Moderate expansion of the lateral ventricles of the brain in a child. Dilation of the lateral ventricles

To understand why the ventricles of the brain are enlarged, you need to know the anatomical side of the problem. The ventricles located in the medulla small baby, are represented by a variety of cavity formations necessary for the preservation cerebrospinal fluid.

The capacitive structure of the brain for liquor storage is the lateral ventricles. In terms of size, they are larger than all the others. The left ventricular formation of the brain is the first, and located on the right edge is the second.

The third ventricular element is closely interconnected with the two located laterally due to the hole located between the column of the fornix and the anterior thalamic ending, connecting the third ventricular element with the lateral ones (interventricular). The corpus callosum has sides, and these cavity formations in the form of ventricles are localized on the sides, just below this body. The composition of the lateral ventricles is presented in the form of anterior, posterior, inferior horns, as well as the body.

The fourth ventricular component is very important and is located near the cerebellum and medulla oblongata. It is similar to a rhomboid shape, which is why it is called the rhomboid fossa, in which the canal of the spinal cord is located with the canal where there is communication between the fourth ventricular component and the aqueduct.

It is worth noting that if there is a 5th ventricle located in the brain region during ultrasound diagnostics during pregnancy, then this is the norm.

Together with the accumulation function of the ventricles, the secreting function of spinal cerebrospinal fluid is performed. IN in good condition this fluid drains into the area of the subarachnoid space, but sometimes this process is disrupted; various ventricles located in the brain region of the helpless infant are dilated. This indicates an impaired outflow of cerebrospinal fluid from the ventricular zone, and a hydrocephalic condition develops.

What does this mean

There is no need to panic if some of the ventricles located in the brain region of a helpless baby are dilated. After all, dilatation of some ventricles located in the brain region is not always pathological. A slight enlargement of any ventricle located in the area of the baby’s brain is due to physiology due to the baby’s large head.

Enlargement of the ventricles of the brain in newborns is not uncommon until one year of age. In this situation, it is necessary to find out not only how dilated some of the ventricles located in the brain zone of a small baby are, but also to measure the entire liquor apparatus.

An excess of cerebrospinal fluid is considered the main root cause of what actually causes this expansion of the ventricles of the brain. The cerebrospinal fluid does not flow due to an obstruction in the place where it leaves, which results in dilatation of the existing ventricular system located in the medullary region.

Dilation occurs in those babies who were born prematurely. When dilatation of some lateral ventricles located in the area of the brain in newborns, or their asymmetry, is suspected, they need to be measured and a qualitative parameter established. This is what happens when the existing lateral ventricles of the human brain are expanded, and what this means is already clear. Conditions when many ventricles are dilated require careful description.

Ventriculomegalic state

With it, the cavity system of the ventricular apparatus is enlarged, which will result in dysfunction of the central nervous system.

Ventriculomegalic types

Depending on the severity, the pathology occurs in mild degree, medium and heavy; location determines the following types:

lateral, in which there is a pronounced enlargement of some ventricles in small child, such as rear and side;
another type, where the pathology is located in the area near the visual thalamus and frontal region;
V next case the focus affects the cerebellar region with the medulla oblongata of the brain.

What are the causes of the pathology

The main root cause of possible pathology in newborns is considered to be a chromosomal abnormality in pregnant women. Other circumstances that determine why certain ventricles of the brain zone in a small child are enlarged include infectious diseases, physical trauma, hydrocephalic obstruction, hemorrhagic manifestations, and complicated heredity.

Symptoms of the disease

Dilated certain ventricles of the brain in a small child are the root cause of the Down, Turner, and Edwards syndromes. In addition, enlarged certain ventricles of the brain area in a small infant affect cardiac activity, brain structures and the musculoskeletal system.

Diagnostic measures

This condition in children is diagnosed using an ultrasound examination of the head.

How is it treated

In a condition where the lateral ventricles of the child’s brain are dilated, the main thing is to prevent complicated conditions in the body. Diuretics, vitamin preparations, and antihypoxants are prescribed. Additional methods treatments for this condition are massage procedures with special physical therapy. To prevent complicated conditions, potassium-sparing agents are used.

Hydrocephalic-hypertensive syndrome

Another course of the disease cannot be excluded, in which enlarged ventricular medullary components are observed in newborns - hydrocephalic hypertension syndrome.

With it, cerebrospinal fluid is overproduced, accumulating under the meninges and the ventricular system of the brain. This pathology is rare and requires diagnostic confirmation. This syndrome is classified according to the age of the child.

Causes

The root causes are divided into those that existed before birth and those that have already been acquired. Congenital occur due to:

complicated course of a woman’s condition during which she is pregnant, complicated childbirth;
intrauterine cerebral hypoxia, trauma during childbirth, developmental anomalies;
early labor;
intrapartum trauma with hemorrhage into the subarachnoid space;
intrauterine infectious pathology;
brain abnormality;
prolonged labor;
a long period between the breaking of amniotic fluid and the expulsion of the fetus;
maternal chronic pathology.

Acquired root causes include:

neoplasms of oncological or inflammatory nature;
foreign body located in the brain;
condition after a skull fracture with penetration of bone fragments into the brain;
infectious pathology;
cause of unknown etiology.

All the root causes of this syndrome lead to the development of dilation of the ventricles of the brain in infants.

Manifestation of pathology

The clinical syndrome manifests itself:

high intracranial pressure;
increased volume of fluid in the ventricular system.

The symptoms boil down to:

baby refuses to feed breast milk, whiny, capricious for no apparent reason;
he has a decrease in activity in muscle fibers;
reflexive activity is poorly expressed: poor grasping and swallowing;
burps frequently;
there is strabismus;
upon examination, the iris is half-covered by the lower eyelid;
the sutures of the skull diverge ─ this also indicates that there is an increase in some of the lateral ventricles of the child’s brain region;
tension with bulging fontanelles shows that the ventricles of the brain are dilated in the child;
month after month the head circumference increases, this too important sign the fact that some of the lateral ventricles of the brain are slightly expanded in infants;
the fundus shows what visual discs edematous, also an indicator that dilatation of the lateral ventricles located in the brain region of a small baby is occurring.

These manifestations indicate that the ventricular system of an enlarged brain in a small child, or the fifth ventricle of the brain, is enlarged; serious consequences are possible. Older children age category Sometimes they acquire this syndrome immediately after they have had an infectious pathology or damage to the skull and brain.

A characteristic feature of this problem is considered to be morning pain in the head area, of a squeezing or bursting nature, localized in the temporal and frontal zones, with nausea and vomiting.

The complaint, in which a certain ventricle of a region of the brain in a small child is enlarged, is the inability to raise the eyes upward with the head down. This is often accompanied by a feeling of dizziness. With observed paroxysm skin pale, lethargic, lack of activity. The child is irritated by bright lights and loud sound effects. Based on this, it is already possible to assume that the left ventricle of the child’s brain is enlarged.

Due to high muscle tone in the legs, the child walks on his toes, he has severe squint, he is very sleepy, and his psychomotor development is slow. This is what enlarged ventricles of a diseased brain lead to in a small child of 3 years old.

Diagnostic measures

Highly accurate diagnosis of hydrocephalic syndrome with hypertension, to find out whether the cerebral ventricle is really enlarged in an infant, is not easy. Applying the latest diagnostic methods impossible to install accurate diagnosis, in which the syndrome leads to the development of slight dilatation of the ventricular system of a small area of the child’s brain, or the 3rd ventricle located in the area of the brain is expanded, or dilatation of the left ventricle, located in the area of the child’s brain, may occur.

The diagnostic parameters of a newborn are the circumference of the head region and the activity of reflexes. Other diagnostics include:

ophthalmological examination of the fundus;
neurosonographic examination to see how enlarged the ventricle of a certain part of the brain is in a newborn;
Carrying out a computed tomographic examination and MRI will help to accurately determine that this may be a slight dilatation of the lateral ventricles of the brain in a child;
lumbar puncture study, which determines the degree of pressure of the cerebrospinal fluid. This method is accurate and reliable.

Therapeutic measures

Neurological and neurosurgical specialists are required to treat this disease. Patients are constantly monitored by doctors, otherwise the enlarged ventricles of the child’s brain will bring serious consequences.

Until six months of age, when dilatation of the left lateral ventricle of the brain is observed in newborns, treatment is outpatient. The main treatment is:

diuretics together with drugs that reduce the reproduction of cerebrospinal fluid;
nootropic group of drugs that improves cerebral circulation;
sedatives;
special gymnastic exercises with massage.

Therapeutic measures for the syndrome, in which an enlargement of the left ventricle of the brain is detected in newborns, are long-term, lasting more than 1 month.

Older children age group They are treated for hydrocephalic syndrome, depending on the pathogenesis, depending on the root cause of the pathology. When the syndrome arose due to infectious disease, prescribe drugs against bacteria or viruses. In case of cranial trauma or oncology it is indicated surgery. If left untreated, the enlarged ventricular system of the brain in newborns will cause serious consequences.

Complicated conditions

The manifestation of hydrocephalic syndrome with hypertension causes complicated conditions in the body, in which the child will have the following consequences:

psychomotor development of the baby is slow;
will become completely or partially blind;
auditory dysfunction, possibly completely deaf;
may fall into a coma;
completely or partially paralyzed;
the fontanel bulges abnormally;
epileptic seizures are manifested;
involuntarily urinates, performs an act of defecation;
may die.

This is what the increased condition of the ventricular elements of the brain in newborns will lead to, what the possible consequences are, if treatment is not performed on time.

In the infancy period, the prognosis is most favorable due to the frequency arterial type pressure and intracranial pressure, which come to normal levels over time the older the baby gets. In the older age category of children, the prognosis is unfavorable, depending on the root cause of this syndrome and the characteristics of treatment.

Immediately after birth, the baby begins an active hospital life: he is given vaccinations and undergoes many tests that allow him to assess the health of the newborn. Among them, a mandatory procedure is an ultrasound of the brain; it is important to check it for the absence of pathologies, and also to assess how developed it is, because everything depends on this later life baby.

Ultrasound examination of the brain in an infant

Anatomy of the ventricular system of the brain

The structure of the human brain is heterogeneous; it consists of several parts, each of which is responsible for a specific vital function. Anyone healthy person the brain consists of four ventricles, which are interconnected by vessels, canals, openings and valves.

The brain consists of the lateral ventricles, the third and fourth. The side ones also have their own numbers: the left one is designated by the first number, and the right one by the second. 3 and 4 have a different name - front and rear, respectively. Lateral ventricles have horns - anterior and posterior, and the body of the ventricles. Cerebrospinal fluid (CSF) constantly circulates around all ventricles.

A change in the size of one or all ventricles entails a deterioration in the circulation of cerebrospinal fluid. This can have serious consequences: it leads to an increase in the volume of fluid in the spinal cord and a deterioration in the functioning of the body. Asymmetrical ventricles are not normal occurrence in babies and children under one year old.

Standard size chart

The sizes of all parts of the brain have standards for each age. Deviation from the average values is not always a pathology, however, doctors still take into account the normal values and, if values exceeding the standards are detected, they prescribe a number of additional examinations.

The norms for the size of parts of the brain in newborns and infants are presented in the table.

Why do the ventricles of a child’s brain enlarge?

The lateral ventricles may increase in size due to impaired circulation of cerebrospinal fluid. The reasons may be:

difficulty in cerebrospinal fluid drainage;
impaired adsorption of cerebrospinal fluid;
overproduction (excessive production) cerebrospinal fluid.

In addition, dilatation (enlargement) of the lateral ventricles can lead to their asymmetry. This is a condition in which parts of the brain are unequally enlarged in size. More often, an increase in the width of the lateral ventricles occurs due to:

infections;
head injuries;
tumors;
hydrocephalus (we recommend reading:);
hematomas;
thrombosis

Hydrocephalus (we recommend reading:)

The ventricles may be asymmetrical due to hemorrhage. The pathology occurs due to compression of one of the ventricles by additional blood flow. In newborns, the condition can be triggered by prolonged stay in the womb after a puncture or rupture of the bladder and development of asphyxia.

Symptoms of pathology

Asymmetry of the cerebral ventricles is accompanied by an increase intracranial pressure, therefore causing a wide variety of symptoms. In this regard, diagnosis can be difficult, and it is difficult to associate them with any disease. In newborns, deviations from the norm are expressed in the following manifestations:

lack of appetite;
lethargy of the limbs;
tremor;
swollen veins on the forehead, temples and back of the head due to obstruction of blood outflow;
lack of reactions required by age: decreased grasping and motor reflexes;
the pupils of the eyes are directed in different directions;
irregularities of the skull;
frequent belching and nausea not associated with food intake.

A child with this diagnosis refuses to breastfeed and often spits up.

Diagnostic methods

Expansion of the cerebrospinal fluid spaces of the brain in children is one of those pathologies that cannot be left to chance. To prescribe competent treatment, you must first make a diagnosis. Modern medicine knows several methods for diagnosing brain conditions. The most informative is considered radiology diagnostics, however it is suitable for children after they have grown bone tissue fontanelles (more details in the article:). Other methods include:

MRI – magnetic resonance imaging. It allows you to get a complete picture of the condition of soft tissues, including the brain, but has many contraindications. For young children, it is prescribed only in extreme cases, because for reliable result It is necessary for the patient to lie still for at least 20 minutes, which infants cannot do. There is a way out - this general anesthesia, but it negatively affects the baby’s health.
An alternative to MRI is diagnosis using a computed tomography scanner - CT. It is carried out much faster and does not require anesthesia, therefore it is the most preferable way to diagnose the condition of the brain in an infant. It has a significant disadvantage compared to MRI - more low quality pictures, especially if we're talking about about small shooting areas. CT scans best show hemorrhage in the interthecal spaces, so a diagnosis can be made quickly and treatment can be prescribed.
NSG, or neurosonography. The procedure allows you to estimate only the size of the ventricles, but does not provide a visual picture. The device is capable of capturing organ sizes from 1 mm, no less.
An additional diagnostic method is to assess the condition of the fundus. During the process, you can see dilated vessels, which will indicate that the patient has increased intracranial pressure.
Cerebrospinal fluid puncture, which is performed in lumbar region spine. By analyzing the taken material, the state of the cerebrospinal fluid is assessed.

MRI of the brain allows you to correctly assess the severity of the pathology (we recommend reading:)

Treatment options

Mild enlargement of the lateral ventricles is treated with medications. More serious cases, as well as if the patient is under 2 years of age, must be treated in a hospital. Older children are sent to outpatient treatment. The neurologist prescribes:

Diuretics that enhance kidney function and help eliminate excess fluid. This reduces the volume of blood in the vessels and the amount of intercellular fluid. Accordingly, cerebrospinal fluid will be produced in smaller quantities and will cease to put pressure on the ventricles, causing them to enlarge.
Nootropics for stimulation cerebral circulation. They are prescribed to prevent fluid from compressing the blood vessels of the brain, which can lead to death. These drugs, in combination with diuretics, help cope with hypoxia and remove excess fluid from the ventricles into the blood, and then out through the kidneys, this helps alleviate the condition of children.
Sedatives. The child may become anxious and stressed, resulting in the production of adrenaline, which increases blood pressure and constricts blood vessels. As a result, hydrocephalus progresses. Sedatives Use only as prescribed by a doctor with strict adherence to dosage.
Drugs to improve muscle tone. Due to increased intracranial pressure, it is reduced, and since the muscles cannot control the stretching of the veins, the latter swell. Except medicines For this purpose, massage and therapeutic exercises are used. You can start doing exercises with your baby to reduce blood pressure under the supervision of a doctor; sudden movements should not be allowed.

If the cause of dilatation or asymmetry of the 3rd and 4th ventricles is an infection caused by bacteria or viruses, such as meningitis, hydrocephalic syndrome may become one of the complications. In this case, you first need to treat the underlying cause of the enlarged ventricles.

Sometimes the deviation in the size of the liquor spaces from the norm is physiological, for example, when the newborn is large. This condition does not require specific treatment; it may only require a course of massage and special physical therapy.

Official medicine does not recognize the treatment of ventricular dilatation using acupuncture, taking homeopathic remedies and other methods of non-traditional intervention. People who engage in such practices, instead of the expected healing, can cause irreparable harm to the child. Taking vitamins is also ineffective, but they can be prescribed as a concomitant tonic in parallel with the main course of treatment.

Complications and consequences for the child

Although dilatation of the ventricles of the brain is not fatal dangerous disease, it can lead to various complications. The most dangerous condition is a rupture of the wall of a vein or ventricle. This pathology leads to immediate death or coma.

Enlargement of the ventricles of the brain may have severe consequences, therefore a child with such a diagnosis should long time be observed in a medical facility

An enlarged ventricle can compress the visual or auditory nerve, leading to partial or complete blindness or deafness. If the compression is due to accumulated fluid, the condition will be reversible and vision or hearing will return when excess liquid will leave this place.

A state of prolonged ventricular dilatation can lead to. The mechanism of seizures is currently not fully understood, but it is known that they appear in various brain lesions.

How younger child who has been diagnosed with dilatation, the greater the chance of full recovery. Less dangerous, but still unpleasant complications include:

delayed speech development, mental and mental development;
urinary and fecal incontinence;
blindness and deafness occurring in episodes.

Dilatation of the chambers of the heart, aorta - prerequisites, symptoms, diagnosis, treatment

Expansion of cavities various organs in the human body is called dilatation. This expansion can be either physiological or pathological. The four-chambered human heart, consisting of 2 atria and 2 ventricles, is also a cavitary organ. As a result of sequential contraction of the myocardium, blood moves through the pulmonary and systemic circulation. Due to a variety of pathological processes, one of the chambers of the heart may expand. However, in some diseases, dilatation of both atria and both ventricles occurs.

Types of pathology

Tonogenic dilatation. This type of expansion develops due to increased pressure in the chambers of the heart as a result of excess blood filling. The muscle wall remains normal for some time.
Myogenic dilatation appears when various changes heart muscle. At the same time, it decreases contractility myocardium.

Left atrium (LA) dilatation

The peculiarity of the left atrium is to pump oxygenated blood into the left ventricle. The blood then goes to the aorta and is distributed throughout the body. Between the atrium and the ventricle there is a kind of cusp - a valve. Dilatation of the left atrium may be a consequence of a pathological change. Blood is difficult to push through the narrow opening. In addition to pulmonary blood, enters the left atrium in reverse blood from the left ventricle. Due to overload, its walls are stretched.

picture: dilatation of the left atrium with mitral valve insufficiency

Dilation of the left atrium does not have its own symptoms, since this condition is not an independent disease. The patient may experience signs of arrhythmia, valve stenosis, or valve stenosis. Among these symptoms: severe pallor of the skin,.

It happens that a person has never had problems with the heart or lungs, has not felt unwell about this, and only learned the diagnosis after an ultrasound examination. I require such cases additional examination patient in order to find the cause (alcoholism, diseases thyroid gland, diabetes mellitus). The patient is registered with a cardiologist, who monitors changes in the size of the heart cavity.

Atrial fibrillation can be both a cause of left atrium dilation and a consequence. The presence of both diagnoses in a patient determines the tactics of medical intervention: there is no point in carrying out correction heart rate if the heart chamber is dilated.

One of the reasons for LA dilatation is. This disease also manifests itself by stretching. The trigger for this can be alcoholism, infections, neuromuscular and autoimmune pathologies. It is not always possible to find the reasons, but even slight dilatation can lead to adverse consequences: acute arrhythmia.

Important! Regardless of the reasons for left atrium enlargement, it is necessary to undergo a full diagnostic examination by a cardiologist and begin the prescribed treatment.

Dilatation of the left ventricle (LV)

The main reasons for the development of left ventricular dilatation include:

Overload of the ventricle with excess blood. From the left atrium, blood is pushed into the left ventricle and then into the aorta - the largest arterial vessel body. Thus, this chamber is a kind of pump that pumps blood through big circle blood circulation With aortic stenosis or narrowing of the aortic valve, the ventricle has difficulty pushing blood and dilates from overload.
Pathology of the muscular wall of the ventricle itself, as a result of which it becomes thinner and stretched.
(inflammatory disease heart muscle). All these misfortunes thin the muscular wall of the left ventricle, make it flabby and lead to stretching.

However, sometimes the disease begins without any reason. When this develops, it is called dilated cardiomyopathy. This diagnosis is made after excluding all possible reasons dilation.

How to treat?

As in the case of treatment of atrial dilatation, dilatation of the left ventricle is cured by eliminating the causes that caused it: ischemic heart disease, defect, hypertension. Sometimes irreversible sclerotic or scarring changes can occur in the heart muscle; treatment in this case is aimed at slowing down the development of the disease.

The treatment of moderate dilatation may be based on metabolic therapy, which affects metabolic processes in cells and tissues, but severe cases still require a more serious approach.

The danger of LV dilatation can come from:

Heart failure;
Arrhythmias;

Not all forms of LV dilatation are amenable to definitive treatment, but timely identification of the problem and correct treatment stops the development of pathology and prolongs the patient’s life.

Right atrium (RA) enlargement

If a person suffers from bronchopulmonary diseases, his bronchi may spasm. The pressure in the vessels of the pulmonary circulation increases, and compensatory expansion right atrium. Among other reasons: infectious lesions myocardium, pulmonary disorders blood vessels, pathological changes heart muscle.

Causes of dilatation of the right ventricle (RV)

One of the reasons is valve insufficiency. This may be a consequence of bacterial or pulmonary hypertension. As a result, the right ventricle becomes overloaded.
Some patients have no pericardium from birth. This sign may also be accompanied by stretching of the muscle wall. Due to this, the pulmonary artery dilates. High blood pressure in this vessel indicates an increase in pressure in the chamber. The result is stretching of the muscle walls of the pancreas.
A pathology such as also leads to pancreatic failure and dilatation. The root cause of the disease is obstructive bronchopulmonary diseases and their resulting hypoxia.
RV dilatation is directly related to pulmonary hypertension.

Pressure in pulmonary artery may increase due to birth defects heart, while pathology of the right ventricle of a different etiology develops. Ventricular hypertrophy in this case can be severe, but it does not lead to RV failure.
One of the causes of isolated dilatation of the right ventricle is arrhythmogenic dysplasia. The etiology of this disease has not been precisely identified; it is congenital and is not accompanied by pulmonary hypertension, hypertrophy or insufficiency of the pancreas. With this disease muscle layer The pancreas is very thin. More often observed in male patients.

Diagnosis of cardiac dilatation

Diagnosis of any disease begins with an analysis of the patient's complaints. As for myocardial dilation, patient complaints of weakness, swelling, and shortness of breath may indicate an advanced form of the disease when heart failure develops. Moderate dilatation is not felt by a person.
One of the diagnostic methods is. With this method, not only the enlarged parts of the heart are identified, but also some of the reasons for these changes: for example, a heart attack unnoticed by the patient. As a result of the study, the diameter of the LV is measured, which normally should not be more than 56 mm. Although there are quite physiological deviations: for example, in a tall athlete the size of the ventricle is slightly increased, and in a short woman, on the contrary, it is decreased. By the way, for such a woman, a diameter of 56 mm can be considered dilatation. Echocardiography is considered the most informative method. Echo signs of dilatation make it possible to identify the size of the heart parts, determine contractility, valvular insufficiency, blood clots in the chambers of the heart, hypokinesia of the heart muscle even with slight dilatation.
Some changes in the heart can be determined by an ECG. However, this method is not informative enough to diagnose dilatation of any cardiac chamber.
To differentiate dilated cardiomyopathy from ischemic heart disease, carry out .

Aortic dilatation

The aorta is the largest vessel in the body, which receives oxygen-rich blood from the left ventricle. A dangerous condition is expansion (dilatation) or. Typically, the aorta dilates at a “weak spot.”

One of the reasons for this condition is arterial hypertension. Inflammation of the aortic wall can also lead to pathology.

The danger of an aneurysm is:

In sudden rupture of the aorta. This creates a strong internal bleeding life-threatening.
In the formation of blood clots. This condition is also extremely life-threatening.

More often, an aortic aneurysm is discovered during examination by chance. But still, some signs are sometimes present:

Unreasonable sore throat and cough.
Hoarseness of voice.
Difficulty swallowing due to compression of the esophagus.
When the aorta ruptures, there is severe chest pain that spreads to the neck and arms. The prognosis in this case is unfavorable - the person dies quickly.

Aortic dilatation does not develop immediately. This is a long process, as a result of which the vessel wall undergoes gradual changes. Timely detection pathology can prevent the terrible consequences of the disease.

In addition to the aorta, more small vessels. This occurs due to abnormally increased blood volume, exposure to hormones, or chemicals. Vascular dilatation leads to circulatory disorders, which affects the functioning of all body systems.

Basics of prevention

Both congenital and acquired pathologies lead to dilatation of the arteries and chambers of the heart. However there are several simple rules, following which you can prevent or stabilize the disease:

Quitting smoking and overuse alcohol;
Moderate nutrition;
Non-admission physical fatigue and nervous overload.

Before answering the question why the ventricles of a child’s brain are enlarged, you should have an idea of what these ventricles are.
The cerebral ventricles are the whole system, interconnected cavities in the brain, necessary for the deposition of cerebrospinal fluid (CSF).

What are they?

Lateral ventricles. They are the same containers in the brain intended for depositing cerebrospinal fluid. In size, the lateral ventricles are superior to all others. The ventricle located on the left side is designated as the first, and the one located on the right is designated the second. Both lateral ventricles communicate with the third ventricle using special (Monroy) foramina. The location of these ventricles is on the lateral sides, slightly below the corpus callosum. The lateral ventricles contain the anterior, posterior, inferior horns and body.

Fourth ventricle. Is very important education brain, and is located between medulla oblongata and the cerebellum. In terms of its structure, the fourth ventricle looks like a rhombus, but many associate its shape with the shape of a tent with a roof and bottom. The very bottom of the fourth ventricle has a diamond shape, which is why it is called the rhomboid fossa. In this anatomical education the spinal canal is located, as well as the canal connecting the fourth ventricle with the aqueduct.

In addition to the storage function, the cerebral ventricles also perform a formative function, namely the formation of cerebrospinal fluid. Normally, the synthesized cerebrospinal fluid should exit into the subarachnoid space, but there are situations when this process fails. If the body's normal flow of cerebrospinal fluid from the ventricles is disrupted, the condition is called hydrocephalus.

What does ventricular dilatation mean in a child?

You should not always panic if such a condition occurs. An increase in the size of the ventricles of the brain in a child does not always signal the presence of a pathological process. This process may be physiologically determined, and it only means that the child simply has a large head size. Enlargement of the ventricles of the brain is not uncommon in children under the first year of life. In this case, it is imperative to establish the sizes of not only all ventricles, but also the remaining liquor systems.
Excessive accumulation of cerebrospinal fluid is the basis of why the ventricles of the brain may be enlarged in an infant or child early age. Disruption of the outflow of cerebrospinal fluid can be caused by a certain obstacle in the way of its exit.

A condition such as enlargement of the ventricles of the brain in a child is most often observed in children born ahead of schedule. This is due to the fact that in such children the size of the lateral ventricles is comparatively larger than in children born according to their term. If there is a suspicion of enlargement or asymmetry of the lateral ventricles, it is necessary to measure them and determine qualitative characteristics. Let us consider in more detail the conditions in which an increase in the size of the ventricles of the brain in children is possible.

Ventriculomegaly

This pathology means an enlargement of the cavities of the cerebral ventricles, as a result of which a number of disorders of the functions of the central nervous system develop. Most often, this pathology affects the lateral ventricles of the brain.

Types of ventriculomegaly

According to severity, this disease can be divided into severe, moderate and mild forms. Depending on the location of the pathological process, ventriculomegaly is divided into the following types:

Side shape. With this form, the lateral and posterior ventricle enlarges.
Type No. 4. Affects the area of the cerebellum and medulla oblongata.
Type No. 3. Pathological process localized in the area between the visual hillocks and the frontal part.

Why does it occur

The main reason for the development of this process is chromosome abnormalities in the body of a pregnant woman. Secondary causes of the development of the disease include all kinds of infections.

Main symptoms

Such a complex pathology can cause the child to develop Turner and Down syndromes. Moreover, ventriculomegaly affects the structure of the brain and heart.

Diagnostics

Pathological enlargement of the ventricles of the brain is determined using ultrasound diagnostics of the brain.

Treatment

The key point in the treatment of this pathology is the maximum prevention of the development of possible complications from organs and systems. First of all, it is carried out drug therapy, which includes taking diuretics, vitamin preparations and antihypoxants. Additional methods include massage and special therapeutic exercises. To prevent the development of serious neurological complications, it is recommended to take drugs that retain potassium ions in the child’s body.

One more cannot be ruled out. possible option pathology in which the ventricles of the brain in an infant will be dilated, namely hypertensive-hydrocephalic syndrome (HHS).

What is

This syndrome refers to a condition characterized by excessive production of cerebrospinal fluid, which tends to accumulate under the membranes of the brain and in its ventricles. In terms of frequency of occurrence, hypertensive-hydrocephalic syndrome is a rather rare pathology and requires serious justification.

What is it like?

Classify this pathology according to the age of the children, and the HGS of newborn children and older children are distinguished.

Why does it occur

All causes of the appearance of HGS can be divided into congenital and acquired. TO congenital reasons can be attributed:

Complicated course of pregnancy followed by complicated childbirth.
Damage to the child’s brain due to intrauterine oxygen deprivation, developmental defects and birth trauma.
Childbirth before the due date.
Intrapartum trauma followed by hemorrhage into the subarachnoid space.
Any intrauterine infections.
Anomalies of brain development.
Late birth.
Long period of time between departures amniotic fluid and expulsion of the fetus.
Some chronic diseases mother.

Acquired causes of HGS include:

Any tumor formations of the brain (cysts, hematomas, abscesses).
Availability foreign body in the brain.
Fractures of the cranial bones with subsequent penetration of bone particles into the brain.
Infectious diseases.
Unknown cause of HGS.

How does the disease manifest itself?

At the core of everything clinical picture Hypertension-hydrocephalic syndrome is based on the following factors:

Increased intracranial pressure (hypertension).
An increase in the amount of cerebrospinal fluid in the ventricles of the brain (hydrocephalus).

In newborns, HGS can be suspected based on a number of factors: the following signs:

The child refuses breastfeeding, cries and is capricious for no particular reason.
Overall muscle tone decreases.
Shaking (tremor) of the upper lower limbs.
All sharply reduced innate reflexes, such as swallowing and grasping.
There is frequent regurgitation.
Strabismus develops.
During medical examination A child may have a rising sun symptom, when the child's iris is half covered by the lower eyelid.
There is a divergence of the cranial sutures, in particular the sagittal one.
The fontanelles are tense and bulging.
Every month there is a pathological increase in head circumference.
During fundus examination, swelling of the optic discs is clearly visible.

In older children, the manifestation of symptoms of HGS develops immediately after the infectious process or traumatic brain injury.
Most characteristic feature enlargement of the ventricles of the brain in a child and the development of the HGS is the appearance of a headache, which most often appears in the morning. Also characteristic constant nausea and vomiting. The headache is of a pressing or bursting nature, and is localized in the temples or forehead.

Often such children complain about the inability to raise their eyes up and at the same time lower their heads down. Cases of dizziness are also common. During characteristic attacks, the child’s skin becomes pale and general weakness and reluctance to do anything. Loud sounds and bright lights are strong irritants for such children.

For the reason increased tone in the muscles of the lower extremities, such children can walk on their toes, they develop strabismus, it is noted increased drowsiness and slowing of psychomotor development.

How to diagnose

In general, carry out accurate diagnosis hypertensive-hydrocephalic syndrome, and it is quite difficult to understand whether the ventricle of the brain is really enlarged in a newborn. Not always, even the most latest methods diagnostics allow us to make this diagnosis with 100% accuracy. In children in the neonatal period, the main diagnostic criteria are indicators of head circumference and control of reflexes. To others diagnostic measures can be attributed:

Condition assessment vascular network fundus for swelling, hemorrhage or spasm.
Carrying out neurosonography to determine the size of the ventricles of the brain.
MRI and computed tomography brain.
Lumbar puncture to determine cerebrospinal fluid pressure. This method is the most reliable.

Treatment Options

Treatment of this pathology should be carried out by a neuropathologist together with a neurosurgeon. Children with this syndrome should be under constant medical supervision to avoid possible complications and worsening of the condition. In newborns up to six months, enlargement of the ventricles of the brain and the HPA is treated on an outpatient basis. The main therapeutic measures include:

Taking diuretics (diuretics), as well as medicines, reducing the production of cerebrospinal fluid (Diacarb).
Inclusion of nootropic drugs in therapy. This group of drugs improves blood supply to the brain.
Taking sedatives.
Special gymnastics and massage.

Treatment of children infancy is long-lasting and serious. Sometimes this takes several months.

In older children, treatment of HGS is pathogenetic in nature, and the selection of therapy is carried out according to the cause that caused it. this syndrome. If the disease occurs after an infection, then the therapy must include the use of antibacterial or antiviral drugs.
If the cause of HGS was a traumatic brain injury or tumor process, then surgical intervention cannot be ruled out.

Possible complications

A condition such as hypertensive-hydrocephalic syndrome can cause a number of complications from various organs and systems. Such complications include:

Delayed psychomotor development.
Complete or partial blindness.
Persistent hearing impairment up to deafness.
Development of coma.
Complete or partial paralysis.
Abnormal bulging of the fontanelle.
Development of epilepsy attacks.
Incontinence of feces and urine.
Fatal outcome.

The prognosis for children during infancy is considered to be most favorable. This is due to periodic increases in blood and intracranial pressure, which return to normal with age. For older children, the prognosis is less favorable, and depends solely on the cause that led to the development of HGS, as well as the approach to treatment.

At pathological course Dilatation may develop during pregnancy or childbirth - this is if the paired or unpaired ventricles of the brain in an infant are enlarged. In such cases, immediate treatment is necessary. Up to a year possible full recovery the functioning of the ventricular system and the baby’s recovery.

What is it

To store and collect cerebrospinal fluid, the human brain has 2 paired and 2 unpaired ventricles. Each of them contains a reservoir for cerebrospinal fluid. Features of each element of the ventricular system:

The first (left) ventricle and the second (right) ventricle. They consist of three pairs of horns and a body, connected to each other. Dilatation of the lateral ventricles is often diagnosed in newborns. Liquid accumulates in the horns or body of the cerebrospinal fluid collectors.

Third ventricle connected to the paired ones and located between their anterior and lower horns.

Fourth ventricle (rhomboid fossa) collects all the liquid from the three previous elements. From it, the fluid is distributed along the spinal or central canal.

The growth of the ventricles occurs gradually, consistent with the linear dimensions of the skull. However, in the presence of provoking factors, dilatation of the third or fourth collector for cerebrospinal fluid occurs. Sometimes on ultrasound examination the expectant mother may notice the presence of the 5th ventricle. This is the norm.

Ventricular system

The ventricular system is designed to store and secrete cerebrospinal fluid. At proper operation In the tanks of its collectors, cerebrospinal fluid collects from the surrounding veins. From there, the cerebrospinal fluid is distributed into the subarachnoid space.

An enlargement of one of the ventricles in an infant is not always pathological. Minor deviations in their size are due to the baby’s large head at birth. Expansion of the elements of the ventricular system is observed up to one year of age. When a pathology is detected, it is recommended to measure the entire liquor apparatus.

Disruption of the outflow from the ventricles of the brain occurs due to the appearance of an obstruction to the excretion of cerebrospiral fluid. With prolonged accumulation of fluid, an enlarged head and a hydrocephalic condition of the infant are observed. Which leads to disruption of brain function. These disorders occur due to pathological or premature birth, head injury of a newborn.

Indicators of normal sizes

The sizes of the ventricles are determined by ultrasound examination of the infant's brain. At the slightest deviation, there is a risk of cerebrospinal fluid stagnation.

Normal indicators of the elements of the ventricular system in newborns:

Lateral (first and second): 4 mm. Features of paired elements: front horns - up to 4 mm, rear horns up to 15 mm, lateral bodies 4 mm each.
Third: 5 mm.
Normal fourth ventricle measurements range from 3 to 6 mm.

Brain structures in healthy children should grow symmetrically and gradually. Indicators are calculated depending on the linear dimensions of the skull. If one of the ventricles is larger than normal, it is necessary to examine the entire liquor apparatus and make sure of the asymmetry of the paired or pathological increase unpaired elements.

Hydrocephalic-hypertensive syndrome

When fluid is retained in the ventricles of the brain, their volume increases and intracranial pressure increases. With hydrecephalic-hypertensive syndrome, disruption and atrophy of the hemispheres occurs.

The causes of the pathology are as follows:

Congenital hydrocephalus: fetal hypoxia, pathological childbirth, birth of a child before 35 weeks, maternal infection or virus during pregnancy, genetic pathologies of brain development.

Acquired hydrocephalus: infection, neoplasms in the ventricles, head trauma, disruption of the integrity of the bones of the skull and brain.

A newborn with this syndrome is characterized by tearfulness, impaired motor skills and retardation in physical and psycho-emotional development. There is a gradual or sharp enlargement of the head, the bones of the skull diverge, and the fontanelle protrudes.

It is also necessary to pay attention to a baby who has strabismus, who often spits up, is capricious in the morning, and reacts negatively to bright lights and loud sounds.

If dilatation of the left ventricle is diagnosed in newborns up to six months, it is possible inpatient treatment. The child is prescribed sedatives, diuretics and nootropic drugs. Massage and gymnastic exercises are required.

Ventriculomegalic state

Enlarged and dilated ventricles affect the functioning of the central nervous system. If the changes evenly affected every element of the liquor structure, this is the norm. There are types and degrees of severity of the ventriculomegalic condition.

Based on localization, the following types of pathology are distinguished:

Enlargement of the rear or side (left, right) element.

Enlargement affecting the visual thalamus and frontal region of the brain.

Enlargement of the fourth ventricle, which affects the cerebellum and medulla oblongata.

The main causes of this congenital condition are abnormal development of the fetus due to abnormalities in the chromosomal sequence. Other factors are associated with abnormal birth, head trauma, or infections affecting the brain.

After ultrasound diagnosis of the brain in newborns, diuretic, potassium-containing and vitamin medications are prescribed. Lack of adequate treatment leads to the development of Down syndrome, Turner syndrome, genetic mutation Edwards.

The child will not be able to live a full life, since the dilated ventricles will negatively affect the brain and heart.

Causes of dilatation

Dilatation may occur in utero or develop gradually after an abnormal birth or head injury. Even the smallest changes in the size of the liquor structures can lead to serious consequences. Their increase leads to increased intracranial pressure, which provokes hydrocephalus.

The main causes of dilated paired or unpaired ventricles of the brain in infants:

Pathological pregnancy: lack of oxygen, early placental abruption.
Early labor, prolonged labor, lack of labor activity.
Head injury during childbirth, due to a fall, blow, accident.
Benign and malignant tumors in the brain that obstruct the outflow of fluid.
Cyst formation.
Foreign bodies entering the brain.
Past infectious diseases.
Subdural and subarachoid hemorrhages leading to ventricular asymmetry.

Dilatation in infants leads to diseases of the nervous system and developmental disorders. It is possible to detect pathology in the first days of the child and mother’s stay in the neonatal unit. Therefore, it is possible to prevent the development of serious complications.

Symptoms of enlargement

Manifestations of enlarged ventricles are not noticeable with minor changes. With the gradual accumulation of fluid, disturbances in the functioning of the central nervous system, heart, organs of vision and hearing are observed.

Based on the following signs, doctors may suspect dilatation in a newborn:

lack of appetite and frequent regurgitation;
tremor of the chin, arms and legs;
epileptic seizures;
motor impairment;
retardation in mental and physical development;
strabismus and other visual impairments;
pale skin;
the appearance of enlarged veins on the forehead, temples and head;
the head enlarges, the bones of the skull diverge.

If ventricular enlargement occurs at an older age, the child may complain of nausea and headache. Coordination problems, hallucinations, and memory loss are also observed. The presence of certain symptoms may depend on the degree of dilation of the cerebral ventricles and the location of the pathology.

Diagnostics

Disease detection includes instrumental examinations. Such diagnostic measures make it possible to accurately determine the size and depth of the ventricles and the degree of fluid accumulation in them. If there are external changes in the outline of the skull or when characteristic symptoms The doctor prescribes the following procedures:

Fundus examination to examine the condition of blood vessels and identify visual impairments.

Neurosonography to determine the size of each of the paired ventricles.

Magnetic resonance therapy for older children. Prescribed when it is difficult to diagnose a child’s condition using other methods.

Computed tomography to detect subtle changes in the size of the ventricles.

Ultrasound examination of the child’s brain to identify echo signs of ventricular dilatation. In addition to accurate measurements of cerebrospinal fluid structures, it is possible to determine the volume of accumulated cerebrospinal fluid.

Puncture of cerebrospinal fluid to determine its composition and nature.

Only after an examination can a doctor prescribe adequate treatment. If the changes are minor and symmetrical, it is prescribed constant surveillance for the child's condition. Identified cysts can resolve on their own during the first year of life.

How is an ultrasound performed on infants?

An ultrasound examination is carried out through the child’s non-overgrown fontanel. Therefore, after a year, when the bones of the skull grow together, a computed tomography or MRI is prescribed.

The procedure is carried out according to the following algorithm:

Treatment of the spring with a special gel that promotes the penetration of ultrasonic rays.
Setting up the device based on the age of the child being examined.
Brain examination and recording of results.

Based on the presented conclusion, you should not make a diagnosis yourself. After studying the results, examining the child, recording accompanying symptoms developmental disorders of the brain, treatment will be prescribed.

Interpretation of ultrasound results

The results are interpreted by the attending physician; sometimes a consultation with a neurosurgeon is required. If the examination reveals that the baby’s ventricles are dilated, but pathological symptoms missing, you need to be examined again.

In addition to the size and depth of the elements of the liquor apparatus, which were mentioned above, we provide the following indicators: the interhemispheric gap should be no more than 3 mm;
subarachnoid space about 3mm.

These measurements indicate the condition of the ventricles and the degree of dilatation. If they are greatly enlarged, there are disturbances in the structures of the brain. The lateral ventricles should not exceed 4 mm, otherwise hydrocephalus is diagnosed.

Treatment of the disease

Dilatation therapy includes drug treatment and physiotherapeutic procedures.

For the treatment of enlargement of the lateral and unpaired ventricles of the brain of newborns, the following is prescribed: diuretics to reduce the production of cerebrospinal fluid; nootropics to improve blood circulation; Central sedatives nervous system; gymnastics and massage of the child to improve the child’s condition and relieve muscle tone; vitamin complexes to prevent rickets.

If the enlargement of the ventricles is a consequence of an infectious disease, antibiotics and antiviral drugs are prescribed. In case of violations of the integrity of the skull and brain, surgical treatment is performed.

Consequences and complications

The consequences of an enlarged cerebral ventricle can be different. It all depends on the degree of expansion and localization of the pathology. The main complications that can occur if medical recommendations are not followed:

loss of vision and hearing;
impaired coordination, lack of physical and mental activity;
lagging behind peers;
paralysis;
constant growth of the head, deformation of the bones of the skull;
epileptic seizures and loss of consciousness;
hallucinations;
hemorrhagic shock;
paralysis;
lethal outcome.

If an ultrasound reveals a slight enlargement of the ventricles, but the baby is not capricious and develops according to the norm, a repeat examination is scheduled. To avoid the development of possible complications, do not ignore doctor’s orders. Go through everything necessary examinations and treat the child.