affected the brain and caused some neurological signs: memory and speech impairment.

Drowsiness during the day is a very ambiguous symptom, often indicating the presence of a variety of disorders and pathologies. Pay attention to the main reasons

Outdoor:

• Nausea and vomiting.
• Feeling tired, present all the time.
• Increased sweating.

Increased sweating is known as hyperhidrosis. Observed in many people and can lead to disastrous consequences

• Minor problems with eyesight.
• Violation of gait.
• Change in sexual behavior in adults.

Internal:

For more information about symptoms, see the video:

• Vomiting and nausea.
• Violation of visual and auditory function.

The cerebral cortex is accompanied also by such symptoms: inability to control and coordinate movements, temporary loss of memory, increased irritability, sudden changes mood.

And for hydrocephalus, epileptic seizures, urinary incontinence, too rapid sexual development, inhibition of the function of producing certain hormones are characteristic.

A serious sign of hydrocephalus is confusion of consciousness, a violation of the mental function up to the development of dementia. A person can change his personality.

In children, the disease manifests itself in its own way: the skull of the baby increases in size, as the fibrous joints, with which the bones of the skull are connected, are still soft and not closed. As for adults, manifestations of hydrocephalus can simultaneously speak about other serious pathologies: Alzheimer's disease, Parkinson's disease.

Braincines in adults are often misdiagnosed, so treatment may be ineffective. This is especially characteristic of a moderate form of pathology. Determine hydrocephalus can only be through careful differential diagnosis.

Why does the disease develop?

Despite the fact that a mixed or moderate type of pathology is diagnosed in an adult, it develops due to the influence of such causes:

1. Stroke.
2. Infectious damage to the substance and shells of the brain: encephalitis or meningitis.
3. Malignant or benign tumors that overlap the outflow of liquor.
4. Injury of the head.

1. Problems with the functionality of the nervous system.
2. A small density of brain matter.
3. Congenital or acquired developmental abnormalities.
4. There are blood clots in the brain.
5. Aneurysm rupture or other vascular pathologies.

1. Subarachnoid hemorrhage. This reason is considered one of the most common. With her more often a mixed form of the disease is diagnosed.
2. Surgical intervention.
3. Excessive production of cerebrospinal fluid.
4. Bickers-Adams Syndrome.

Features of pathology diagnostics

In order to determine the cause of the development of mixed or moderate hydrocephalus, the patient needs to undergo a thorough examination, which involves such procedures:

• External examination of the patient using neurological tests.
• CT or MRI. The second procedure is considered safer.
• Ultrasound of the brain (three-dimensional).

More information about the procedure of ultrasound of the brain can be found in this video:

• Control of intracranial pressure.
• Methods of screening monitoring.
• Neurosonography.

In addition to these studies, dopplerography is used to determine the hydrocephalus of the brain - the investigation of the vessels of the neck and head. Only an integrated examination using several methods can make an accurate diagnosis.

Traditional treatment of pathology

Hydrocephalus has its own code for the ICD: G90. Treatment with medication is used, even if it is congenital, but has a moderate form of development. The patient is prescribed medications that help reduce intracranial pressure: "Lasix as well as diuretics.

Also, patients can be prescribed drugs to eliminate epileptic seizures: Diacarb. In addition, this medicine reduces high intracranial pressure.

"Diacarb" has a low cost, but it is quite effective. Naturally, the remedy has its contraindications and causes many side effects.

To appoint "Diakarb" can only the doctor.

The drug "Diakarb" is available in pharmacies in Russia at a price of 230-270 rubles for 30 tablets

In addition to medicines, therapeutic massage is also useful. These methods of hydrocephalus therapy will help to compensate for damage to the adult, but will not cure the disease completely.

Dropsy of the brain: surgical treatment

For complete recovery of an adult, surgery is used. There are several types of surgical interventions:

1. Shunting. This method of carrying out the operation is most often used. Intervention involves the introduction of special silicone catheters with valves into the cranial cavity. By means of these devices, excess fluid is discharged into the abdominal cavity. Shunting ensures the maintenance of optimal intracranial pressure. It is impossible to perform such an operation in the presence of visual problems, chronic form of hydrocephalus. Shunting helps an adult to return to normal life, restore work ability, and avoid disability. But after such an operation, consequences may remain. Disadvantage of the presented procedure can be considered a small diameter of the shunt. The handset is capable of quickly failing, which requires its replacement. And the procedure must be performed immediately. In addition, the tubes can initially be infected, and also provide a slow or very rapid outflow of cerebrospinal fluid. The shunting operation lasts about an hour under general anesthesia.

1. Installation of an external drainage system. The hydrocephalus in adults is treated in this way only in the event that it is impossible to get rid of the surplus liquor differently. This procedure can provoke the maximum number of complications, for example: a patient can get a serious infection that will further exacerbate his condition.
2. Endoscopy. This method of treating cerebral hydrocephalus in an adult is the newest and most effective. However, its cost is quite high, because the procedure requires the presence of complex technical equipment and high-quality skill of the surgeon. But this method of treatment is the safest. During the operation, the doctor with the help of a neuroendoscope, equipped with a microscopic video camera, penetrates the brain channels. The whole procedure is displayed on the screen with high resolution. Further, with the use of a special catheter in the right place, a hole is made, and the cerebrospinal fluid flows out of the site of the cluster along a previously prepared pathway. Such a surgical procedure is carried out only once. In this case, the body does not need to enter any tubes - that is, the process allows for a permanent effect. However, endoscopy is not always carried out.

Neurosurgeon Alexander Vyacheslavovich Pechiborshch tells about the treatment of the disease by surgical methods:

Surgical treatment of brain hydrocephalus in an adult is advantageous, since it allows one to partially or completely get rid of the problem. Naturally, a decision of the surgery should be made by a doctor's consultation.

Features of nutrition and restorative treatment

The struggle with brain hydrocephalus in adults requires a revision of the way of life. In order not to aggravate the state of the patient's health, it is necessary to adjust the diet of his nutrition.

The diet provides for an improvement in the exchange of water-salt balance.

Therefore, you should stop using fresh bread, fatty meat and fish, smoked products, sausages, sweets - they all contribute to fluid retention in the body.

It is better to give preference to fresh vegetables and fruits, cereals. It is best to refuse fried foods. Food is more useful to cook for a couple.

The drinking regime is also important.

For example, to improve the removal of excess fluid from the body using folk remedies with a diuretic effect: decoctions of parsley and oregano.

During the recovery period, the patient must be protected from possible postoperative infection, head shots, too much activity and other problems.

Prognosis of the disease

If the signs of hydrocephalus are not detected in time, the consequences can be sad. And disability is not the worst thing that can happen to a sick person. So, the consequences of pathology are as follows:

• Risk of incorrect physical and mental development.
• Problems with the work of the nervous system.

Violation of the nervous system affects the body much more seriously than it seems. To realize the full scale of the problem, just look at what functions lie on the central nervous system

• Violation of mental function.
• Disability.

These consequences are possible if the treatment was not started on time. Timely the same therapy can significantly improve the quality of life of the patient, restore his work capacity. That is, the forecast is positive in the case of quality work of doctors.

How to prevent a disease?

Hydrocephalus in some cases can lead to death, so its treatment is mandatory. However, pathology can be prevented. For this, it is necessary to observe such preventive measures:

1. Even during pregnancy, a woman must strictly follow all the prescriptions of doctors.
2. The adult should treat any infectious pathologies capable of provoking the development of hydrocephalus.
3. It is better to avoid injuring the head, which can also trigger the mechanism of the disease.
4. It is also important to be careful and attentive in your daily life (avoiding falls and bumps). And this rule applies to both children and adults.

We hope that today's article gave you an idea of ​​what hydrocephalus is, how it develops and is treated. This information will help to notice signs of the disease in time and, having begun therapy, to avoid any complications.

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Symptoms of brain hydrocephalus in adults

Brain hydrocephalus in adults is a disease that can occur as a complication of various diseases brain, such as stroke, traumatic brain injury, swelling, hemorrhage, infectious process, meningitis.

And also as an independent nosological form, at which an active process of accumulation of cerebrospinal fluid in the cerebrospinal fluid takes place. Clinical symptoms and manifestations of the disease depend on the causes and forms of hydrocephalus in adults:

• circulatory disorders CSF-occlusive hydrocephalus, proximal and distal forms
• disturbances of its absorption - disresorbative and areosorbent forms
• disturbances in its production - a hypersecretory form, which increases the ventricles of the brain

Today, hydrocephalus in adults does not have clear diagnostic boundaries

Brain hydrocephalus in adults is a disease treated by neurologists, neurosurgeons.

Most people, as well as doctors, consider hydrocephalus to be exclusively a child's pathology, which in the last few years are recorded fairly often in children and are almost always congenital disease.

One thousand newborn babies have 1-10 children with a dropsy of the brain. Read more about the treatment of hydrocephalus in children.

That is why, so far, there are no clear criteria for diagnosis of hydrocephalus in adults in unspecialized polyclinics and hospitals (although it is enough to do Rheoencephalography and echo-encephalography). And often patients after trauma and stroke under the mask of other diseases are unsuccessfully treated in psychiatric hospitals, neurological hospitals, in polyclinics and discharged from regular hospitals with diagnosis:

However, with a specialized examination of patients in neurosurgical hospitals, hydrocephalic syndrome is found in 25% of adult patients in people over 18 years old.

But the timely competent, adequate diagnosis of hydrocephalus in adults with the correct surgical Almost 100% of cases can be used to achieve recovery of patients, to help them in the social rehabilitation.

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After operations performed by highly qualified specialists, most patients can return to their previous work, some with incomplete labor adaptation after surgery can do without outside help, returning to full-fledged life.

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Especially relevant are modern methods of external drainage and the introduction of thrombolytics into the ventricles of the brain, which can reduce lethal outcomesin acute formshydrocephalus arising from non-traumatic subarachnoid hemorrhages. As a person, at the onset of such a disease dies within 2 days, and the provision of emergency surgical care saves him life and permanently stabilizes the patient's condition.

Causes of its occurrence

To date, it has been established that almost all disorders, pathology of the central nervous system can contribute to such a complication as hydrocephalus. The most frequent, the main diseases in which hydrocephalus can form:

• Ischemic or hemorrhagic stroke - acute disorders of cerebral circulation.
• Oncological diseases - tumors of the brain, more often intraventricular, trunk, parastolovoy localization.
• Encephalopathy of various origins - post-traumatic, chronic hypoxic conditions, alcoholism.
• Infectious, inflammatory diseases of the central nervous system - tuberculosis, meningitis, encephalitis, ventriculitis.
• Traumatic or non-traumatic intraventricular, subarachnoid hemorrhage, arising from the rupture of aneurysms and arteriovenous vessels of the brain.

Internal and external hydrocephalus in adults

There are many different classifications of hydrocephalus, the main one of which is congenital hydrocephalus or acquired.

Brain hydrocephalus in adults is an acquired form of hydrocephalus, which in its turn is subdivided according to pathogenesis into 3 species.

Formerly, four forms were also distinguished, mixed, external hydrocephalus, which is manifested by an increase in the subarachnoid space and the ventricles of the brain with progressive brain atrophy.

By pathogenesis	Open - communicating, disrebtsorptive hydrocephalus. In this case, the processes of resorption of cerebrospinal fluid are violated because of the lesion of venous sinuses, mice, arachnoid villi, pachyon granulation, while CSA absorption is impaired in venous bed. Closed - occlusive, non-communicating hydrocephalus, in this case there is a change in CSF flow by cause of closure of the cerebrospinal ducts after the inflammatory adhesion process, due to a tumor or clots blood. Hypersecretory hydrocephalus, it appears due to excessive production of cerebrospinal fluid.
By the level of CSF pressure	Hypotensive Hypertensive Normotensive
According to the rate of flow	Chronic hydrocephalus, the duration of which is from 21 days to six months or more. Subacute progredient hydrocephalus, which lasts for a month. Acute hydrocephalus, in which the time from the onset of the first signs, symptoms of hydrocephalus in an adult before the onset of gross decompensation, is no more than 3 days.

Symptoms, signs of hydrocephalus

Acute hydrocephalus

In acute occlusal hydrocephalus in adults, the symptoms are due to signs of increased intracranial pressure:

Headache is especially pronounced in the morning upon awakening, which is explained by an additional increase in intracranial pressure during sleep.

Nausea and vomiting - also observed in the morning, after vomiting, sometimes there is relief of the headache.

Drowsiness is one of the most dangerous signs of increased intracranial pressure, if drowsiness occurs, then a rapid, rather sharp deterioration in the neurological symptoms is near.

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Symptoms of axial dislocation of the brain - the rapid suppression of the patient's consciousness until a deep coma, while the patient takes a forced position of the head, there are oculomotor disorder. If there is compression of the medulla oblongata, then the signs of hydrocephalus are manifested by depression of cardiovascular activity and respiration, which can result in a fatal outcome.

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Stagnation of optic discs - violation of axoplasmatic flow in the optic nerve and increase of pressure in the subarachnoid space around it, leads to visual impairment.

Chronic hydrocephalus

If chronic hydrocephalus is formed, then the symptoms, the clinical picture is significantly different from acute hydrocephalus in adults:

Dementia - often the first symptoms, signs of brain hydrocephalus in adults occur 15-20 days after injury, a hemorrhage, meningitis or other illness:

• The person confuses the day with the night, that is, during the day it experiences drowsiness, and at night insomnia. Decrease in the overall activity of the patient, he becomes inert, indifferent, indifferent, non-initiative.
• The memory is broken - first of all this reduction of short-term numerical memory, the person at the same time incorrectly calls the month, the number, and forgets his age.
• In the late advanced stages of the disease can develop gross mnestic-intellectual disorders, when a person is not able to behave service, the questions that are asked to him, he can not answer or answer monosyllabically, inadequately, think for a long time, pause between words.

Apraxia walking is a syndrome where a person in prone position can easily show how to walk or to ride a bicycle, and when he gets up, he can not walk normally, he spreads his legs widely, swings, scuffles.

Incontinence this symptom may not always be, and is a late and unstable sign of hydrocephalus in adults.

Changes in the fundus are usually absent.

Types of diagnostic studies of the brain in adults

• Computer tomography - a fairly accurate diagnosis of the contours of the brain, ventricles, skull and subarachnoid space., is made to determine the shape and size of the ventricles, the definition of anomalies - cysts, tumors.
• Magnetic resonance - according to MRI data it is possible to determine the severity and form of hydrocephalus. These studies are indispensable for clarifying the causes of hydrocele.
• Cisternography or radiography of skull base tanks - it is used to refine the type of hydrocephalus and determine the direction of the cerebrospinal fluid.
• Radiography of blood vessels or angiography - after the introduction of a contrast medium in the artery, abnormalities are detected at the level of the blood vessels.
• Neuropsychological examination - the collection of anamnesis of the patient, a questioning of the patient, which reveals the presence of disorders, deviations in the functioning of the brain.
• Echoencephalography.

Treatment of acute and chronic hydrocephalus

• Diuretics - osmotic (urea and lures, glymarite). Saluretics - diacarb, acetazolamide (inhibitors of carbonic anhydrase), ethacrynic acid, furosemide (loop diuretics)
• Plasma substitute solutions (20% albumin solution).
• Vasoactive drugs - magnesium sulfate (25% solution), venotonics (troxevasin, gliwenol).
• Glucocorticosteroids (dexamethasone, prednisolone, methylprednisolone, betamethasone).
• Painkillers - NSAIDs (nimesil, nimesulide, ketonal, ketoprofen), antimigrenous (treksimed).
• Barbiturates (phenobarbital, nembutal, amytal).

If the patient has clinical signs of the disease, non-surgical, conservative treatment of brain hydrocephalus in adults is ineffective. For the treatment of acute hydrocephalus, which occurs most often with intraventricular hemorrhages - this is a formidable complication that requires urgent neurosurgical intervention.

Surgery

To date, medical technologies in the treatment of neurological diseases in developed countries allow to use low-traumatic and quickly performed operations by the method of neuroendoscopic operating.

In Russia, such a method has not yet found wide application (in remote regions from Moscow and St. Petersburg) due to a lack of qualified specialists and very expensive equipment.

In Western countries, these operations are widespread.

The essence of the method is that a special instrument with a neuroendoscope (camera) is inserted into the brain channels at the end. Therefore, doctors can observe the whole operation on the big screen.

At the bottom of the 3rd ventricle, an opening is made by a special catheter (into which the liquor flows), which connects to the cerebral cisterns. Having created such a hole, the threat to the patient's life disappears.

Neurosurgeons perform various types of shunting:

• ventriculo-atrial bypass - with the right atrium, and also with the superior vena cava connect the ventricles of the brain;
• ventriculo-peritoneal bypass - the cerebrospinal fluid is sent to the abdominal cavity;
• ventriculo-cisternostomy - into the large occipital cistern;
• atypical bypass surgery - into other cavities.

Such operations last 1-2 hours, the patient spends 2-3 days in the hospital.

To produce such liquor-shunting systems, silicone is used - an inert material that is safe for the body.

With an increase in intracranial pressure above the norm, these systems produce spinal fluid in the cavity (the abdominal cavity or the occipital cistern, etc.).

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Hydrocephalus of the brain in an adult: symptoms, causes, treatment, diagnosis

Hydrocephalus of the brain (hydrocephalus) is a disease that occurs more as a complication of another disease than as an independent pathology. The disease occurs because of the accumulation of cerebrospinal fluid (CSF) in the head of a person.

The disease can proceed as a complication of such diseases:

• Stroke;
• Craniocerebral injury;
• Tumor, hemorrhage.

The disease of cerebral hydrocephalus in an adult is difficult to diagnose, as a result of which, in rare cases, even a lethal outcome is possible. Therefore, a very careful examination of a qualified physician is required to avoid possible consequences.

Factors of disease occurrence

Most often, this disease occurs in infants, but also develops in an adult. At the moment, studies show that almost any disturbance of the central nervous system can provoke hydrocephalus.

One of the most common causes of brain hydrocephalus in adults:

• Postponed ischemic or hemorrhagic stroke;
• Congenital hydrocephalus
• Neoplasms (swelling);
• Infectious diseases (meningitis, encephalitis);
• Craniocerebral injury;
• Vascular pathology;
• Alcoholic, toxic and other encephalopathies;
• Intraventricular hemorrhage. And it does not matter, the hemorrhage was formed due to trauma or not;
• Violations of the central nervous system.

Classification

In medicine, there are 2 types of hydrocephalus - it is congenital and acquired. Congenital pathology of the brain is more common in children. Acquired pathology occurs in adults and is classified into 4 types, depending on the mode of origin and development of the disease.

These are the following types:

1. External or open hydrocephalus.

This type of disease is manifested due to excess content of cerebrospinal fluid in the SAK.

However, it is worth noting that the cerebrospinal fluid directly in the ventricles of the brain is normal.

The reasons for the development of this form are atherosclerosis, hypertension and craniocerebral trauma.

It should also be noted that in this case, latent hydrocephalus often develops, due to which the volume of the brain can diminish markedly, and the free space is filled with cerebrospinal liquid.

This type of hydrocephalus is similar to the previous type, however in this case a large amount of cerebrospinal fluid is observed just inside the ventricles.

The reason for the non-occlusive form is the plugging of the liquor-conducting pathways as a result of the inflammatory adhesion process, also the cause may be intraventricular hemorrhage or a tumor.

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In the event of any trauma or blockage of the interventricular, asymmetric hydrocephalus of the brain may occur. The growing enlargement of the ventricles causes the death of brain tissue, leading to a flattening of the gyri.

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From the name it becomes clear that the cerebrospinal fluid fills both the ventricle of the brain and the subarachnoid space. Often occurs in the elderly as a result of insufficient stability of the cervical vertebrae, hypertension and atherosclerosis.

1. Hypersecretory. It arises from the excess of cerebrospinal fluid.

It is worth summarizing that excessive accumulation of cerebrospinal fluid is carried out for two main reasons: a disbalance in the formation of absorption and a violation in the circulation of the liquid. Under conditions of the standardly produced cerebrospinal fluid, its absorption is less.

Thus, these two factors are the leading sources of hydrocephalus development.

It is also worth noting that a form such as atrophic hydrocephalus of the brain most often occurs without signs of increased intracranial pressure and is detected only with an additional examination of the patient.

Symptoms of acute and chronic disease

For the acute form of the disease, the symptoms of the symptoms of the underlying disease, against which hydrocephalus manifested itself.

The acute form has the following symptomatology of the disease:

• Headache. The most acute pain symptoms are manifested in the morning, which is a consequence of increased intracranial pressure during sleep;
• Sleep disturbances, or to be more precise, permanent drowsiness. This violation indicates that focal neurologic symptoms will begin to appear in the near future;
• Dizziness accompanied by nausea and vomiting;
• Pathology of the eyes and optic nerves;
• Cognitive impairment (speech dysfunction, memory impairment);
• Sharp oppression of consciousness, cardiovascular system and respiration, which can not lead to the death of a person.

Chronic hydrocephalus often happens with slight increased intracranial pressure. This form appears gradually, usually after a few months, and the symptomatology in comparison with the acute course, has significant differences.

The chronic form has the following symptomatology of the disease:

• Dementia. With this disease, a persistent decline in cognitive activity is observed in a person, with a partial or complete loss of previously acquired knowledge. Also there is no skill in further learning and self-service.
• Apraxia walking, in which a person is not able to do any targeted movements, for example, to ride a bicycle. When walking a person, it seems to be shaking, instability appears, the gait slows down. At the last stage, a person can not stand and even sit.
• Frequent urination, especially at night. With the further course of the disease there is already incontinence of urine.

Diagnostics

Clinical symptoms of hydrocephalus are fairly easy to detect, even at the first examination of the patient, a specialist can make an accurate diagnosis. To determine the severity of the disease and its form, the following methods are used to diagnose the disease:

• Radiography of the skull and blood vessels. The study reveals the thinning of the bones of the skull.
• Ultrasound, namely echoencephalography. It allows to determine the degree of increase in intracranial pressure.
• Magnetic resonance and computed tomography. The magnetic resonance method determines the form of hydrocephalus and its severity. Computed tomography allows you to know the shape and size of the ventricles, as well as possible anomalies, such as a tumor.
• Neuropsychological examination. The patient's anamnesis is carried out.
• Ophthalmoscopy. An assessment is made of visual disturbances and the current state of the optic discs.
• Lumbar puncture. It is carried out for the study of cerebral fluid.

Only after full diagnosis of the patient, therapeutic therapy is prescribed.

Treatment

What direction the treatment will give the doctor, depends on its etiology. Nonsurgical therapy, as a rule, is used in the acquired form of the disease, which is inflammatory, after a head trauma or hemorrhage.

In this case, drug treatment includes the following forms of medications:

• Diuretics and saluretics.
• Plasmasubstitutional solutions.
• Vasoactive drugs;
• Diuretics;
• Anti-inflammatory drugs;

It is worth noting that in most cases, a complete cure is possible only through surgical intervention.

The operation to eliminate cerebral hydrocephalus is performed using the following methods:

• Shunting the brain. This method does not apply to the chronic form of the disease. The essence of the operation is to remove excess cerebrospinal fluid in other areas of the body.
• Endoscopy. It is carried out with mixed, substitutive and symmetric hydrocephalus, as it is in these areas that the effectiveness of endoscopy has been proved. The purpose of the operation is to remove the fluid and the causes of circulation disorders, as a rule, this is caused by tumor formation.

Also do not forget that in hydrocephalus it is important to follow a properly selected diet.

In hydrocephalus it is recommended:

• Increase consumption of diuretics;
• Sufficient intake of vitamins, amino acids, proteins and carbohydrates;
• It is possible to avoid the consumption of salt and products containing it;
• It is necessary to reduce the consumption of fatty, smoked and spicy food, especially dangerous different fast food.
• Refusal of alcoholic drinks and sweet soda;

In some cases, use the services of traditional medicine, but it should be noted that studies show its low effectiveness in the treatment of hydrocephalus. It is advisable to treat this disease with the help of folk recipes, only at the initial stage.

At the initial stage of the disease it is useful to use such recipes:

• In order to improve the outflow of cerebrospinal fluid, decoctions of watermelon skins, black elderberry bark, kidneys and birch leaves are used.
• With an acute headache, an excellent decoction of melissa leaves.

Consequences of hydrocephalus

How many live with the disease? At the first symptoms, it is very important to immediately visit a qualified specialist. If you start treatment in time, you can significantly shed life to the patient. But how much the person will live will be able to tell only his attending physician.

Brain hydrocephalus in adults is dangerous because if you do not treat such a dangerous disease or the treatment is not properly chosen, serious complications can arise.

The most common such complications include:

• Weak muscular tone of hands and feet;
• Loss of auditory and visual functionality;
• Serious respiratory and cardiovascular disorders;
• Violation of the water-salt balance;
• Appearance of epileptic seizures;
• Manifestation of symptoms of dementia;
• Increased likelihood of death in brain function atrophy.

A source: http://umozg.ru/zabolevanie/gidrotsefaliya-golovnogo-mozga-u-vzroslogo.html