Edema of the brain in the period of newborns is a very serious diagnosis, which can have complications in the future. Therefore, treatment can be divided into two conditional stages: emergency care and restorative treatment.
The main element in the treatment of edema is active dehydration therapy. This allows you to reduce the concentration of fluid in the brain cells and reduce swelling. The drugs that are used for rehydration with edema are osmotic diuretics. These include mannitol, as well as saluretic lasics.
- Manitol is an osmotic diuretic, which acts by increasing the outflow of fluid from the tissues, enhancing filtration in the glomeruli, and the liquid is not reabsorbed in the tubules. Thus, the drug raises the osmotic pressure in the vessels of the brain and causes fluid to move from the brain cells to the vessels. Due to this action, the rheological properties of the blood improve and oxygen passes better into the cortical cells. This action of the drug lasts four to six hours, until its concentration is greater in the vascular bed than in the tissues. Therefore, the repeated administration of the drug must be carried out after such a time. Dosage of the drug is 0.5 grams per kilogram of the body weight of the child 20% solution. Side effects - headache, nausea, vomiting, with prolonged use - dehydration and hypernatremia. Precautions - with congenital heart disease use with great caution.
- Furosemide is a loop diuretic, which acts in the proximal tubules, has a rapid diuretic effect. It reduces the absorption of sodium in the kidneys, but also has a direct effect on the edema of the brain by reducing the synthesis of cerebrospinal fluid. And the effect of reducing intracranial pressure is equal to the rate of removal of fluid from the body, which makes it possible to quickly reduce the risk of complications in edema. The method of application of the drug can be intravenous and intramuscular. The dose is 0.5 to 1 milligram per kilogram of the child's body weight. Side effects - hypovolemia, hypokalemia, metabolic alkalosis, impaired glucose tolerance, arterial hypertension, cardiac arrhythmias, acute tubulo-interstitial nephritis, vomiting, diarrhea, aplastic anemia.
- Glucocorticoids occupy a significant place in the treatment of cerebral edema due to a wide range of their properties. They reduce the permeability of the wall of brain neurons for sodium and water and reduce the synthesis of cerebrospinal fluid. If the edema is of infectious origin or there is a suspicion of meningitis or encephalitis, then they reduce the inflammation focus and normalize the function of the cerebral vessels. You can use any drug, with calculation for dexamethasone: the dosage can be 0,3 -0,6- 0,9 mg per kilogram single dose. Repeat reception should be every four to six hours. Precautions - to avoid removal of the drug, you must maintain the interval between hormones and diuretics for at least 15 minutes. Adverse effects - hypofunction of the adrenal glands, septic complications, thromboembolic complications, osteoporosis, muscle atrophy, hypokalemia, sodium retention, leukocytosis, thrombocytosis, intercurrent diseases. To prevent the occurrence of side effects of SCS, they should be prescribed in accordance with the circadian rhythm after the first day of admission, gradually reducing the dose to 4-6 days of treatment (for the prevention of withdrawal and atrophy of the adrenal glands), while prescribing potassium, calcium, vitamin D.
- A child with brain edema is treated only in the intensive care unit, so he is immediately transferred to artificial lung ventilation. Ventilator has a therapeutic effect by reducing the pressure of CO2 in the vessels. This, in turn, causes a spasm of the vessels that are not damaged and are normally regulated and causes additional blood flow to the damaged areas. The use of ventilation in the mode of hyperventilation in short courses can reduce intracranial pressure in as early as 2 hours.
- In addition to the main drugs, infusion of isotonic solutions in the zero water balance regime is also used. Maintain acid-base balance of blood through control and infusion of bicarbonate. It is also necessary to control the rheological properties of the blood, because it is easy to lead to hypercoagulability.
Treatment of cerebral edema is a very difficult task that requires a lot of knowledge and practical skills. Positive dynamics is observed after the first day and in two to three weeks the child can already be discharged. But the consequences can be serious and physiotherapy and alternative means are already at home at the recovery stages.
Physiotherapy treatment of children with motor impairment after the transferred brain edema is one of the main methods in rehabilitation. To this end, you can use different methods - massage, physiotherapy, physiotherapy, reflexology. The main type of massage depends on many factors: the presence of hypertonic or hypotonic muscles in the child, impaired motor activity, and the state of cognitive functions. Classical massage includes stroking, shaking, felting, kneading, rubbing, fretting, shading. Along with this, segmental, circular, acupressure massage (combining inhibition and stimulating action) is used. Also, with increased muscle tone, special exercises are recommended for all muscle groups with alternate involvement of the upper and lower extremities.
Vitamins can be used in the syndrome of child depression. Encefabol is recommended for this. It is a derivative of the molecule of pyridoxine (vitamin B6) and has a complex trophic effect at the level of neurons and glial elements. The drug activates the exchange of glucose in the brain tissues, easily passes through the blood-brain barrier, has antioxidant properties and stabilizes the processes of inter-neuronal transmission. Encephabol has a positive effect on the microcirculation of the brain, improves the plasticity of erythrocytes and increases the level of ATP in them. The drug is presented in two forms: a 100 mg tablet No. 50 and a suspension in 200 ml bottles (100 mg in 5 ml). Schemes of prescription for children of the first months of life - 1 ml of suspension (20 mg) every morning for a month, for children up to a year the daily dose is gradually increased to 5 ml (100 mg).
Actovegin is a vitamin preparation containing amino acids, oligopeptides, nucleosides, microelements, electrolytes, intermediate products of lipid metabolism. The drug completely lacks proteins, antibodies and pyrogens. Due to its low molecular weight, it passes well through the blood-brain barrier. Actovegin increases the efficiency of energy processes at the cell level by increasing the accumulation of glucose and oxygen. Increasing the transport of glucose and oxygen and increasing intracellular utilization accelerates the metabolism of ATP, which in turn increases the energy resources of the cell. The use of fatty acids and amino acids stimulates intracellular protein synthesis and the exchange of nucleic acids. Along with this, there is an activation of cholinergic processes and accelerated elimination of toxic metabolic products. Therefore, the use of this drug in the recovery period accelerates the recovery and recovery after the transferred brain edema. The drug is used in the early recovery period parenterally (intravenously and intramuscularly), not more than 20 mg / day. For 15-20 days, then orally in a dose of 50 mg 2-3 times daily for 1.5-2 months.
Alternative treatment of cerebral edema
Alternative methods of treatment of brain edema in newborns are used closer to the first year of life, when one can see those or other changes that are subject to correction.
- Clay is known for its healing properties for children with spastic muscle manifestations or with hyperkinetic disorders. For treatment, you can take the infusion of clay inside. For this, the blue clay is best suited. A glass of boiled water should be mixed with a teaspoon of clay and take on a tablespoon of this solution three times a day. Massages with blue clay are very useful. To do this, you need to spread clay on the limbs or spasmodic muscles and massage with light movements.
- Baths with medicinal herbs - this is a very good method for treating the nervous system and restoring the function of excitation or inhibition. If the child after the transferred edema has increased excitability and hypertonic muscles, then you need to take 1-2 times a week a bath of oats. To do this, dry grass oats need to be insisted in a liter of water and add to a warm bath. If, on the contrary, the hypotonus in the child is dominated by a decreased motor activity, then in this case the bath must be taken with needles.
- Special gymnastics at home with rubbing the muscles with balls. Use this medication every day. The best thing is for the mother to learn this from the doctor-masseur and be able to do it herself, taking into account the peculiarities of the child's violations.
- Grass wormwood must be poured a hundred grams of olive oil and insist for three days in a dark place. After this, you need to rub the muscles with an oil solution and gently massage.
Herbal treatment has many positive results, since herbs can affect muscles, nerve endings and, due to this, stimulate the work of the autonomic nervous system. If, after a cerebral edema, a child has a convulsive syndrome, then in addition to medication, it is very important to correct the work of the nervous system with the help of herbs.
- Very good effect in the treatment of edema and its effects is tincture of herbs rue and a mordant. To do this, take 30 grams of herb rue and the same number of seeds, pour the boiled water and insist. It is necessary to give the child two drops three times a day. If your mother is breastfeeding, you can take such an infusion to your mother.
- If, after swelling in the baby, there are disturbances in coordination of movements, then the periwinkle flowers are excellent in this. To make a tincture on a glass of hot water, take 50 grams of dry leaves. After insisting, you need to dilute this glass of water twice and give the child to drink a teaspoon at night.
- Grapefruit herb can be used for convulsive syndrome. To do this, you need to prepare an aqueous solution of 20 grams of grass and 300 grams of water. You need to give three drops three times a day.
Homeopathy in the treatment of brain edema can also be used for a long time in the recovery period.
- Cannabis indica is a means of homeopathic origin, which is used to improve nerve conduction with increased spastic muscle activity. Produced in the form of a mono drug in granules. Dosage of the drug for a child at the beginning of therapy - two pellets three times, and in more severe cases, the dose is doubled. There may be side effects in the form of pale skin and mucous baby, as well as involuntary twitching of the muscles that quickly passes.
- Tarrantula sp. 30 is a remedy that improves muscle trophy and the state of brain eeyronons, improving the cognitive abilities of the baby. It is produced in granules and in such a dilution it is necessary to take one granule three times a day. Side effects can be in the form of abdominal cramps. Precautions - do not use for allergies to honey.
- Sokale kornutum - used to correct the syndrome of hyperexcitability with pronounced vegetative disorders. The drug is used in granules - two granules four times a day. Side effects can be in the form of drowsiness or loss of appetite, then the dose should be reduced.
- Nervochel is a combination drug that can be used in a convulsive syndrome. It includes potassium bromide, ignition, valerian, zinc. These drugs reduce increased excitability and convulsive alertness. For use by children from 1 year, you can use half the tablets three times a day, after three years you can use a whole tablet. The course of treatment is from two weeks to a month. Side effects can be in the form of allergic manifestations.
Alternative methods of treatment can be used only on the recommendation of a doctor and should not exclude the main drug therapy.
Surgical treatment of edema can be carried out with ineffectiveness of medications and in certain conditions. If the swelling is caused by a tumor, then during the neurosurgical treatment of this tumor, local edema is corrected. Sometimes there is a need to reduce intracranial pressure, then they can dissect the meninges through the fontanelles and perform decompression.
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