Statistics show that cerebral edema in newborns occurs no more than 4% of children. Of the causative factors in the first place is the birth trauma, as one of the most common causes of edema. A lethal outcome in children with brain edema occurs in 67%, which indicates the seriousness of the problem.
Given that the newborn baby all the symptoms have their own peculiarities of the flow, then immediately suspect the presence of cerebral edema is a bit difficult. But if there were complicated births or pregnancy, or there are other risk factors in the form of birth trauma in the child, then it is under the close supervision of doctors. After all, the first signs of cerebral edema can begin three days after the injury, while healthy children are already discharged home. Therefore, not only the doctor should observe the child, but the mother should pay attention to all the symptoms.
With swelling, each cell increases in volume very quickly, so there is an increase in intracranial pressure, even though the cranium of the newborn has fontanels. All the symptoms of edema are associated with increased pressure. There may be systemic manifestations and local signs. Systemic symptoms include nausea, vomiting, headache. But these symptoms in the newborn have their own characteristics. So nausea in a young child immediately causes vomiting, and this vomiting is food that was eaten a few hours ago. It is very difficult to steal such vomiting and it is difficult to correct, since it arises because the membranes of the brain are irritated at elevated pressure. Headache in a newborn can manifest as a so-called "brain cry", in which the baby is very much crying and has a characteristic pose of throwing the head back. If the cerebral edema develops against the background of an infectious process in the form of encephalitis or meningitis, then systemic manifestations also include an increase in body temperature, as a reaction to the infectious process. But the peculiarity of newborn babies is also that the temperature may not rise, but this does not exclude the infectious process.
The edema of the parenchyma of the brain in newborns is also accompanied by local symptoms. These symptoms appear when compression occurs in certain areas of the cerebral cortex. More often it is manifested by paresis or paralysis of a specific part of the body, or in newborns there are often convulsions. Seizures can begin with a simple chin jerk and in a few seconds can spread to the entire body. Often there is a small-amplitude tremor, short-term breath retardation, visual disturbances with horizontal nystagmus. There are also focal and generalized convulsions. One of the specific symptoms in newborns, which indicate the beginning of the process of damage to the cortex, is the rolling of the eyes.
Also characteristic of edema, which is increasing gradually, the emergence of a group of symptoms, such as increased excitability. The syndrome of increased nervous reflex excitability is manifested by increased spontaneous motor activity, restless surface sleep, frequent unmotivated crying, revival of unconditioned and tendon reflexes, muscular dystonia, tremor of limbs and chin, emotional lability.
The syndrome of vegetative dysfunction also occurs with edema. Manifests the marbling of the skin, transient cyanosis, a violation of the rhythm of breathing and cardiac activity, thermoregulation disorders and dysfunction of the gastrointestinal tract with pylorospasm, constant regurgitation, increased peristalsis, constipation, vomiting, persistent hypotrophy. These symptoms can be isolated and may be the first to manifest, then it's hard to think about swelling.
Cerebral edema in a newborn during labor often occurs with accompanying birth trauma. Then the first signs can begin after birth, when the child can not breathe or it starts to convulsions. This is a direct indication for resuscitation.
Speaking about the spread of edema, it should be noted several types of this pathology, which differ clinically.
Moderate cerebral edema in newborns is when the process is not spreading so quickly and is easily amenable to correction. Morphological changes in the brain at a given degree in the future do not lead to a pronounced organic neurologic deficit.
At the same time there are arriving violations of hemolytic dinamics with a slight hypertensive syndrome, diapedic subarachnoid hemorrhages, local zones of cerebral edema. Clinical manifestations can also be minimal.
Periventricular cerebral edema in newborns is an edema in the area around the ventricles. More often such edema is observed with ischemic brain damage due to acute or chronic hypoxia of the child in utero or already in childbirth. This type of edema with timely diagnosis does not have a rapid spread with the risk of brain wedging. But there may be other complications.
The edema of the brain's ventricles in the newborn often occurs as a result of an intra-gastric hemorrhage. This leads to an increase in their volume, which presses the parenchyma around the ventricles and causes swelling. Then the clinic of such edema develops against the background of symptoms of impaired child's consciousness.