Uneven expansion of the subarachnoid space of the parietal lobes. The problem of expansion of the subarachnoid space

The human brain is a very complex organ; like the heart, it is forced to constantly work. In this active mode, it requires optimal nutrition and blood supply to function properly. So that in the future you understand what we are talking about, the human brain consists of three membranes:

The space between the arachnoid and pia mater is called the subarachnoid space. The arachnoid membrane itself surrounds the brain and is covered with endometrium on top. It communicates with the other two tissues using subarachnoid connections - membranes. The choroid subarachnoid plexuses form the ventricular system of the brain and spinal cord, consisting of 4 reservoirs. It is in these reservoirs that cerebrospinal fluid circulates.

Subarachnoid spaces, as mentioned above, are cavities in the brain that are filled with a special liquid called cerebrospinal fluid. The cavity filled with fluid serves the function of nourishing and protecting the brain. Liquor is an optimal environment for the exchange of useful substances between the blood and the organ itself - the brain; it also carries nutrients to the nerve cells and ventricles of the brain. The end products of brain tissue metabolism are isolated and removed in the cerebrospinal fluid. Liquor constantly circulates in the brain cavities, its movement determines the contraction of the heart, body position, breathing, and even the movement of the epithelium on the choroid plexuses. Under normal conditions, the amount of fluid in the subarachnoid space should remain no more than 140 ml.

As a rule, the diagnosis of dilation of subarachnoid convexital spaces does not apply to adults, but is given to young children and, in particular, infants. This could occur due to birth trauma or abnormalities in brain development. If such a phenomenon has occurred, then the baby is prescribed an ultrasound scan of the brain; it is this diagnostic method in children that determines the deviation of the subarachnoid convexital spaces.

The expansion of the subarachnoid convexital spaces indicates that there is an uneven distribution of fluid. This leads to cerebrospinal fluid pouring into the cavity and causing dropsy or hydrocephalus. Unevenly distributed cerebrospinal fluid can provoke intracranial pressure and dilate the ventricles of the brain. If during the course of this disease the ventricles are within normal limits, then there is a possibility that by the age of 2 the baby will be able to outgrow hydrocephalus, but in any case the doctor is obliged to prescribe treatment. Parents should not wait for the child’s skull to strengthen by the age of 2 and the disease to recede on its own; this may not happen, but you will still lose time.

In some cases, uneven expansion of the subarachnoid convexital spaces indicates that an inflammatory process or tumor is occurring. The very principle of the development of these diseases is very simple and understandable. Meningitis or another infectious disease provokes inflammation and constantly increases the production of fluid - cerebrospinal fluid. A huge amount of this liquid begins to expand the space. If a tumor develops in the brain, then an obstacle is created to the circulation of cerebrospinal fluid; accordingly, the pressure increases and unevenly dilated pathways appear in the places where the mechanical obstruction has formed. Of course, other options are also possible that caused the expansion of convexital spaces, for example, an abscess or hematoma, which gave rise to cerebral edema.

Modern medicine has advanced very far in the study of brain pathologies, so for adults it offers many methods for studying this organ and its abnormalities. For example, magnetic resonance imaging and lumbar puncture make it possible not only to determine the presence of a tumor and pathology, but also to establish the layer-by-layer structure of the brain and the nature of tumor growth. This allows doctors to accurately understand the necessary tactics for treating inflammatory diseases. The results of ultrasound and MRI diagnostics can only be deciphered by a qualified doctor, so do not engage in self-diagnosis. The duration of recovery directly depends on the timely determination of the cause of the disease.

Of course, like any disease, this pathology has its symptoms. In most cases, as mentioned above, it appears in young children, but sometimes there are older patients who can clearly describe the symptoms. Most often, expanded convexital spaces manifest themselves in the form of signs such as:

• persistent headache;
• dizziness;
• nausea;
• vomit;
• memory impairment (in adults);
• drowsiness;
• irritability;
• fatigue;
• increase in the size of the skull (in young children);
• increased sensitivity to light and auditory stimuli.

In the first stages, the disease may not manifest itself in any way, which significantly complicates timely diagnosis. The intensity of the manifestation of such signs directly depends on the type of deformation. In young children, these symptoms are a consequence of postpartum trauma, arachnoiditis or meningitis, and in adults they are a sign of a tumor in the brain or the result of a mechanical injury.

Modern medicine classifies the expansion of the subarachnoid space into the following degrees:

A mild degree of expansion is a violation of 1-2 mm, a medium degree is 3-4 mm, and a severe degree is more than 4 mm.

A neurologist is involved in the treatment of such pathologies in the brain; it is he who should be consulted if you have reason to suspect hydrocephalus or arachnoiditis. Consultation with a doctor is necessary if there has been a head injury due to childbirth or mechanical impact. Even if the doctor does not diagnose anything, it is much better to play it safe and not worry in vain than to suffer from a serious illness and not even know it.

Treatment of an enlarged subarachnoid space in most cases involves eliminating the very cause that provoked this condition in the child. As a rule, the provoking factors of enlarged subarachnoid convexital spaces are sinusitis, otitis and increased intracranial pressure or infectious diseases. As a treatment for this deviation, a complex of antibacterial drugs and vitamins (especially group B) is prescribed. Treatment takes quite a long time and is prescribed individually, taking into account the patient’s age and the nature of the expansion of the subarachnoid spaces. Among the drugs that are used in the treatment of this disorder in children, the following can be noted:

• products that expel excess fluid (Diacarb, Veroshpiron, Asparkam);
• medications to improve brain trophism (Cavinton, Pantogam).

If we are talking about an adult or a child over 3 years old, then the treatment tactics will be slightly different. Treatment will include:

• diuretics;
• barbiturates;
• glucocorticosteroids;
• saluretics;
• vasoactive drugs;
• plasma expander solutions;
• painkillers.

In addition to drug therapy, the doctor can prescribe a number of physioneurological procedures that will eliminate the symptoms of the disease and restore normal metabolism of brain cells and tissues.

Speaking about treatment prognoses, they are favorable, the main thing is to start drug therapy in a timely manner.

If drug therapy does not provide the desired result, then surgical intervention is indicated.

Such diseases cannot be ignored and left to chance; at the first symptoms, qualified medical diagnosis is immediately required. If the disease is neglected, the person will experience dementia, gait disturbances, speech defects, problems with urination, developmental delays and a number of other unpleasant phenomena. Now you know what expansion of the subarachnoid space means. Being theoretically savvy in such medical issues, you will be able to cope with the disease and recognize its symptoms in a timely manner.

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The subarachnoid space is filled with cerebrospinal fluid (CSF). The total amount of cerebrospinal fluid ranges from 120 to 140 ml. Above the large grooves and fissures of the brain there are cisterns - areas where the amount of cerebrospinal fluid is especially large.

Liquor comes from the ventricles of the brain, and the outgrowths of the arachnoid membrane absorb it. Impaired circulation leads to expansion of the subarachnoid space.

Poor circulation of cerebrospinal fluid is always associated with some pathological process affecting the brain. This could be a traumatic brain injury, a brain tumor, a stroke, or an infectious brain disease (for example, meningoencephalitis). All these traumatic factors trigger the process of atrophy, the amount of gray and white matter decreases, which leads to an expansion of the subarachnoid space.

There are three degrees of severity of this disorder: mild - expansion by 1-2 mm, moderate - by 3-4 mm and severe - more than 4 mm.

Possible clinical manifestations are impoverishment of mental activity, as well as pseudobulbar syndrome, characterized by a triad of symptoms: speech impairment caused by paralysis of the muscles involved in articulation, loss of sonority of the voice (speech becomes whispered) and impaired swallowing. Headaches and blurred vision due to congestion in the fundus are also possible.

Timely treatment, including surgery, allows such patients to return to a full life. Even if it is not possible to achieve full work adaptation, a person can at least do without outside help in everyday activities.

In infants, the cause of expansion of the subarachnoid space, as a rule, is increased intracranial pressure, birth trauma, or an infection that affects the brain as a result of complications of otitis media or a runny nose. The diagnosis is made according to neurosonographic studies.

Often the prognosis is favorable: by the age of two, the subarachnoid space and ventricles of the brain return to normal on their own, and the child seems to “outgrow” the disease. But you shouldn't count on it. This disorder threatens the child with developmental delays, so it must be treated.

Treatment is prescribed by a neurologist. It includes B vitamins and other drugs, as well as antibiotics if the disease was caused by an infection.

Dystrophy is insufficient nutrition of an organ, which can lead to malfunction and even death. Left ventricular dystrophy is not an independent disease - it is one of the symptoms or a complication of some other disease. What can dystrophy of the left ventricle lead to?

With dystrophy, the wall of the left ventricle of the heart decreases or thins. Therefore, deterioration occurs throughout the body.

Quite often, patients experience weakness and weakness. Heart failure in the form of arrhythmia often occurs.

There may be a decrease in hemoglobin in the patient’s blood and the development of anemia.

Pain and discomfort in the heart area accompany almost every patient.

Perhaps the development of shortness of breath when walking or physical activity. There is also a decrease in performance.

In severe cases, swelling of the lower extremities appears, palpitations and decreased blood pressure become more frequent.

The development of myocardial dystrophy leads to disruption of the functioning of other organs and systems in the body. This suggests that this pathology leads to various diseases of one or more organs.

Without treatment and proper adherence to diet and rest, a condition close to heart failure may develop.

Dystrophy of the left ventricle during physical overstrain can lead to hemorrhages and necrosis in the heart muscle. This may manifest as bradycardia and hypotension. In untrained people, heavy loads during myocardial dystrophy can lead to toxic damage. Myocardial dystrophy leads to coronary insufficiency with foci of necrosis in the muscular layer of the left ventricle.

With insufficient nutrition, for example, during starvation or cachexia, dystrophy can lead to atrophy of the heart fibers. In this case, a violation of protein, electrolyte and vitamin metabolism occurs. Over time, nitrogenous wastes, ammonium, and bile acids increase in the blood.

Left ventricular dystrophy in diabetes can be complicated by acidosis.

The toxic effect on the myocardium during hyperthyroidism leads to overload of the already weakened and thinned ventricle of the heart. This increases cardiac output and increases blood pressure. Dystrophy can be complicated by atrial fibrillation, systolic murmur and the development of cardiac delirium. If treatment is not carried out during this period, circulatory failure develops.

At the first signs or discomfort in the heart area, consult a doctor.

Diet and treatment of concomitant diseases are important in the treatment of the pathological condition.

• Dystrophy of the left ventricle of the heart: features and dangers of the disease
• Dystrophy of the left ventricle of the heart - how is the disease characterized?
• Myocardial dystrophy

Subarachnoid space: causes, symptoms and diagnosis of its expansion

The brain is a rather complex structure. It, like the human heart, is constantly working. To function properly, this complex system must have a good blood supply and nutrient supply. This “nutritious” role for the brain is played by its membranes, which not only maintain homeostasis, but also protect against injuries, various bacteria and viruses. There are three membranes of the brain - hard, arachnoid and soft.

Subarachnoid space and its significance

The space between the arachnoid (arachnoid) and soft membranes is called subarachnoid. The arachnoid membrane surrounds the brain and is covered with endothelium. It is connected to the hard and soft membranes by supra- and subarachnoid connective tissue membranes. Its outer surface is not fused with the hard shell, but in some places so-called granulations depart from it, which penetrate deep into the latter and, along with it, onto the inner surface of the cranial bones or into the sinuses, which ensures the resorption of fluid into the venous system. The inner surface of the arachnoid membrane is connected to a soft, thin membrane. In places where such adhesions are absent, expansions are formed - the so-called cisterns.

The environment where cerebrospinal fluid circulates consists of the ventricular system and the subarachnoid space of the brain and spinal cord. The ventricular system is formed from 4 reservoirs - two lateral, third and fourth.

Their choroid plexuses are the main source of cerebrospinal fluid production into the subarachnoid space. The norm for children is on average 80–120 ml, and for adults - from 120 to 160 ml per day, and it is completely renewed 3–5 times.

CSF circulation

The circulation of cerebrospinal fluid is a rather complex process.

It constantly flows from the lateral ventricles through the interventricular foramen to
the third, and then to the IV ventricle. From the latter, through the median and lateral openings, the liquor enters the large tank. Then it moves to the basal and washes the subarachnoid convexital spaces of both hemispheres, after which it goes to the spinal cord. Eventually the fluid returns to the brain, where it is absorbed by the dural venous system. In general, the functions of the cerebrospinal fluid are very important. Cerebrospinal fluid performs the function of protecting the brain from injury and regulating internal pressure, plays an excretory, immunological and transport role.

Expansion of the subarachnoid space and its causes

Changes in size and pressure in the subarachnoid space are often a sign of an inflammatory process or tumor.
The mechanism for the development of such changes is quite simple. The inflammatory process (usually arachnoiditis or meningitis) increases the production of cerebrospinal fluid, which gradually stretches the subarachnoid space. During the tumor process, a mechanical barrier is created to the outflow of cerebrospinal fluid, which is a consequence of a local increase in pressure and the formation of expansions in a certain area of ​​the ventricular system of the brain. However, other options are possible that can lead to expansion of the subarachnoid space. In particular, a temporary change in the size of the cerebrospinal fluid circulatory system is possible with reactive cerebral edema and a decrease in intracranial space due to a hematoma or abscess.

Symptoms of expansion of the subarachnoid space

The expansion of the subarachnoid space leads to an increase in cerebrospinal fluid pressure, which has relatively characteristic symptoms.
Patients note a stubborn, persistent headache with symptoms of nausea and fountain-like vomiting, increased sensitivity to visual and auditory stimuli, and dizziness. The degree of manifestation of symptoms depends on the severity of development and on how dilated the subarachnoid space is. In children, expansion of the subarachnoid space is most often observed with hydrocephalus and arachnoiditis. Much less often, birth trauma or developmental defects of the nervous system become the causes of this complication.

In adults, tumors and inflammatory processes of the subarachnoid space are more common. Hydrocephalus is extremely rare and most often develops after a brain injury.

Diagnostics

The expansion of the subarachnoid space is easily determined using
instrumental examinations, the sequence of which is determined by the underlying disease. Echoencephalography is performed more often in children and makes it possible to see the displacement of the brain relative to the bones of the skull under the pressure of the cerebrospinal fluid. CT and magnetic resonance imaging are mostly used in adults. The latest methods make it possible to establish the layer-by-layer structure of the brain and the nature of tumor growth, and, in combination with the results of a lumbar puncture, determine the treatment tactics for inflammatory diseases.

The cavity between the membranes of the spinal cord - soft and arachnoid - filled with cerebrospinal fluid is called the subarachnoid space. Ligaments that fix the position of the spinal cord pass through this space.

The pathways for cerebrospinal fluid consist of the subarachnoid spaces of the spinal cord and brain and the ventricular system. The ventricles of the brain, whose function is to produce cerebrospinal fluid, are lined with epithelium of various types - cubic and cylindrical. Under normal conditions, they hold less cerebrospinal fluid than the subarachnoid spaces. The walls of the ventricles are quite strong and inflexible, and the subarachnoid spaces change their volume under the influence of various factors.

Liquor plays the role of a shock absorber - it protects the brain from traumatic influences, performs a transport role and immunological functions.

The subarachnoid space of the brain and spinal cord have direct communication with the ventricles of the brain, forming a series of communicating vessels. The outer part of the arachnoid spaces is divided by membranes. This structure forms separate chambers and tanks.

CSF pressure increases briefly with changes in functional states - heavy physical work, stress, even with emotional disorders. With injuries, inflammatory processes of the central nervous system and cancer, its increase increases, which leads to expansion of the subarachnoid space.

Expansion of the subarachnoid space in infants

The subarachnoid convexital spaces in infants expand as the head grows - it increases in circumference. Parents may notice a pathological process by the protrusion of the fontanelles - places of the skull where the bones of the skull converged so that the child could pass through the birth canal without hindrance.

Also, in infants, expansion of the interhemispheric fissure and subarachnoid space is accompanied by a rapid increase in the skull, which leads to the fact that the child cannot raise his head. In this case, a diagnosis is made of perinatal encephalopathy. In addition to the general impairment of the condition, a decrease in reflex function, children become capricious, refuse to eat, lag behind their peers physiologically, and lose weight.

There is another very indicative symptom - “moon gaze”. The eyelids of sick babies are constantly drooping and part of the white is visible from under the skin - the pupil and iris roll under the eyelids. With minor brain lesions, this look appears periodically; with severe lesions, the iris can be seen for a short time.

In children, brain atrophy may also occur, in which expansion of the convexital subarachnoid spaces occurs. The furrows in the frontal, parietal, temporal and occipital regions increase.

The ventricular system is also pathologically deformed due to expansion. In this case, serious examinations are carried out only in the second year of life - earlier, diagnostic measures are considered dangerous to the baby’s life.

Not only computer and tomographic studies may be required, but also the extraction of cerebrospinal fluid using a puncture.

At an early age, children undergo neurosonography - the condition of the cranial cavity can be examined using this method only before the fontanelles fusion.

If a significant area is damaged or leukomalacia is diagnosed - this term refers to softening of the brain, a condition when functional abilities are impaired, impulse signals in the required volume are not sent or received - in the future the child will lag behind in development.

But you shouldn't panic. The child’s body has a great chance of recovery; with timely and adequate treatment – ​​when the first symptoms appear – the chances of recovery increase.

What does moderate expansion of the subarachnoid space in adults indicate?

Expansion of the subarachnoid convexital spaces – uneven or uniform – cannot occur without reason. Impaired circulation of the cerebrospinal fluid is always caused by pathological processes of an inflammatory or traumatic nature, which negatively affect the general condition, cause the ventricles of the brain to spasm, and lead to the expansion of the interhemispheric fissure.

Factors causing this change:

• congenital pathologies of the liquor-conducting system;
• traumatic brain injuries of varying severity;
• infectious diseases – encephalitis and meningitis of various etiologies;
• oncological processes of the brain - arachnoendotheliomas, meningiomas and the like.

In these diseases, brain volume increases due to edema, but functional cells of the gray and white matter of the brain atrophy due to increased intracranial pressure.

The amount of cerebrospinal fluid increases, the pattern of convolutions of the cerebral cortex is smoothed out, the subarachnoid space first expands slightly, and then the pathological changes increase.

If treatment is neglected - leaving the victim in a helpless state - then physiological vital activity will not recover on its own, and death is possible. But even with adequate treatment, some brain functions will be lost to a significant extent.

The expansion of convexital spaces is progressing.

There are 3 degrees of severity of such changes:

• light, insignificant – up to 2 mm;
• average – from 2 to 4 mm;
• severe – more than 4 mm.

Symptoms of intracranial disorders: changes in mental activity, sensory and motor disorders, pseudobulbar syndrome.

Pseudobulbar syndrome is a condition during which speech is simultaneously impaired - the functions of sound reproduction are lost, words can only be pronounced in a whisper, and swallowing becomes difficult. This is due to the fact that an uneven change in the position of the hemispheres and their compression leads to disruption of the activity of the cortical centers innervating the muscles of the pharynx and larynx, which leads to paralysis or paresis of the laryngeal muscles.

Surgical treatment does not always help victims; complete adaptation to work and life is practically impossible to achieve. However, with timely treatment, it is possible to restore a person’s ability to perform daily activities – when caring for himself – without outside help. In some cases, thinking abilities and intellectual qualities are preserved.

The subarachnoid space is a cavity between the arachnoid and pia mater of the brain, where cerebrospinal fluid circulates in an amount of 130 ml. There are cisterns here - places of slight expansion of the arachnoid and soft shells. It contains the largest amount of cerebrospinal fluid.

What does it mean

Expansion of the subarachnoid spaces is a pathological condition formed as a result of the influence of harmful factors on the brain, for example, traumatic brain injury, or a defect in fetal maturation.

The expansion of the subarachnoid spaces of the brain in adults is not an independent disease. This pathological condition reflects painful processes in the cranium.

Reasons

Causes may be congenital or acquired. Congenital causes of expansion of subarachnoid spaces:

1. Injuries to the fetus during the mother's pregnancy.
2. Congenital defects in the development of the nervous system.
3. Chromosomal abnormalities.

Acquired reasons:

• Trauma to the skull and brain.
• Neuroinfections: meningitis, encephalitis, inflammation of the arachnoid membrane.
• Brain tumors.
• Hemorrhagic stroke and minor hemorrhages.
• Brain swelling.
• Acute intoxication with heavy metals.
• Chronic heart, kidney and liver failure.

Inflammation of the membranes of the brain leads to the formation of adhesions. This impedes the circulation of cerebrospinal fluid, which leads to increased intracranial pressure and infantile hydrocephalus. Most often this appears after inflammation of a meningococcal, tuberculous and syphilitic nature.

During the period of manifestation of inflammation, the hemodynamics of the blood and blood vessels of the brain changes: the permeability of arteries and veins increases, and plasma enters the intercellular space. This causes swelling, which further increases intracranial pressure.

Tumors, being a voluminous process, compress brain structures and tissues, pinching lymphatic and blood vessels. This complicates the outflow of cerebrospinal fluid and blood, the brain becomes congested, the pressure in it increases and diffuse hydrocephalus occurs.

Expand the subarachnoid spaces and chronic diseases of the heart and kidneys. Due to disruption of the functioning of these organs, the outflow of blood from the brain worsens, which leads to a deterioration in the outflow of cerebrospinal fluid and intracranial hypertension. Less commonly, pathology is caused by poisoning with heavy metals: lead, bromine or mercury.

In newborns, the expansion of spaces is mainly due to congenital malformations of the central nervous system and heart.

People with enlarged subarachnoid spaces may experience disturbances in the circulation of cerebrospinal fluid: excessive production of fluid and impairment of its utilization. These pathologies are considered as individual characteristics of a person.

Symptoms

Uneven expansion of the subarachnoid spaces of the brain in children is observed by the following symptoms:

1. Irritation to bright lights, loud sounds and strong odors.
2. Sleep disturbance.
3. Vomiting immediately after eating.
4. Crying for no reason.
5. Damage to the oculomotor nerve, which manifests itself as strabismus.
6. Pulsation and bulging of the fontanelle, incomplete closure of the sutures.
7. Trembling in the limbs and chin.
8. Changes in behavior and reactions when the weather changes.

In adults, symptoms are:

• Liquorodynamic headache. Characterized by bursting and aching pain in the head. The symptom is accompanied by dizziness, nausea and often vomiting, which brings temporary relief to the patient.
• Mental disorders: emotional lability, irritability, tearfulness, apathy, agitation. Decreased concentration, memory loss and slower thinking. Intolerance to bright light, loud music and strong odors. Sleep is usually shallow, intermittent, with difficulty falling asleep.
• Autonomic disorders: dizziness, loss of appetite, alternating constipation and diarrhea, excessive sweating, heart pain.

Over time, prolonged expansion of the subarachnoid spaces can lead to hypertensive encephalopathy. This condition is caused by impaired cerebral circulation and liquor circulation, which causes diffuse or focal lesions of the cerebral cortex. The disease is accompanied by severe headaches, restlessness and anxiety, impaired consciousness in the form of syncope or somnolence.

With developed encephalopathy, memory decreases, attention is distracted and intelligence decreases. Also, as the disease progresses, an asthenic syndrome develops: patients become irritable, weak, and exhausted. They increase anxiety and are prone to depression.

Diagnosis and treatment

Instrumental methods help diagnose the expansion of spaces:

1. . A method accessible to everyone, including children and pregnant women.
2. Computer and.
3. Cisternography. A contrast agent is injected into the brain cisterns, after which X-rays are taken.

The goal of treatment is to relieve intracranial hypertension, reduce symptoms and improve the patient’s standard of living.

After determining the etiology of the enlargement, the underlying disease is treated. For example, in case of a tumor, surgery is prescribed to remove the tumor; in case of infections, antibacterial or antiviral agents are prescribed. After eliminating the underlying disease, symptomatic therapy begins.

Full treatment includes the following:

• Diuretics to relieve cerebral edema and reduce intracranial pressure.
• B vitamins to restore nutrition to nervous tissue.
• Antibiotics and antivirals for the treatment of infectious diseases.
• Nootropic drugs for restoring cognitive functions.
• Analgesics for headaches.

No one can argue with the fact that it is quite complex. He is entrusted with many tasks that he must consistently perform throughout his life. For the brain to function properly, it must be provided with adequate nutrition through proper blood supply.

Pathologies associated with brain function are always serious. One of the common problems is expansion of the subarachnoid space. According to the ICD (International Classification of Diseases), expansion of the subarachnoid space in adults is rare; more often, such pathology is found in newborns. We will talk about its causes, diagnosis, treatment and methods of prevention.

Structural features of the brain

To understand the essence of this pathology, it is important to know what membranes cover the brain. There are three of them:

• arachnoid;
• hard;
• soft.

The subarachnoid space is located between the arachnoid and soft membranes. The first covers the entire surface of the brain, which in turn is enveloped by the endometrium. To communicate with other tissues, plexuses under the arachnoid membrane - membranes - are used. The system of ventricles of the spinal cord and brain consists of the subarachnoid vascular plexuses. It consists of 4 reservoirs in which cerebrospinal fluid constantly circulates.

Subarachnoid spaces are small cavities in the brain filled with a special fluid (CSF). Their job is to nourish and protect the brain. The cerebrospinal fluid contains nutrients that are used to maintain the vital activity of nerve cells and the ventricles of the brain. Tissue waste products are also removed through the cerebrospinal fluid. If the subarachnoid space is expanded, it begins to compress adjacent tissues and blood vessels. Brain cells that do not receive proper nutrition suffer.

Liquor continuously circulates in the cavities of the brain. This is ensured by heart contractions, breathing, and body position. Normally, the volume of liquid filling the cerebrospinal fluid spaces should not exceed 140 ml.

What does this diagnosis mean?

Most often, the diagnosis “Expansion of the subarachnoid space” is made to infants. This pathology can be caused by birth trauma or a deviation in brain development. If an enlarged subarachnoid convexital space is suspected, an ultrasound scan of the brain is performed. This is the main diagnostic method.

If there is an expansion of the cerebrospinal fluid spaces of the brain, the cerebrospinal fluid is unevenly distributed and spills out of the subarachnoid space. The result is hydrocephalus (dropsy), increased intracranial pressure, and dilation of the ventricles of the brain. In this case, the cerebrospinal fluid system does not work correctly, which is why brain tissue and internal organs suffer.

The expansion of external liquor spaces leads to various pathologies (asymmetry of the cranium, impaired vision, speech, coordination, some brain functions, mental development, etc.). The degree of development of such pathologies directly depends on how much the subarachnoid space is expanded. Weak and moderate expansion of external liquor spaces is amenable to complex treatment if it is started in a timely manner. If the ventricles are not dilated, then there is a chance that by the age of two the baby’s brain condition will normalize and hydrocephalus will go away.

It is important that parents do not expect everything to go away on its own. You could waste precious time. The bones of the skull will become stronger, but the dropsy may remain. It is imperative to conduct a full diagnosis and, if necessary, undergo a course of treatment.

Sometimes expansion of the subarachnoid spaces can be observed with a tumor, cystic formation or inflammatory process. This is extremely dangerous, as it often leads to death. If medical care is provided on time, the prognosis is quite favorable.

During an inflammatory process, such as meningitis, more cerebrospinal fluid is produced than necessary. A large amount of fluid leads to expansion of the space (dilatation). If the problem is a tumor, then it interferes with the proper circulation of fluids inside the brain, creating a physical barrier to it. Other reasons may be an abscess, a hematoma, due to which cerebral edema began.

Diagnostics

Nowadays, brain pathologies are quite easily diagnosed. For this purpose, hardware methods are used (ultrasound, MRI), and, if necessary, lumbar puncture. The latter allows not only to detect a tumor, but also to examine all its layers and structure. This method allows you to select the treatment regimen for other formations as accurately as possible.

Basic diagnostic methods:

1. Neurosonography. Duration of the procedure is ~ 15 minutes. It is carried out if we are talking about a newborn, and consists of attaching a special ultrasound sensor to the patient’s head. Through the open fontanel, it allows you to collect information about the state of the brain. The advantage of this method is that it can be performed frequently, without any consequences for the baby. Now neurosonography is done in the maternity hospital to exclude pathologies of brain development. The result is deciphered by a pediatrician or neurologist.
2. CT, . These methods, although effective, are expensive. They are mainly used to diagnose children over 3 years of age and adults. Now considered the most accurate. To diagnose infants, using CT or MRI is very problematic, since the patient must lie absolutely still during the procedure. If such a diagnosis is indicated for a small patient, it is performed under general anesthesia.
3. Cisternography. The purpose of the procedure is to determine how correctly the flow of cerebrospinal fluid is directed. It allows you to accurately determine the type of hydrocephalus in a particular patient.
4. Angiography. With this diagnostic method, a special contrast agent is injected into the artery. The goal is to identify deviations in vascular patency.
5. Neuropsychological examination. The patient is examined and the doctor interviews him. This examination is carried out in children over 3 years of age and adults. The doctor collects the data from all tests and the results of a visual examination. The goal is to identify disorders in the functioning of the brain.

The results of an ultrasound or MRI should only be deciphered by an experienced doctor. Self-diagnosis is unacceptable and extremely dangerous here. It is very important to accurately establish the cause of the pathology and immediately begin to eliminate it. This directly affects the course of recovery and further functionality of the brain.

A blood test is also carried out, the patient’s behavior, the presence of symptoms, and their severity are assessed.

Alarming symptoms

When the convexital spaces expand, the following symptoms are observed:

1. (it appears immediately after waking up);
2. nausea;
3. vomit;
4. dizziness;
5. memory impairment (in adults);
6. irritability;
7. drowsiness;
8. fatigue;
9. in children, the size of the skull increases;
10. high sensitivity to light and sound.

At first, the disease occurs without visible symptoms. Then they make themselves felt, but the intensity may vary. It depends on the degree of brain damage and the amount of cerebrospinal fluid released. If the lesion is local and minor, symptoms may be minimal. This condition responds well to treatment, but it is important to start it at the first sign of pathology, before irreversible structural changes occur. The larger the accumulation of fluid, the more significant these changes are. Over time, the cavities may become larger. External changes may occur in infants - the cranium enlarges (especially its frontal or posterior hemisphere), and basal brain functions suffer.

The causes of pathology at different ages differ. In infants, this is most often birth trauma, meningitis, arachnoiditis, or developmental pathologies (genetic code is disrupted). In adults – mechanical trauma, pseudocyst or tumor.

There are different degrees of uniform expansion of the subarachnoid space:

1. light (1-2 mm);
2. average (3-4 mm);
3. severe (4 mm or more).

Localization also varies (interhemispheric, posterior, anterior, etc.). Different amounts of fluid may accumulate, and the external manifestations will also be different. Sometimes the skull becomes enlarged and its pronounced asymmetry is observed.

Treatment

In order for treatment of the enlarged arachnoid or subarachnoid space to be as effective as possible and tissue damage to be minimal, you should seek the help of a neurologist as early as possible. His consultation is mandatory if there has been an injury, including a birth injury, there is a suspicion of an inflammatory process, or if the listed symptoms are bothering you.

Please note that this pathology can be asymptomatic for a long time.

For successful treatment, it is important to establish the exact cause and eliminate it. Liquor dynamics must be taken into account. It can express the degree of expansion, show how much the surrounding tissues, vessels, and nerves suffer. Often, sinusitis, intracranial pressure, otitis media, and infectious diseases can provoke expansion in a child. With this development, antibacterial drugs and B vitamins are prescribed. Treatment can be quite long. It is prescribed purely individually, taking into account the nature of the pathology and the age of the patient. The patient must be constantly under the supervision of doctors; in the first stages of treatment, he may be placed in the neurology department.

It is important to limit the spread of cerebrospinal fluid, protect the hemispheres and sulci of the brain from compression, and clear the path for fluid to drain. To do this, it is important to determine exactly which area is affected, which lobe of the brain suffers from compression. This could be the hypothalamus, the cerebellum, several departments at once, etc.

This deviation in children is treated with a complex of drugs:

1. means for removing excess cerebrospinal fluid (Asparkam, Veroshpiron, Diakarb);
2. agents that improve brain trophism (Pantogam, Cavinton).

For the treatment of children over 3 years of age and adults, slightly different tactics are chosen. They are shown:

1. barbiturates;
2. diuretics;
3. saluretics;
4. glucocorticosteroids;
5. plasma substitutes (solutions);
6. painkillers;
7. vasoactive agents.

Not all of the listed drugs are included in the treatment regimen. Their selection directly depends on the identified cause. If the problem is hydrocephalus, diuretics are prescribed; when the cause is an infection, antibiotics are prescribed.

It is advisable to supplement treatment with medications with physioneurological procedures. They reduce symptoms, restore the metabolism of cells and brain tissue. The main goal of treatment is to restore blood supply to the brain and normal drainage of cerebrospinal fluid. This will stabilize intracranial pressure and restore the metabolism of cells and tissues.