To eliminate the intracranial pathology associated with abnormal development of cerebrospinal fluid, there are several methods. Treatment of dropsy in the newborn can be both conservative and operative. To ensure a good prognosis, the neuropathologist in a team with a neurosurgeon deals with the development of a treatment regimen.
- Medicamental treatment of hydrocephalus
To normalize intracranial pressure, it is necessary to reduce the production of CSF or to speed up the process of its elimination. To do this, use drugs that block enzymes responsible for the secretion of cerebrospinal fluid and increase the volume of urination. Such drugs are taken simultaneously with potassium preparations, since this substance is washed out of the body.
Particular attention is paid to diuretics, which also contribute to the removal of excess fluid. In addition, medications are used that improve the work of neurons with increased intracranial pressure. If within 2-3 months after the onset of conservative therapy there is no improvement in the patient's condition, then they resort to surgery.
- Surgical treatment of dropsy
In most cases, surgery is the only way to stop the progression of pathology, normalize intracranial pressure and save the brain. The mode of operation depends on the form and stage of hydrocephalus.
If the pathology has a closed form, then this indicates an obstruction (tumor, cyst, aneurysm of the vessel, hematoma), which prevents the cerebrospinal fluid from circulating normally. The operation is aimed at its elimination. If tumor neoplasms sprouted into the brain or they do not have clear boundaries, then surgical treatment is aimed at creating a pathway for the withdrawal of cerebrospinal fluid. To do this, perform shunting.
With the open form of hydrocephalus, that is, when the fluid is not absorbed where it is needed, a bypass is performed: ventriculo-peritoneal, ventriculo-atrial, lumbo-peritoneal. Interventions aimed at normalizing the absorption of cerebrospinal fluid, for example, dissection of arachnoid adhesions, may also be performed. With an increase in the synthesis of cerebrospinal fluid, operations that stop this process are performed. It can be the installation of clamps on the vascular plexus of the ventricles or the coagulation of these structures.
The method of treatment is determined by the doctor, individually for each patient. For this purpose, a complex of various diagnostic measures is carried out, which establish the type and severity of the disease.
Conservative treatment of dropsy of the brain in a newborn is performed to alleviate painful symptoms and prevent complications of the pathological condition. Medications are also prescribed to eliminate the consequences of the disease, for example, epilepsy or oligophrenia. Before the appointment of any medicine, the doctor conducts a thorough diagnosis of the condition of the baby.
For the treatment of a newborn, the following drugs can be used:
- Veroshpiron - an antagonist of the hormone produced by the cortical layer of the adrenal glands. Has a pronounced diuretic effect. Does not affect the renal circulation and the function of the renal tubules. Does not cause acid-base balance disturbances. Has a tablet form of release.
- Indications for use: puffiness caused by cardiovascular insufficiency, diseases with accumulation of fluid in the abdominal cavity, movement of limbs due to delay in the release of potassium ions by the body.
- The method of administration and dosage are selected by the attending physician, individually for each patient. As a rule, the drug is taken 50 mg 3 times a day.
- Side effects: dizziness, increased drowsiness, hyperkalemia, hyponatremia, skin allergic reactions.
- Contraindications: severe renal failure, hyperkalemia, the first trimester of pregnancy.
- Mexipur is an antioxidant with a retarding effect on free radical reactions. Has a membrane-protective activity. Reduces the risk of hypoxia and oxidant stress, has nootropic properties. It affects the processes in the cerebral cells, has an anticonvulsant, anxiolytic effect. It is available in the form of tablets and a solution for injection.
- Indications for use depend on the form of release of the medicine. Tablets are prescribed for cognitive disorders, vegetovascular dystonia, alcohol withdrawal, anxiety conditions against a background of neuroses. Injections are indicated for acute disorders of cerebral circulation, neurocirculatory dystonia, cognitive disorders in the background of atherosclerosis, discirculatory encephalopathy, with acute purulent-inflammatory pathologies of the abdominal cavity.
- Usage: tablets are taken orally, single dose is 250-400 mg, maximum daily dose is 800 mg. The course of treatment is determined by the attending physician. The injection solution is used for intramuscular and intravenous administration. The initial dosage is 50-450 mg with a gradual increase to achieve the desired therapeutic effect.
- Side effects: nausea, drowsiness, movement coordination disorders, headaches, allergic reactions, dry mouth, increased anxiety, hypotension, hypertension, emotional reactivity.
- Contraindications: acute violations of the liver, lactation, intolerance of the active ingredients of the drug, pregnancy, severe impairment of the kidneys.
- Overdose causes increased drowsiness, which passes on its own after the medication is stopped.
- Mannitol is an osmotic diuretic. Reduces intraocular and intracranial pressure, accelerates the process of excretion of water and sodium by the kidneys. Does not affect the level of potassium ions in the blood plasma. Produced in the form of an infusion solution.
- Indications for use: cerebral edema, increased intraocular and / or intracranial pressure, oliguria, accelerated diuresis. The drug is used for complications associated with the introduction of incompatible blood, as well as to prevent kidney ischemia, hemoglobinemia and hemolysis in surgical interventions with extracorporeal circulation.
- Method of use: the agent is used parenterally. The solution is administered by infusion dropwise or slowly. The dosage is calculated at 500-1000 mg / kg body weight of the patient. The duration of therapy depends on the results of treatment in the first days of the drug.
- Side effects: various dyspeptic phenomena, dryness of the oral mucosa, nausea, vomiting, arterial hypotension, tachycardia, electrolyte balance disorders, skin allergic reactions.
- Contraindications: individual hypersensitivity to the components of the drug, severe forms of kidney damage, chronic heart failure, violations of water-electrolyte balance, pregnancy and lactation.
- Overdose develops with the use of high doses of the drug and its too rapid introduction. It is manifested by increased intraocular and intracranial pressure, increased extracellular fluid and disturbances in the water-electrolyte balance.
- Diacarb - saluretic, causes diuresis by removing certain electrolytes, without interfering with electrolyte balance in the body. Has a tablet form of release.
- Indications for use: a delay in the body of sodium and water. Edema due to circulatory failure, with liver cirrhosis and kidney failure, pulmonary-cardiac syndrome. Puffiness caused by glaucoma, increased intracranial or intraocular pressure, tetany, epilepsy, gout.
- Method of administration: The drug is taken orally 125-250 mg 1-2 times a day for 2 days. The duration of therapy should not exceed 5 days.
- Side effects: drowsiness, fatigue, headaches, disorientation, leukopenia, hemolytic anemia. Overdose manifests itself by the same side reactions. Symptomatic therapy is indicated for their elimination.
- Contraindications: acidosis, adisson disease, hypochloraemia, hypochloruria, hypokalemia, diabetes. It is not used in pregnancy and simultaneously with ammonium chloride, which can cause acidosis.
- Vazobral is a combined drug. Contains azobral dihydroergocryptine - dihydrated ergot derivative, which blocks alpha1 and alpha2 adrenoreceptors of smooth muscle cells, platelets. Stimulates dopaminergic and serotonergic receptors of the central nervous system. Reduces the adhesion of platelets and erythrocytes. Reduces the permeability of the vasculature, improves blood circulation and metabolism in the brain. Increases the resistance of brain tissue to hypoxia. Produced in the form of a solution and tablets for oral administration.
- Indications for use: cerebrovascular insufficiency, cerebral circulatory disorders, decreased mental activity, memory impairment, decreased attention, orientation disorders, migraine, cochleovestibular disorders of ischemic origin, retinopathy, Raynaud's disease, chronic venous insufficiency. The drug is not assigned with increased sensitivity to its components.
- Method of application: 1-2 capsules or 2-4 ml 2 times a day. The duration of treatment is determined by the attending physician.
- Side effects: nausea, epigastric pain, skin allergic reactions, arterial hypotension, syncope.
- Asparks are a source of potassium and magnesium. It is used to restore the electrolyte balance. Regulates metabolic processes, has antiarrhythmic properties. Promotes the penetration of potassium and magnesium into the intracellular space, stimulates the intercellular synthesis of phosphates. It is produced in ampoules with a solution for infusions.
- Indications for use: hypokalemia, hypomagnesemia, chronic circulatory insufficiency, coronary heart disease, cardiac arrhythmias, intolerance or toxic effect of digitalis preparations, ventricular extrasystole, atrial fibrillation paroxysms.
- Method of application: the drug is administered intravenously drip or intravenously struino. Dosage and duration of therapy depend on the severity of the disease state, the patient's age and the doctor's indications.
- Side effects: nausea, vomiting, diarrhea, ulcers of the gastrointestinal tract, flatulence, vein thrombosis, dizziness, increased sweating, paresthesia, bradycardia, skin allergic reactions.
- Overdosing manifests itself in the form of hyperkalemia. To eliminate it, intravenous administration of NaCl solution or 300-500 ml of 5% dextrose solution (with 10-20 units of insulin per 1 liter) is indicated. If necessary, hemodialysis and peritoneal dialysis are possible.
- Contraindications: severe forms of myasthenia gravis, hyperkalemia, renal failure, violation of atrioventricular conduction.
- Actovegin - activates the cellular metabolism by increasing transport and accumulating glucose and oxygen. Improves blood circulation. It has several forms of release: dragee forte, injection and infusion solution, cream, ointment and eye gel.
- Indications for use: cerebral circulatory insufficiency, ischemic stroke, peripheral circulation disorders, trophic disorders, ulcers and bedsores, burns, prevention and treatment of radiation injuries. The drug is effective for damage to the cornea and sclera. The method of administration and dosage depends on the severity of the course of the disease and on the age of the patient.
- Side effects: skin allergic reactions, excessive sweating, fever, itching and burning in places of application or administration of the drug.
- Contraindications: hypersensitivity to the components of the drug, pregnancy and lactation.
- Cavinton - expands the vessels of the brain, improves blood flow and supply the brain with oxygen. Reduces platelet aggregation, enhances the metabolism of norepinephrine and serotonin in the brain tissues, reduces the pathologically elevated viscosity of the blood. Produced in the form of 2% solution in ampoules and tablets for oral administration.
- Indications for use: neurological and mental disorders, which are caused by disorders of cerebral circulation, hypertension, vasovegetative symptoms, memory disorders, speech disorders, dizziness. The drug is used in ophthalmic practice and with hearing loss.
- How to use: 1-2 tablets 3 times a day for a long period of time. Improvement is observed after 1-2 weeks of regular use of the drug. Intravenous administration is indicated for neurologic disorders of cerebral circulation. The initial dosage is 10-20 mg. The course of treatment is 1-2 months.
- Side effects: heart palpitations and lowering of blood pressure.
- Contraindications: severe ischemic heart disease, pregnancy, unstable blood pressure and low vascular tone. The drug is not allowed under the skin.
- Pantogam - nootropic, improves mental activity and memory. It improves the quality of metabolic processes and the body's resistance to hypoxia. Has anticonvulsant effect, improves the condition of patients with cerebral insufficiency, hyperkinetic disorders, neuroleptic syndrome, clonic form of stammering in children. Has a tablet form of release.
- Indications for use: mental failure, oligophrenia, speech delay, epilepsy, polymorphic seizures and epileptic seizures, trigeminal neuralgia. Subcortical hyperkinesis caused by the administration of neuroleptic drugs.
- Dosing: The drug is taken orally 15-30 minutes after eating. The recommended dosage is 500 mg 4-6 times a day, the course of treatment is 2-3 months.
- Side effects are manifested in the form of various allergic reactions. When they occur, the withdrawal of the drug is indicated.
All medicines used to treat hydrocephalus in children should be appointed by the attending physician. During therapy, careful monitoring of the condition of the baby and the progress of treatment are shown.
In combination with drug therapy, as well as before and after surgery, patients are prescribed vitamins, which improve the metabolic process in the brain cells.
Consider the main ones:
- Vitamins of group B-B1 improves coordination of movements and reduces the level of fatigue. B2 accelerates mental reactions, relieves headaches and drowsiness. B3 responds to the level of concentration of attention, the speed of recovery of memories. B5 takes part in the transfer of impulses between the nerve cells of the brain. B6 raises the level of intelligence and improves thought processes. B9 fights with increased fatigue, insomnia and apathy. B12 regulates sleep and wakefulness.
- Vitamin C - ascorbic acid has antioxidant properties, protects the body from increased emotional or physical exertion.
- Vitamin D - calciferol advocates the prevention of oncological brain damage. Supports the elasticity of the walls of capillaries and large vessels, prevents oxidative processes.
- Vitamin E - strengthens the walls of the vessels of the brain, prevents their destruction.
- Vitamin R - a bioflavonoid prevents hemorrhages in the brain and fragility of capillaries.
Vitamins are chosen by the doctor, individually for each case of hydrocephalus and each patient individually.
To additional methods of therapy of dropsy of the brain, includes physiotherapy. Most often, patients are prescribed:
- Microcurrent reflexotherapy.
- Manual therapy.
Physiotherapy is carried out at the stage when the main treatment is successfully performed, and it is necessary to restore the body. Physiotherapy procedures are appointed to accelerate the outflow of cerebrospinal fluid and to improve the psychological state and development of patients.
A cerebral cortex in newborns is not a new disease. Alternative treatment of this pathology has been used for a long time. For therapy, infusions and medicinal decoctions are most often used. Consider alternative means of dropsy:
- Grapes - it can be eaten as raw, as well as making juice, compotes.
- Broth from elderberry - rhizome and bark of the plant must be poured with boiling water, boil, sue and strain. This drug is effective in the early stages of the disease.
- Juice onions and pumpkins - for therapeutic purposes taken on an empty stomach 1-2 spoons.
- Infusion from the root of parsley.
- Decoction of melissa or leaves of birch, ara of marsh.
Alternative treatment is not an alternative to medicamental or surgical. Before applying this method, it is necessary to consult with the attending physician and evaluate all the risks of such therapy.
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Another option of alternative medicine is the treatment with herbs. When the development / outflow of cerebrospinal fluid is disturbed, the following recipes are recommended:
- Take 20 grams of peppermint and 200 ml of boiling water. Pour the plant and let it brew for 30 minutes. After cooling, strain, and take as tea, but without additives and sweeteners 3 times a day.
- Pour 2 tablespoons of cornflower flowers into 1 liter of boiling water. Once the infusion has cooled, it should be filtered. The drug is taken 50 ml 3 times a day. Infusion cornflower helps to remove excess fluid from the body.
- A tablespoon of astragalus pour a glass of boiling water and let it brew for 3 hours in a dark place. Strain and take 50 ml 2-3 times a day.
- Root the black elderberry fill with alcohol in a proportion of 1:10. The agent should be infused for a week. Take 25 drops 3 times a day.
- Crush the powdered state of the buckthorn berries. Use the powder to make a medicinal drink. The drug is taken up to 3 times a day, but the daily dose should not exceed 5 g of powder.
Before using herbal remedies for the treatment of hydrocephalus, especially in children, you should consult your doctor.
In some cases, even with the most serious diseases, resort to the use of alternative therapeutic methods. Homeopathy with dropsy of the head in a newborn recommends such drugs:
- Natrum sulphuricum (Aconl, Arn2, Belli, Helll, Hyper2, Nat-sl, Sill) - hydrocephalus caused by trauma.
- Helleborus niger - the disease occurs with severe seizures, there is strabismus or other visual impairment.
- Mercurius - bouts of insomnia, anxiety, inhibition.
- Secale cornutum - a violation of coordination of movements, a sharp loss of body weight.
- Apis - severe headaches, the child often tilts his head, with urination there is little urine.
- Apocynum cannabinum - the seams of the skull and fontanelle are widely open, increased intracranial pressure.
- Sulfur - pupils react poorly to light, painful sensations intensify at night.
- Glonoin - abnormal enlargement of the skull, vomiting of cerebral origin.
All of the above drugs can only be used according to the prescription of a homeopath physician, who will assess all the risks of this therapy for the baby and will select the necessary dosage of medications.
In most cases, surgical treatment of edema of the brain is the only way to stop the pathological growth of intracranial pressure and save the brain. The mode of operation depends entirely on the form and stage of the disease. The main task of the operation is the removal of cerebrospinal fluid from the ventricles of the brain to other cavities of the body.
- Closed hydrocephalus
The type of surgical intervention in this case depends on the cause of the disorder.
- If a failure in the development and withdrawal of cerebrospinal fluid is associated with the presence of a tumor, a cyst or a hematoma, the doctor removes pathological tissue. This normalizes the intake and absorption of cerebrospinal fluid.
- If tumor formations sprouted into the brain, and do not have clear boundaries, then shunting is indicated. During the operation, the doctor creates a path for the movement of the cerebrospinal fluid, which will bypass the congestion.
Most often, the liquor is removed by means of silicone catheters into the abdominal cavity, which has an increased absorption capacity. This type of operation is called ventriculo-peritoneal bypass. Annually it is carried out for more than 200 thousand newborns.
With ventriculo-atrial bypass, the cerebrospinal fluid is diverted to the right atrium. It is also possible to carry out endoscopic ventriculostomy, which is most effective in occlusal forms of dropsy. If the pressure in the skull grows very quickly, and shunting is dangerous, then external ventricular drainage is performed. A catheter is inserted into the ventricle of the brain, through which the liquor is diverted.
- Open hydrocephalus
If the cerebrospinal fluid is not absorbed where it should, then the following operations are shown:
- Ventriculo-peritoneal bypass.
- Ventriculo-atrial bypass.
- Lumbo-peritoneal shunting.
Surgical interventions are possible that activate suction of the cerebrospinal fluid, for example, dissection of arachnoid adhesions. If there is an increased synthesis of the liquid, the operation is aimed at suppressing the process. To do this, clamps can be placed on the vascular plexuses of the ventricles or cauterized structures that line the ventricular wall.
If the surgical treatment was successful, then the progression of the pathology ceases. The kid returns to normal life, develops on a par with peers. In some cases, the operation with dropsy is not performed. For example, when intracranial pressure does not increase, and there are no clear signs of disease progression. In this case, the child should be observed regularly with a neuropathologist and a neurosurgeon. It is necessary to systematically measure the circumference of the head, carry out neurosonography and CT. It may be prescribed medication with drugs that reduce the production of cerebrospinal fluid.