Expansion of the horns of the lateral ventricles. Dilatation of the lateral ventricles of the brain

However, certain deviations from the norm can cause the development of neurological pathologies. One such condition is asymmetry of the lateral ventricles of the brain. This disease may not cause clinical symptoms, but in some cases it indicates the presence of a number of diseases.

What are the ventricles of the brain, their role

The ventricles of the brain are strips of tissue necessary for the deposition of cerebrospinal fluid. External and internal factors may lead to their increase in volume. The lateral ventricles are the largest. These formations participate in the formation cerebrospinal fluid.

Asymmetry is a condition in which one or both cavities are enlarged to varying degrees.

1. Lateral. The ventricles are the most voluminous, and they contain cerebrospinal fluid. They connect to the third ventricle via the interventricular foramina.
2. Third. Located between the visual tuberosities. Its walls are filled with gray matter.
3. Fourth. Located between the cerebellum and medulla oblongata.

Causes of dilatation

Enlargement or dilatation of the lateral ventricles of the brain occurs due to increased output cerebrospinal fluid. This leads to the fact that it cannot be excreted normally.

This, in turn, leads to disruption of the flow of cerebrospinal fluid. This disease most often occurs in premature babies, but is observed in people of any age.

What causes the disorder in newborns?

This is how dilatation of the lateral ventricles looks schematically

Dilatation of the lateral ventricles of the brain in infants is often a sign of hydrocephalus, and can also be caused by a number of other reasons.

In newborns, asymmetry is caused by trauma or space-occupying lesions in the brain. Regardless possible reason, an urgent consultation with a neurosurgeon is required.

Mild asymmetry can be congenital pathology which does not cause symptoms. In this case, only constant monitoring is required so that the difference between the ventricles does not change.

The main causes of dilatation include:

• viral and other diseases of a woman during pregnancy;
• oxygen starvation of the fetus;
• premature birth;
• birth injuries;
• malformations of the central nervous system.

Ventricular asymmetry can also result from hemorrhage. This pathology occurs due to compression of one of the ventricles by an additional volume of blood. Due to hemorrhage, the ventricles of the brain in an infant may be enlarged for the following reasons:

• various maternal diseases, for example, type I diabetes or heart defects;
• intrauterine infections;
• long time between the time the water broke and the baby was born.

The most common cause of dilatation is hypoxia. Other causes account for less than 1% of cases. It is hypoxia that leads to the accumulation of cerebrospinal fluid, which, in turn, increases intracranial pressure. This leads to expansion of the cavity of the lateral ventricles.

Risk zone for adult patients

A change in the size of the lateral ventricles leads to disruption of the circulation of cerebrospinal fluid. Asymmetry of the lateral ventricles of the brain in adults occurs for the following reasons:

Provoking diseases

The main disease causing this pathology is hydrocephalus. It can interfere with the absorption of cerebrospinal fluid. This leads to its accumulation in the lateral ventricles.

Excessive formation of cerebrospinal fluid is also observed with serious lesions of the central nervous system. Poor circulation is also associated with the formation of cysts, tumors and other neoplasms.

A common cause of hydrocephalus is a defect of the Sylvian aqueduct. If this defect was discovered during the prenatal period, termination of pregnancy is recommended. At the birth of a child, complex systematic treatment will be required.

Another cause is aneurysm of the vein of Galev and Arnold-Chiari syndrome. However, in children, the disease can be caused by rickets or due to the specific structure of the skull, so observation by a specialist is important if there is a predisposition to the disease.

Symptoms and diagnosis of the disorder

In adults, ventricular asymmetry rarely causes symptoms. However, in some cases, this anomaly can cause the following symptoms:

In addition to these symptoms, the picture of the disease can be supplemented by symptoms of diseases that caused ventricular asymmetry.

Such symptoms include cerebellar disorders, paresis, cognitive impairment or sensory disorders.

In infants, symptoms depend on the severity of the pathology. In addition to general discomfort, symptoms such as throwing back the head, regurgitation, increased head size and others may occur.

Symptoms of the pathology also include strabismus, refusal to breastfeed, frequent crying, anxiety, tremors, and decreased muscle tone.

However, quite often the pathology does not cause characteristic symptoms and can only be detected after an ultrasound scan.

Health care

Dilatation of the lateral ventricles of the brain itself does not require treatment. It is prescribed only in the presence of symptoms characteristic of the pathology. Treatment is aimed at eliminating the disease that is causing the dilatation.

The following drugs are used to treat ventricular asymmetry:

• diuretics;
• nootropic substances;
• anti-inflammatory drugs;
• vasoactive drugs;
• neuroprotectors
• sedatives;
• if the disease is caused by infections, antibacterial agents are prescribed.

If the pathology is caused by a cyst or tumor, their removal is required. If the patient's condition quickly deteriorates, an operation is performed to form a new connection of the ventricular system, which will bypass the anomaly.

Most often, ventricular dilatation occurs in infants. In the absence of timely and competent therapy, dilatation may persist and even worsen. With mild dilatation and the absence of obvious symptoms, the condition does not require special treatment. All that is needed is constant monitoring of the size of the asymmetry, as well as the general condition of the child.

In the event that the disease is caused by injury, violation intrauterine development, infection or tumor, requires constant monitoring of the patient, treatment of symptoms, and, if possible, elimination of the causes of the pathology.

The child is treated by a neurologist together with a neurosurgeon. To minimize the risk of complications, a child with this diagnosis should be constantly monitored by doctors. Most often, diuretics are prescribed for treatment, which promote the production of cerebrospinal fluid, which puts pressure on the lateral ventricles.

Additionally, it requires taking medications to improve blood supply to the brain, and sedatives are prescribed.

A massage is required, physiotherapy and other methods of physiotherapy. Infants with this diagnosis are observed on an outpatient basis. Treatment of the pathology may take several months.

Older children are treated depending on the cause of the pathology. An appointment is scheduled antimicrobials, if the cause of asymmetry is a brain infection. In case of tumors, cysts and other formations, surgery is prescribed.

Mild pathology most often does not cause any symptoms. IN in rare cases there may be a slight delay motor sphere, however, it also goes away completely over time. A severe form of the pathology can lead to cerebral palsy as a result of high intracranial pressure.

Asymmetry of the lateral ventricles of the brain is not the most dangerous, but it requires attention pathology that occurs in people of any age.

If you encounter this problem, you should visit experienced specialist, who will prescribe the appropriate tests to confirm the diagnosis. Treatment consists of eliminating the cause of dilatation, as well as reducing intracranial pressure.

This section was created to take care of those who need qualified specialist without disturbing the usual rhythm of your own life.

Hydrocephalus of the brain in adults: causes, symptoms, treatment

Hydrocephalus in adults (“dropsy of the brain”) is a pathological condition characterized by excessive accumulation cerebrospinal fluid (CSF) in the cerebrospinal fluid spaces of the brain. Hydrocephalus can be an independent nosological entity, or it can be a consequence various diseases brain. It requires mandatory qualified treatment, since the long-term existence of the disease can lead to disability and even death.

The disease in children differs significantly from the manifestations of the disease in adults due to the fact that children's body The brain is still developing. In this article we will look at the causes, symptoms and treatment of hydrocephalus of the brain in adults.

Causes

Each person in the brain has special spaces containing a special liquid - cerebrospinal fluid. Inside the brain itself there is a system of brain ventricles communicating with each other, outside the brain there is a subarachnoid space with brain cisterns. Liquor performs very important functions: protects the brain from blows, jolts and infectious agents (the latter thanks to the antibodies it contains), nourishes the brain, participates in the regulation of blood circulation in the closed space of the brain and skull, ensures homeostasis due to optimal intracranial pressure.

The volume of cerebrospinal fluid in an adult is ml, and it is renewed several times a day. Cerebrospinal fluid production occurs in choroid plexuses ventricles of the brain. From the lateral ventricles of the brain (containing approximately 25 ml), cerebrospinal fluid flows through the foramen of Monro into the third ventricle, whose volume is 5 ml. From the third ventricle, the cerebrospinal fluid moves to the fourth (also contains 5 ml) along the aqueduct of Sylvius (aqueduct of the brain). At the bottom of the fourth ventricle there are openings: the median unpaired Magendie and two lateral Luschka. Through these openings, cerebrospinal fluid enters the subarachnoid space of the brain (located between the pia mater and the arachnoid membrane of the brain). On the basal surface of the brain, the subarachnoid space expands, forming several cisterns: cavities filled with cerebrospinal fluid. From the tanks, cerebrospinal fluid flows to the outer (convexital) surface of the brain, as if “washing” it from all sides.

Absorption (resorption) of cerebrospinal fluid occurs in venous system brain through arachnoid cells and villi. The accumulation of villi around the venous sinuses is called pachion granulations. Part of the cerebrospinal fluid is absorbed into lymphatic system at the level of the nerve sheaths.

Thus, the cerebrospinal fluid produced in the choroid plexuses inside the brain washes it from all sides and is then absorbed into the venous system, this process is continuous. This is how circulation occurs normally, the amount of fluid produced per day is equal to that absorbed. If “problems” arise at any stage, either with production or with absorption, then hydrocephalus occurs.

The causes of hydrocephalus can be:

• infectious diseases of the brain and its membranes - meningitis, encephalitis, ventriculitis;
• brain tumors of stem or peri-stem localization, as well as brain ventricles);
• vascular pathology of the brain, including subarachnoid and intraventricular hemorrhages as a result of rupture of aneurysms, arteriovenous malformations;
• encephalopathies (alcoholic, toxic, etc.);
• brain injuries and post-traumatic conditions;
• malformations of the nervous system (for example, Dandy-Walker syndrome, stenosis of the Sylvian aqueduct).

Types of hydrocephalus

Hydrocephalus can be congenital or acquired. Congenital, as a rule, manifests itself in childhood.

Depending on the development mechanism, there are:

• closed (occlusive, non-communicating) hydrocephalus - when the cause is a violation of the flow of cerebrospinal fluid due to an overlap (block) of the cerebrospinal fluid pathways. More often, the normal flow of cerebrospinal fluid is interfered with by a blood clot (due to intraventricular hemorrhage), part of a tumor or adhesion;
• open (communicating, disresorptive) hydrocephalus - based on impaired absorption into the venous system of the brain at the level of arachnoid villi, cells, pachyonic granulations, venous sinuses;
• hypersecretory hydrocephalus - with excessive production of cerebrospinal fluid by the choroid plexuses of the ventricles;
• external (mixed, ex vacuo) hydrocephalus - when the content of cerebrospinal fluid is increased both in the ventricles of the brain and in the subarachnoid space. IN last years this form is no longer classified as hydrocephalus, since the reason for the increase in cerebrospinal fluid content is atrophy of brain tissue and a decrease in the brain itself, and not in disruption of the circulation of cerebrospinal fluid.

Depending on the level of intracranial pressure, hydrocephalus can be:

• hypertensive – with increased cerebrospinal fluid pressure;
• normotensive - with normal blood pressure;
• hypotensive – with low cerebrospinal fluid pressure.

Based on the time of occurrence, they are distinguished:

• acute hydrocephalus – the development period of the process is up to 3 days;
• subacute progressive – develops within a month (some authors consider the period to be 21 days);
• chronic - from 3 weeks to 6 months and above.

Symptoms

The clinical picture depends on the period of formation of hydrocephalus and the level of cerebrospinal fluid pressure, the mechanism of development.

In acute and subacute occlusive hydrocephalus, a person complains of a headache, more pronounced in the morning (especially after sleep), accompanied by nausea and sometimes vomiting, which brings relief. There is a feeling of pressure on eyeballs from the inside, there is a burning sensation, “sand” in the eyes, the pain is bursting in nature. Injection of scleral vessels is possible.

As the cerebrospinal fluid pressure increases, drowsiness occurs, which serves as a poor prognostic sign, as it indicates an increase in symptoms and threatens loss of consciousness.

Possible deterioration of vision, a feeling of “fog” before the eyes. Congestive optic discs are detected in the fundus.

If the patient does not apply for medical care, then a continued increase in the content of cerebrospinal fluid and intracranial pressure will lead to the development of dislocation syndrome - a life-threatening condition. It manifests itself by rapid depression of consciousness up to coma, paresis of upward gaze, divergent strabismus, and suppression of reflexes. These symptoms are characteristic of compression of the midbrain. When compression of the medulla oblongata occurs, symptoms of swallowing disorders appear, the voice changes (to the point of loss of consciousness), and then cardiac activity and breathing are depressed, which leads to the death of the patient.

Chronic hydrocephalus is often communicating and with normal or slightly increased intracranial pressure. It develops gradually, months after the causative factor. Initially, the sleep cycle is disrupted, and either insomnia or drowsiness appears. Memory deteriorates, lethargy and fatigue appear. General asthenia is characteristic. As the disease progresses, mnestic (cognitive) impairments worsen, leading to dementia in advanced cases. Patients cannot care for themselves and behave inappropriately.

The second typical symptom of chronic hydrocephalus is difficulty walking. At first, the gait changes – it becomes slow and unstable. Then comes uncertainty when standing and difficulty starting to move. In a lying or sitting position, the patient can imitate walking or riding a bicycle, but in vertical position this ability is instantly lost. The gait becomes “magnetic” - the patient seems to be glued to the floor, and, having moved from his place, he takes small shuffling steps on widely spaced legs, marking time. These changes are called “gait apraxia.” Rising muscle tone, in advanced cases, muscle strength decreases and paresis appears in the legs. Balance disorders also tend to progress to the point of being unable to stand or sit independently.

Often patients with chronic hydrocephalus complain of frequent urination, especially at night. Gradually, an imperative urge to urinate begins, requiring immediate emptying, and then urinary incontinence.

Diagnostics

The main role in establishing the diagnosis belongs to computed tomography (CT) and magnetic resonance imaging (MRI). These methods make it possible to determine the shape and size of the ventricles, subarachnoid space, and brain cisterns.

X-ray of the cisterns at the base of the brain allows one to assess the direction of the cerebrospinal fluid flow and clarify the type of hydrocephalus.

It is possible to conduct a trial diagnostic lumbar puncture with the removal of ml of cerebrospinal fluid, which is accompanied by a temporary improvement in the condition. This is due to the restoration of blood supply to ischemic brain tissue against the background of a decrease in intracranial pressure. This serves as a favorable prognostic sign when predicting surgical treatment of hydrocephalus. You should know that in case of acute hydrocephalus, lumbar puncture is contraindicated due to high risk herniation of the brain stem and the development of dislocation syndrome.

Treatment

The initial stages of hydrocephalus can be treated with medication. The following medications are used for this:

• to reduce intracranial pressure and remove excess fluid (provided that the outflow of cerebrospinal fluid is preserved) - diacarb (acetazolamide), mannitol and mannitol in combination with furosemide or lasix. Mandatory for this treatment is the correction of potassium levels in the body, for this they use asparkam (panangin);
• To improve the nutrition of brain tissue, Cavinton (vinpocetine), Actovegin (solcoseryl), gliatilin, choline, cortexin, Cerebrolysin, Semax, Memoplant, etc. are indicated.

Clinically advanced hydrocephalus is subject to surgical treatment, medicinal methods improve the condition for a short time.

Acute hydrocephalus, like life-threatening condition requires immediate neurosurgical treatment. It consists of craniotomy and the application of external drainages to ensure outflow excess fluid. This is called external ventricular drainage. In addition, through the drainage system it is possible to administer drugs that dilute blood clots (since intraventricular hemorrhage is one of the most common reasons acute hydrocephalus).

Chronic hydrocephalus requires cerebrospinal fluid shunting operations. This type of surgical treatment involves the removal of excess cerebrospinal fluid into the natural cavities of the human body using a complex system of catheters and valves (abdominal cavity, pelvic cavity, atrium, etc.): ventriculoperitoneal, ventriculoatrial, cystoperitoneal shunting. Unimpeded absorption of excess cerebrospinal fluid occurs in the body cavities. These operations are quite traumatic, but when performed correctly, they allow patients to recover and achieve their labor and social rehabilitation.

Today, the less traumatic neuroendoscopic technique has taken first place among invasive treatment methods. It is still more often performed abroad due to the high cost of the operation itself. This method is called: endoscopic ventriculocisternostomy of the bottom of the third ventricle. The operation lasts only 20 minutes. With this method of treatment, injected into the ventricles of the brain surgical instrument with a neuroendoscope (camera) at the end. The camera allows you to display an image using a projector and accurately control all manipulations. An additional hole is created at the bottom of the third ventricle, connecting to the cisterns of the base of the brain, which eliminates the cause of hydrocephalus. Thus, the physiological fluid flow between the ventricles and cisterns is restored.

Consequences

Hydrocephalus is dangerous disease, ignoring the symptoms of which is fraught with disability or even a threat to life. The fact is that the changes that occur in the brain as a result of the long-term existence of hydrocephalus are irreversible.

Untimely treatment can result in a tragedy for a person: loss of ability to work and social significance. Mental impairment, mobility problems, urination problems, decreased vision, hearing, epileptic seizures, - here is the list of possible consequences of hydrocephalus if its treatment is not started in a timely manner. Therefore, at the slightest suspicion of hydrocephalus, it is necessary to seek qualified medical help.

TVC, program “Doctors” on the topic “Hydrocephalus”

The ventricles of the brain are considered an anatomically important structure. They are presented in the form of peculiar voids, lined with ependyma and communicating with each other. During development, brain vesicles are formed from the neural tube, which are subsequently transformed into the ventricular system.

Tasks

The main function performed by the ventricles of the brain is the production and circulation of cerebrospinal fluid. It provides protection to the main parts of the nervous system from a variety of mechanical damage, maintaining a normal level of cerebrospinal fluid takes part in the delivery nutrients to neurons from circulating blood.

Structure

All ventricles of the brain have special choroid plexuses. They produce liquor. The ventricles of the brain are connected to each other by the subarachnoid space. Thanks to this, the movement of cerebrospinal fluid occurs. First, from the lateral ones it penetrates into the 3rd ventricle of the brain, and then into the fourth. At the final stage of circulation, the outflow of cerebrospinal fluid into the venous sinuses occurs through granulations in arachnoid membrane. All parts of the ventricular system communicate with each other using channels and openings.

Kinds

The lateral sections of the system are located in the cerebral hemispheres. Each lateral ventricle of the brain communicates with the cavity of the third through a special foramen of Monroe. The third section is located in the center. Its walls form the hypothalamus and thalamus. The third and fourth ventricles are connected to each other through a long canal. It is called Sylvian Passage. Through it, cerebrospinal fluid circulates between the spinal cord and brain.

Lateral divisions

Conventionally, they are called the first and second. Each lateral ventricle of the brain includes three horns and a central section. The latter is located in parietal lobe. The anterior horn is located in the frontal, the lower - in the temporal, and the posterior - in the occipital zone. In their perimeter there is a choroid plexus, which is distributed quite unevenly. So, for example, it is absent in the posterior and anterior horns. The choroid plexus begins directly in the central zone, gradually descending into the lower horn. It is in this area that the size of the plexus reaches its maximum value. For this reason, this area is called a tangle. Asymmetry of the lateral ventricles of the brain is caused by a disturbance in the stroma of the tangles. This area is also often subject to degenerative changes. This kind of pathology is quite easily detected on ordinary radiographs and carries a special diagnostic value.

Third cavity of the system

This ventricle is located in the diencephalon. It connects the lateral sections with the fourth. As in other ventricles, the third contains choroid plexuses. They are distributed along its roof. The ventricle is filled with cerebrospinal fluid. In this department, the hypothalamic groove is of particular importance. Anatomically, it is the border between the visual thalamus and the subtubercular region. The third and fourth ventricles of the brain are connected by the aqueduct of Sylvius. This element is considered one of important components midbrain.

Fourth cavity

This section is located between the pons, cerebellum and medulla oblongata. The shape of the cavity is similar to a pyramid. The floor of the ventricle is called the rhomboid fossa. This is due to the fact that anatomically it is a depression that looks like a diamond. It is lined with Gray matter with a large number of tubercles and depressions. The roof of the cavity is formed by the lower and upper brain sails. It seems to hang over the hole. The choroid plexus is relatively autonomous. It includes two lateral and medial sections. The choroid plexus is attached to the lateral lower surfaces cavity, spreading to its lateral inversions. Through the medial foramen of Magendie and the symmetrical lateral foramina of Luschka, the ventricular system communicates with the subarachnoid and subarachnoid spaces.

Changes in structure

The expansion of the ventricles of the brain negatively affects the activity of the nervous system. Their condition can be assessed using diagnostic methods. For example, a computed tomography scan reveals whether the ventricles of the brain are enlarged or not. MRI is also used for diagnostic purposes. Asymmetry of the lateral ventricles of the brain or other disorders may be caused by for various reasons. Among the most popular provoking factors, experts call advanced education cerebrospinal fluid. This phenomenon accompanies inflammation in the choroid plexus or papilloma. Asymmetry of the ventricles of the brain or changes in the size of the cavities may be a consequence of impaired outflow of cerebrospinal fluid. This happens when the holes of Luschka and Magendie become impassable due to the appearance of inflammation in the membranes - meningitis. The cause of obstruction may also be metabolic reactions due to venous thrombosis or subarachnoid hemorrhage. Often, asymmetry of the ventricles of the brain is detected in the presence of space-occupying neoplasms in the cranial cavity. This could be an abscess, hematoma, cyst or tumor.

General mechanism for the development of disturbances in the activity of cavities

At the first stage, there is difficulty in the outflow of cerebral fluid into the subarachnoid space from the ventricles. This provokes expansion of the cavities. At the same time, compression of the surrounding tissue occurs. Due to the primary blockage of fluid outflow, a number of complications arise. One of the main ones is the occurrence of hydrocephalus. Patients complain of sudden headaches, nausea, and in some cases vomiting. Disorders of autonomic functions are also detected. These symptoms are caused by an acute increase in pressure inside the ventricles, which is characteristic of some pathologies of the liquor-conducting system.

Cerebral fluid

The spinal cord, like the brain, is located inside bone elements in suspension. Both are washed with liquor from all sides. Cerebrospinal fluid is produced in the choroid plexuses of all ventricles. The circulation of cerebrospinal fluid is carried out due to the connections between the cavities in the subarachnoid space. In children, it also passes through the central spinal canal (in adults, it becomes overgrown in some areas).

In the first days after birth, not only a huge number of tests are taken from the child, vaccinations are given, many medical procedures are performed, but an ultrasound of the brain is also performed. Doctors need to know the state of the brain, whether all its parts are properly developed, since the subsequent life and health of a person depends on this.

For newborns, the procedure is carried out through the fontanelles, which are non-ossified areas of the baby's skull with a thin, membrane-like structure. There are several fontanelle spots on the baby's head. Their goal is to help the child during childbirth, allowing the head to adapt to the anatomical features birth canal. After birth, the fontanelles tighten, and only one remains, through which the brain is mainly examined.

The main purpose of an ultrasound is to make sure that there are no possible abnormalities and that all indicators are normal, but, unfortunately, this is not always the case. Difficult pregnancy, difficulties during childbirth, genetic abnormalities and so on can disrupt the development of the newborn’s brain. The same reasons can also lead to an increase in the lateral ventricles of the brain in children, which in Lately often diagnosed by doctors.

What are the ventricles of the brain?

In the human brain there are special structures containing cerebrospinal fluid, i.e. cerebrospinal fluid. Their main purpose is the production and circulation of cerebrospinal fluid. There are several types of ventricles: lateral, third and fourth.
The largest are the lateral ones, resembling the letter C. The left lateral ventricle is considered the first, the right - the second. The lateral ventricles communicate with the third, which contains the subcortical autonomic centers. The unpaired or fourth ventricle of the brain resembles a diamond or pyramid in shape.

Being in fact a remnant brain bladder, this ventricle is an extension of the central canal of the spinal cord. All ventricles communicate with each other through holes and channels, which ensures the movement of cerebrospinal fluid and its subsequent outflow.

Reasons for expansion

Unfortunately, expansion of the ventricles of the brain negatively affects the child’s nervous system, development and health. Modern diagnostic methods, in particular computer or magnetic resonance imaging, allow us to assess the situation and condition of the baby and diagnose problems.

Often, infants are found both expansion and asymmetry lateral ventricles of the brain. The objective reason for this is increased secretion and impaired patency of the cerebrospinal fluid. It turns out that the cerebrospinal fluid is simply not able to leave the brain canals in a timely manner. Most experts consider dilation of the lateral ventricles in newborns to be a symptom of a specific disease. This may be (impaired circulation and absorption of cerebrospinal fluid), tumors and neoplasms in the brain, traumatic brain injury, etc.

Enlargement of the ventricles of the brain in a newborn may not be a manifestation of some disease, but a consequence of a developmental defect. For example, expansion of the cephalic ventricles may be a consequence of, or may occur due to the unusual shape of the skull. Doctors also consider chromosomal abnormalities in the mother’s body, infection or virus entering the placenta during pregnancy, a hereditary factor, complicated or early birth, hypoxia and some others.

What to do and how to treat?

Expansion of the ventricles of the brain in a newborn is not always a reason for panic. Their increase does not always indicate a serious pathology, but may be the cause of the individual and physiological development of the child. For example, in large children this is rather the norm.

Today, every fifth child under the age of one year has enlarged ventricles of the brain. If a defect is detected, not only the size of the ventricles will be determined, but also all other systems associated with the transportation and secretion of cerebrospinal fluid. When prescribing the necessary course of treatment, the neurologist will rely both on the numbers and indications of the examination, and on general symptoms. For example, an increase of several millimeters in one ventricle in the absence of pathologies and symptoms of other brain structures does not require drug therapy.

In case of more serious deviations, the doctor prescribes treatment with diuretics, antihypoxic vitamin preparations. Some experts recommend massage and special therapeutic exercises to help drain cerebrospinal fluid. The primary goal in treating enlarged cerebral ventricles is to prevent the development possible complications in the child’s body, his nervous system.

In any case, the treatment of such pathology should be carried out by a neurologist and a neurosurgeon. Newborns with enlarged lateral ventricles are under close and regular medical supervision. Babies under six months are often treated on an outpatient basis, sometimes for several months.

As a small conclusion

Enlargement of the ventricles of the brain in newborns is not considered an acute developmental abnormality. IN serious treatment the child needs it quite rarely, but the final, complete diagnosis and treatment plan must be established by a qualified neurologist, who, of course, will take into account the indications and general manifestations neurological abnormalities. That's why constant observations and consultation with a doctor is vital. Our advice to parents is to contact a good neurologist and, of course, do not panic under any circumstances.

The first is the left lateral ventricle, the second is the right. Through the Monroe (interventricular) foramina, the left and right lateral ventricles communicate with the third ventricle. They are located symmetrically on either side of the midline, just below the corpus callosum. Each lateral ventricle consists of an anterior frontal horn, a central part (body), a posterior occipital part, and an inferior temporal horn.

Causes of dilatation of the lateral ventricles. Diagnostics.

Dilatation, or expansion of the lateral ventricles occurs due to the production large quantity cerebrospinal fluid, as a result of which it does not have time to be excreted normally, or due to the occurrence of obstacles to the exit of the cerebrospinal fluid. This disease most often occurs in premature babies due to the fact that the size of their lateral ventricles is much larger than in children born at term.

When diagnosing hydrocephalus, the size of the lateral ventricles is determined by their quantitative and qualitative characteristics. For this there is sufficient quantity special techniques. In this case, the immediate depth of the lateral ventricles is measured, as well as the size of the cavity of the transparent septum located in the third ventricle.

Normally, the depth of the ventricles ranges from 1 to 4 mm. When these indicators increase by more than 4 mm, as a result of which their lateral curvature disappears and the shape becomes rounded, they speak of the beginning of expansion of the lateral ventricles.

Dilatation of the lateral ventricles is not considered a pathology, but a symptom of some disease. It is this reason that specialists have to diagnose.

Diseases in which dilatation of the lateral ventricles occurs.

Excessive accumulation of cerebrospinal fluid most often occurs as a result of a condition such as hydrocephalus. It is considered a fairly serious brain pathology. In this case, the process of cerebrospinal fluid absorption is disrupted, as a result of which it accumulates in the lateral ventricles, which leads to their dilatation.

Excess cerebrospinal fluid appears with lesions of the central nervous system. In this case, the ventricles dilate due to the slow release of cerebrospinal fluid.

Disturbance in the normal circulation of cerebrospinal fluid occurs due to the occurrence of neoplasms in the form of tumors or cysts, as well as as a result of traumatic brain injuries, inflammatory processes and hemorrhages in the brain.

A common cause of dilatation is a congenital defect of the Sylvian aqueduct. It occurs in 30% of cases of hydrocephalus. Hydrocephalus can also be caused by an aneurysm of the vein of Galen and a subdural hematoma of the posterior cranial fossa.

Arnold-Chiari syndrome causes communicating hydrocephalus. In this case, a displacement of the brain stem and cerebellum occurs. This condition can also be caused by cytomegaly or toxoplasmosis.

Other causes of dilatation of the lateral ventricles.

Dilatation of the lateral ventricles can cause brain defects. At the same time, despite the fact that they do not affect the child’s health, observation by a specialist is still necessary.

Most often, dilatation of the lateral ventricles not caused by serious illnesses, does not lead to serious consequences. It can be a consequence of rickets, and also appear as a result of the specific structure of the skull.

Dilatation and asymmetry of the lateral ventricles is detected by ultrasound examination of the brain. If in doubt, a repeat ultrasound scan is scheduled after a certain period of time.

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Enlargement of the ventricles of the brain in newborns

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. It is a very important formation of the brain, and is located between the 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. This anatomical formation contains the spinal canal, 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 pathological process A. 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 prematurely. This is due to the fact that in such children the sizes of the lateral ventricles are 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 light form. 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. The pathological process is 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. TO additional methods includes 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.

We also cannot exclude another possible pathology in which the ventricles of the brain in an infant will be enlarged, 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?

This pathology is classified 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. Congenital causes include:

• 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 of the 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?

The clinical picture of hypertensive-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 by a number of 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 innate reflexes, such as swallowing and grasping, are sharply reduced.
• There is frequent regurgitation.
• Strabismus develops.
• During a 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. Headache has 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 light are strong irritants for such children.

Because of 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 latest diagnostic methods allow this diagnosis to be made with 100% accuracy. In children in the neonatal period, the main diagnostic criteria are head circumference and reflex control. 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 of the brain.
• Lumbar puncture to determine cerebrospinal fluid pressure. This method is the most reliable.

Treatment Options

The 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 medications that reduce 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 infants is long-term and serious. Sometimes this takes several months.

In older children, treatment for HGS is pathogenetic nature, and the selection of therapy is carried out according to the cause that caused this syndrome. If the disease occurs after past infection, then the therapy necessarily includes taking 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 related to periodic increase arterial and intracranial pressure, which returns 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.

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

They made our third NSG. Conclusion - No gross violations were identified. Moderate dilation of the anterior horns of the lateral ventricles. In words, the uzistka said that there is an expansion of the external liquor spaces, but at the upper limit of the norm. In conclusion, she did not write this. The second NSG was in November, its conclusion was the expansion of external liquor spaces. Moderate expansion of the anterior horns of the lateral ventricles. The first NSG was in August, everything was fine there. In general, there are no positive dynamics. I read on the Internet that such conditions cannot be treated with massages and physiotherapy; medications are needed.

Good afternoon We are 1 month old. Yesterday we had a medical examination. I was very upset, I don’t know what to do. They did an ultrasound Neurosonography, in the conclusion they wrote: Echo signs of dilatation of the lateral ventricles, 3 ventricles. The resistance index in PMA is moderately reduced. We gained little weight in a month. Born on 3920, discharged from the maternity hospital at 3500. Yesterday we weighed 4150. During the ultrasound, the child cried, can the baby’s crying have an effect? Or the baby's weight? The neurologist did not prescribe treatment (only give Elkar, 3 drops, 3 times a day and supplement with formula).

Let's define the terms. Hydrocephalus is a dynamic process of dilatation of the ventricles with a certain clinical picture, if there are no complaints or neurological disorders for a long time, but according to the NSG, the sizes of the ventricles do not fit into standard indicators- This is ventriculomegaly. Isolated ventriculomegaly - changes are detected only on the side of the lateral ventricles without pathological changes on the part of the brain parenchyma. Let's decide on the sizes. Ventriculomegaly is diagnosed in a child when the size of the lateral ventricles is more than 10 mm! Values ​​up to 10 mm are the norm! Ventriculomegaly is divided into three degrees: mild.

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Dilatation of the lateral ventricles of the brain in a newborn child

This article will be relevant for parents whose children have been diagnosed with enlarged ventricles of the child’s brain.

The ventricles are a system of anastomizing cavities that communicate with the spinal cord canal.

The human brain contains structures that contain cerebrospinal fluid (CSF). These structures are the largest in the ventricular system.

They can be divided into the following types:

The lateral ventricles are designed to store cerebrospinal fluid. Compared to the third and fourth, they are the largest among them. By left side there is a ventricle, which can be called the first, according to right side- second. Both ventricles work with the third ventricle.

The ventricle, called the fourth, is one of the most important formations. The fourth ventricle contains the spinal canal. It appears to be diamond-shaped.

An increase in the size of the ventricles is a consequence of a violation of the cerebrospinal fluid (CSF).

Causes of dilatation

In medicine, enlargement of the ventricles is called ventriculomegaly. For whatever reason, dilation occurs, the greatest danger lies in their asymmetry. Symmetrical ventriculomegaly can be either normal or a sign of hydrocephalus.

If the size of the cerebral ventricles in newborns is disproportionate, increased, i.e. If their asymmetry is observed, this most likely indicates a volumetric formation.

The reasons why a child’s indicators are dilated can be congenital or acquired.

• Congenital defects include complications such as:
• Intrauterine hypoxia (oxygen starvation) of the child; Complication of pregnancy and childbirth;
• Premature birth of a child;
• Disturbed development of the central nervous system.

It is also worth taking into account hemorrhages, which in turn causes compression of the ventricle, resulting in its asymmetry.

Acquired pathologies include:

This disease, like hydrocephalus, leads to an increase in cerebrospinal fluid, although it does not appear immediately and the cerebrospinal fluid cavities may not increase for a long time. Only after a sharp rise in intracranial pressure do the sizes begin to expand.

An example of ventricular dilatation can be a disease such as rickets or appear as a result of irregular shape skulls The normal depth of the ventricles is from 1 to 4 mm. An increase in these indicators indicates their expansion.

Manifestations of dilatation

When intracranial pressure increases, a child exhibits the following symptoms:

• Decreased appetite of the child; it often happens that the child refuses breastfeeding.
• Muscle tone is reduced.
• Tremors of the upper and lower extremities appear.
• Clear manifestation of veins on the forehead, the cause is obstructed outflow from the cranial cavity.
• The child's swallowing and grasping abilities are reduced.
• High likelihood of developing strabismus.
• Disproportionality of the head.
• Frequent regurgitation due to high blood pressure cerebrospinal fluid.

A characteristic sign of ventricular enlargement and the development of hypertensive-hydrocephalic syndrome (HHS) manifests itself in a headache that begins in the morning on the left or right. Often the baby feels sick and vomits.

The child often complains of the inability to raise his eyes and lower his head, dizziness and weakness appear, and the skin begins to turn pale.

Diagnostic methods

It is very difficult to determine whether a baby’s ventricle is enlarged. Diagnostics does not provide a 100% guarantee that the diagnosis can be determined, even using the latest methods.

Closing of the fontanelles occurs within a period of 1-2 years, after which changes in the size of the cerebrospinal fluid of the brain are monitored.

TO the following types diagnostic activities include the following:

1. Magnetic resonance imaging. It identifies problems in the soft tissue structures of the child’s brain quite well.
2. The condition of the fundus is assessed for the presence of edema or hemorrhage.
3. Neurosonography. It is carried out to determine the size of the ventricles (both left and right).
4. Lumbar puncture.
5. CT scan.

The problem with diagnosing a newborn using MRI is that the baby needs to lie quietly for about a minute. Since this task is almost impossible for a baby, doctors have to introduce the child into artificial sleep. At the same time, on this procedure there are serious contraindications.

Therefore, most often, computed tomography is used to diagnose the size of the ventricles of the brain. At the same time, the quality of diagnosis is slightly lower than using MRI.

A violation is considered if the ventricles of the brain have a norm different from 1 to 4 mm.

Treatment

Enlarged ventricles are not always a reason to sound the alarm. When the ventricles of the brain are enlarged, this may be a case of individual and physiological development of the baby’s brain system. For example, for large babies this is the norm.

Treatment is carried out if it has been possible to prove through research that the infant’s liquor pressure is increased.

This disease is treated by a neuropathologist and neurosurgeon. The child is under constant medical supervision to avoid deterioration of the baby’s condition.

Treatment is carried out in the following ways:

1. Taking diuretics. Medicines that reduce the production of cerebrospinal fluid are also prescribed.
2. Drugs are prescribed to improve blood supply to the brain.
3. Calming (sedative) drugs.

Also, in the treatment of this disease the following will be ineffective: acupuncture, herbal treatment, homeopathy, therapy with vitamins.

First of all, in the treatment of dilatation of the lateral ventricles in a child is to prevent the development of possible complications in the child.

Possible consequences of HGS

The condition of hypertensive-hydrocephalic syndrome often causes a number of serious complications, these include:

Enlarged ventricles in newborns, as a diagnosis, have a higher chance of favorable outcome than in older children, due to increased arterial and intracranial pressure, which comes to a higher level as they grow older. normal condition.

The expansion of the lateral ventricles of the brain has adverse consequences and primarily depend on the cause of the development of HGS.

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Conclusion

Dilatation in newborns should not be considered an anomaly in the development of the baby. It is rare that this disease requires serious medical assistance. A complete and final diagnosis, which will be established by a qualified specialist - a neurologist, will reflect full picture diseases.

Therefore, observation and consultation with a specialist are necessary so that your child does not suffer any complications.

Enlarged lateral ventricles of the brain in a child

What should you do if the doctor reports on an ultrasound that your child has enlarged ventricles of the brain? If the baby feels normal, there are no deviations in neuropsychic development, a specialist may suggest simply visiting a neurologist regularly to monitor the condition little patient. With pronounced clinical picture brain damage, pronounced neurological symptoms and a significant deviation in the size of the ventricles from the norm require treatment, which is prescribed by a neurologist.

Normal cerebral ventricles in a newborn

Normally, a person has four ventricles in the head: two lateral, they are located symmetrically, the third and fourth, located in the middle. The third is conventionally anterior, the fourth is posterior. The fourth ventricle passes through the cisterna magna, connecting to the central canal ( spinal cord).

Why are doctors concerned about enlarged ventricles of the brain? The main function of the lateral structures is the production of cerebrospinal fluid and regulation of the volume of cerebrospinal fluid. A large release of fluid and a violation of its excretion provokes disruption of brain function.

The depth of the third ventricle should normally not exceed 5 mm, the fourth ventricle – 4 mm. If the lateral ventricles of the brain are considered, the norm for a newborn is calculated as follows:

• Anterior horns – from 2 mm to 4 mm.
• Occipital horns – from 10 mm to 15 mm.
• Lateral bodies - no deeper than 4 mm.

The standard depth for a large tank is 3-6 mm. All brain structures should grow gradually, the size of the ventricles should be linearly consistent with the size of the skull.

Causes of enlarged ventricles of the brain

It is believed that changes in ventricular structures in infants are genetically determined. Pathological changes in the brain develop due to chromosomal abnormalities occurring in pregnant women. There are other factors that provoke asymmetry of the ventricles and excessive enlargement of parts of the brain:

• Diseases infectious etiology, which a woman suffered from during pregnancy.
• Sepsis, intrauterine infections.
• Entry of a foreign body into the brain structures.
• Pathological course of pregnancy caused by chronic diseases mother.
• Premature birth.
• Intrauterine fetal hypoxia: insufficient blood supply to the placenta, increased placental blood flow, umbilical cord varicose veins.
• Long waterless period.
• Rapid birth.
• Birth trauma: strangulation by the umbilical cord, deformation of the skull bones.

Experts also note that the ventricles of the brain in newborns may increase due to the occurrence of hydrocephalus. unknown etiology. TO congenital causes, which provoke expansion of the ventricles of the head include the growth of neoplasms: cysts, benign and malignant tumors, hematomas.

Traumatic brain injury received by a child during childbirth, cerebral hemorrhage, ischemic or hemorrhagic stroke can also cause enlargement of the ventricles of the baby’s brain.

Clinical manifestations of ventricular dilatation

The ventricles not only store cerebrospinal fluid, they also secrete cerebrospinal fluid into the subarachnoid space. An increase in fluid secretion and a deterioration in its outflow leads to the fact that the ventricles stretch and enlarge.

An increase in the ventricular structures of the brain (dilatation, ventriculomegaly) may be a normal variant if a symmetrical expansion of the lateral ventricles is detected. If there is asymmetry of the lateral structures, the horns of only one of the ventricles are enlarged, this is a sign of the development of a pathological process.

Not only the lateral ventricles of the brain can become pathologically enlarged; the normal production and excretion of cerebrospinal fluid may be disrupted in the third or fourth. There are three types of ventriculomegaly:

• Lateral: enlargement of the left or right part of the ventricular structures, expansion of the posterior ventricle.
• Cerebellar: the medulla oblongata and cerebellar region are affected.
• When pathological release of cerebrospinal fluid occurs between the visual tuberosities, in the frontal part of the head.

The disease can occur in mild, moderate, severe form. In this case, not only an expansion of the cavities of the ventricles of the brain is noted, but also a disruption in the functioning of the child’s central nervous system.

There is a normal symmetrical increase in the size of the lateral ventricular structures when the child is large, he has big head or unusual skull shape.

Symptoms of the disease in an infant

Since the outflow of cerebrospinal fluid is impaired, it remains in large quantities in the head, while the intracranial pressure in the newborn increases, and swelling of the tissues, gray matter, and cerebral cortex increases. Due to pressure on the brain, blood supply is disrupted and the functioning of the nervous system deteriorates.

If the growth of the horns of the ventricles of the brain is accompanied by hydrocephalus, the child’s skull bones move apart, the fontanel bulges and becomes tense, frontal part The head can be significantly larger in size than the facial one; a network of veins protrudes on the forehead.

When the ventricle of the brain is enlarged in a newborn or is noted pathological asymmetry lateral ventricles, the child has the following neurological symptoms:

• Impaired tendon reflex, increased muscle tone.
• Visual impairment: inability to focus, squint, constantly downturned pupils.
• Trembling of limbs.
• Walking on tiptoe.
• Low manifestation of basic reflexes: swallowing, sucking, grasping.
• Apathy, lethargy, drowsiness.
• Irritability, loudness, capriciousness.
• Poor sleep, jumping up in sleep.
• Poor appetite.

One of the most striking symptoms is frequent regurgitation, sometimes vomiting. Normally, a child should burp only after feeding - no more than two tablespoons at a time. Due to the fact that when intracranial pressure increases (it is provoked by excessive accumulation of cerebrospinal fluid in the cavity of the cranium), the vomiting center in the fourth ventricle at the bottom of the rhomboid fossa is irritated, the frequency of regurgitation in a newborn increases significantly (more than twice after feeding and later).

The acute, rapid development of the disease provokes severe headaches, which is why the child constantly screams loudly and monotonously (brain scream).

Diagnostic methods

For the first time, a doctor can pay attention to deviations in the size of brain structures from the norm during an intrauterine ultrasound examination of the fetus. If the head size does not return to normal, a repeat ultrasound is performed after the baby is born.

Enlargement of the ventricles of the brain in newborns is diagnosed after neurosonography - ultrasound performed through the skin of an undeveloped fontanel. This study can be carried out until the child’s skull bones have completely fused.

If the disease develops chronically, the doctor may pay attention to the fact that the ventricles of the brain are larger than normal when examining the child with an ultrasound scan at three months of age. To clarify the diagnosis, it is recommended to undergo additional examination:

• Ophthalmological examination - helps to identify swelling of the eye discs, indicating increased intracranial pressure, hydrocephalus.
• Magnetic resonance imaging can be used to monitor the growth of the cerebral ventricles after the bones of the child’s skull have fused. MRI is a long procedure, the time spent under the machine is minutes. In order for the child to lie motionless for such a long time, he is immersed in medicated sleep.
• When undergoing a CT scan, you do not need to remain motionless for a long time. Therefore, this type of study is suitable for children for whom anesthesia is contraindicated. Using CT and MRI, you can obtain accurate images of the brain, determine how much the size of the ventricular system deviates from the norm, and whether there are neoplasms or hemorrhages in the medulla.

It is recommended to undergo an ultrasound of the brain for children in the first month of life if pregnancy or childbirth was accompanied by complications. If the ventricles are enlarged but there are no neurological symptoms, it is recommended to be re-examined after three months.

Treatment

When a child has enlarged ventricles of the brain, only a neurologist or neurosurgeon can prescribe the necessary treatment.

Drug therapy

Enlargement or asymmetry of ventricular structures does not always require treatment. If the child develops correctly, eats and sleeps well, it is considered that enlargement of the ventricular horns is an acceptable deviation from the norm.

If pronounced neurological symptoms occur, the baby is prescribed special medications:

• Diuretics (Diacarb, Furosemide) - to reduce cerebral edema, speed up urination, and normalize fluid excretion from the body.
• Potassium preparations (Panangin, Asparkam) - to replenish potassium deficiency that occurs when accelerated work urinary tract.
• Vitamins (Multitabs, B6, D3, Magne B6) - to prevent rickets and accelerate regeneration processes in the body of a newborn.
• Nootropic drugs (Cavinton, Vinpocetine, Noofen, Ecephabol, Cerebrolysin) - for normalization cerebral circulation, strengthening blood vessels, improving microcirculation in brain tissue.
• Sedative medications (Glycine) – help reduce nervous symptoms: tearfulness, moodiness, irritability; stabilize the process of falling asleep, normalize sleep.

If provoking factors have been identified that caused pathological growth of the ventricles of the brain, they are also eliminated: viral and infectious diseases. If the cause of the pathology is brain damage or tumor growth, surgical intervention: the cyst is excised, cancer tumor is deleted.

When enlarged ventricles of the brain are diagnosed in a child, treatment takes a long period of time. Newborns need to undergo massage courses and constantly perform physical therapy exercises to restore muscle tone and prevent atrophy.

Possible consequences and complications

Probably due to the wide availability of information and the opportunity to consult with other parents, an unhealthy trend has been observed recently. Parents refuse to treat their children for hydrocephalus; they attribute constant crying to capriciousness and stubbornness, and lethargy to character traits. People are scared serious drugs, contraindications and they decide that the disease will go away on its own.

But asymmetry of the ventricles of the brain, their significant increase can lead to serious consequences:

• Delayed mental, physical, mental development.
• Loss of vision: complete or partial.
• Hearing loss.
• Paralysis of limbs, complete immobilization.
• Pathological head growth.
• Inability to regulate bowel movements and urination.
• Epileptic seizures.
• Frequent loss of consciousness.
• Comatose state.
• Lethal outcome.

It’s good if the doctor notes a slight deviation from the norm during the ultrasound and suggests only observing the patient. This is possible if there are no symptoms of the disease: the child is calm, eats well, sleeps, and develops normally.

A diagnosis of “Dilation of the lateral ventricles of the brain in a child” has been made, but you doubt the professionalism of the doctor, and do not want to give your newborn medications in vain? Contact several independent specialists and get a complete examination. Do not refuse treatment, since the actions of the parents determine how fulfilling the child’s life will be.

All information on the site is provided for informational purposes only and cannot replace consultation with your attending physician.

In the first hours after birth, the child is under the supervision of neonatologists, who monitor his physiological condition and make necessary examinations body. In this case, health assessment is carried out in stages, starting from the first minute of life, and ends before discharge.

The most thorough examination is carried out on the first day and consists of a standard procedure for monitoring the activity and appearance of the newborn. If the doctor suspects congenital malformations, then it is possible to use ultrasound examination, which allows us to identify deviations in the formation of not only internal organs, but also the brain. In this case, the sizes of the ventricles are especially carefully measured, which normally should not exceed a certain value.

At this stage, the neonatologist can diagnose dilation of the ventricles of the brain in newborns. Based on the degree of pathology and the impact on the child’s life, the question will be raised about further solving this problem: for example, in case of minor deviations from the norm, observation by a neurologist and monitoring of the condition are prescribed. If the violations are serious and the symptoms are pronounced, then the child needs special treatment and observation in a hospital setting.

The ventricular system consists of 4 cavities located in parts of the brain. Their main purpose is the synthesis of cerebrospinal fluid or cerebrospinal fluid, which performs a large number of tasks, but its main function is to absorb brain matter from external influences, control of intracranial pressure and stabilization of metabolic processes between blood and brain.

The movement of cerebrospinal fluid occurs through channels connecting the common 4th ventricle and the subarachnoid space formed by the membranes of the spinal cord and brain. Moreover, its main volume is located above significant fissures and convolutions of the cortex.

The largest lateral ventricles are located equidistant from the midline below the corpus callosum. The first ventricle is considered to be the cavity located on the left side, and the second - on the right. They are C-shaped and wrap around the dorsal parts of the basal ganglia. They produce cerebrospinal fluid, which enters the third ventricle through the intergastric openings. Structurally, segments I and II of the ventricular system include the anterior (frontal) horns, body and inferior (temporal) horns.

The third ventricle is located between the visual tuberosities and has the shape of a ring. At the same time, gray matter is located in its walls, which is responsible for regulating autonomic system. This section is connected with the midbrain aqueduct, and through the interventricular foramen, located behind the nasal commissure, with the I and II ventricles.

The most important IV ventricle is located between the cerebellum and the medulla oblongata, with the vermis and medullary velum located above it, and the medulla oblongata and pons below it. This cavity was formed from the remains of the posterior medullary vesicle and is common to the rhomboid region. At its bottom lie the nuclei of the V-XII cranial nerves. In this case, the posterior lower corner communicates with the spinal cord through the central canal, and through the upper anterior part with the aqueduct.

Sometimes, when examining a newborn, the fifth ventricle is detected, which is a feature of the structure of the brain. It is located in the anterior midline, below the corpus callosum. Usually its closure occurs by 6 months of age, but if the gap is more than 10 mm, then we are talking about a pathology of the liquorodynamic system.

If an ultrasound revealed asymmetry of the lateral ventricles in a child, the prognosis depends on the degree of pathology and the depth of damage to brain tissue, as well as the reasons that provoked the development of the disease. Thus, a significant increase interferes with normal circulation and production of cerebrospinal fluid, which entails neurological problems. But congenital asymmetry, not aggravated by outflow disorders, in most cases does not require treatment. However, such a child needs observation in order to prevent relapse of the disease and possible consequences.

The size of the ventricles is normal

A healthy newborn normally has 4 ventricles: two lateral, the third is conventionally anterior, and the fourth ventricular component, which is considered posterior. An enlargement of the lateral ventricles entails the production of a large amount of cerebrospinal fluid, which will not be able to circulate normally between the membranes of the brain and, accordingly, perform its functions of regulating metabolic processes. Therefore, when assessing the size of the ventricles of newborns, the following standards are used:

• the lateral anterior horns should fall within the range of 2-4 mm;
• lateral occipital horns- 10-15 mm;
• body of the lateral ventricles - no deeper than 4 mm;
• III ventricle - no more than 5 mm;
• IV - up to 4 mm.

When examining the brain of infants up to one year and older, the use of these standards will be incorrect, since medulla and ventricles will grow, so the assessment is carried out using other indicators and corresponding tables.

Causes of enlarged ventricles

If on initial examination It was found that the ventricles of the brain in a newborn are slightly enlarged, then do not despair, since in most cases this condition requires only observation during the first years of life, and the prognosis is favorable.

Initially, a slight discrepancy between indicators and norms may be genetically determined and be a feature of the structure of the brain, while pathological changes occur due to a chromosomal malfunction during fetal formation.

There are a number of factors that provoke asymmetry and dilatation (enlargement) of the ventricular cavity:

• infectious diseases during pregnancy (in particular, infection of the fetus with cytomelalovirus);
• blood poisoning, sepsis;
• complications caused by chronic maternal diseases;
• premature birth;
• acute hypoxia during fetal development caused by insufficient blood supply to the placenta;
• varicose veins feeding the fetus;
• long anhydrous period and prolonged labor;
• rapid birth;
• birth injuries, hypoxia caused by umbilical cord entanglement;
• deformation of the cranial bones;
• hit foreign objects into brain structures;
• cysts, neoplasms of various nature;
• hemorrhages;
• ischemic and hemorrhagic stroke.

Also, dilation of the ventricles can be caused by cerebral hydrocele of unknown etiology and other congenital diseases.

This is what a well-known pediatrician and doctor in the post-Soviet space says about ventricular enlargement highest category Evgeny Komarovsky.

How it manifests itself

The main function of the ventricles is to secrete cerebrospinal fluid, as well as ensure its normal circulation in the subarachnoid space. If the balance of exchange and production of cerebrospinal fluid is disturbed, then stagnation is formed and, as a result, the walls of the cavities are stretched. The same slight expansion of the lateral segments may be a normal variant, but their asymmetry and enlargement of individual parts (for example, only the horn) will be a sign of the development of pathology.

Enlarged ventricles of the brain in infants can be diagnosed with this congenital disease, like ventriculomegaly. It varies in severity:

1. Slight expansion of the ventricles of the brain up to 11-12 mm, with no significant symptoms. It manifests itself in the child’s behavior: he becomes more excitable and irritable.
2. Increasing the depth of the ventricles up to 15 mm. Most often, the pathology is accompanied by asymmetry and impaired blood supply to the affected area, which entails the appearance of seizures, an increase in head size and a lag in mental and physical development.
3. Ventricular dilatation up to 20 mm, characterized by irreversible changes brain structures, in infants is often accompanied by Down syndrome and cerebral palsy.

In adulthood, an increase in ventricular volume is manifested by the following symptoms:

• Gait disturbance, with the child walking “on tiptoes” or vice versa, focusing only on the heels.
• The appearance of visual disorders, such as squint, insufficient focus of the gaze, as well as double images when trying to see small details.
• Tremor of arms and legs.
• Behavioral disorders that manifest themselves in excessive lethargy and drowsiness, while it is difficult to captivate the child with any activity.
• The appearance of headaches due to increased intracranial pressure, sometimes nausea and even vomiting may occur.
• Dizziness.
• Frequent regurgitation, loss of appetite. Some newborns are able to refuse breastfeeding.

Consequences

Late detection of the pathology that resulted in the expansion of the ventricle of the brain in a newborn can lead to a stop in development and deterioration in physical condition.

The main symptoms of the disease most often appear in the first 6 months after birth and are expressed in persistent increased intracranial pressure. There may also be disturbances in consciousness, vision, hearing loss, epileptic seizures and seizures, peripheral nervous system disorders.

Lack of proper attention to the child and failure to comply with specialists’ prescriptions can provoke the transition of the disease from more light form to severe, treatment of which is carried out only in a hospital setting and, if necessary, with the use of surgical interventions.

Diagnosis and treatment

During pregnancy, dilation of the ventricles of the fetal brain is most often detected during a routine ultrasound examination. Subsequent examinations are carried out to monitor the clinical picture of the disease, but final diagnosis can be diagnosed only after the birth of a child and neurosonography - ultrasound of the brain through a large fontanel that has not yet become overgrown. In this case, the pathology can develop at any age, but most often occurs in infancy.

To make a more accurate diagnosis, the baby may need a consultation and examination with an ophthalmologist, who will assess the condition of the fundus vessels, swelling of the eye discs and other manifestations of increased intracranial pressure.

After the fusion of the cranial bones, it is possible to use MRI of the brain: it will allow tracking the dilatation of the walls of the ventricles in dynamics. However, when using this method, the child will have to remain motionless for a long time, so before the procedure he is put into medicated sleep. If anesthesia is contraindicated, the examination is performed using computed tomography.

A consultation with a neurologist is also required, who will help identify developmental problems even at an early age. initial stage. Depending on the degree of pathology further treatment can be surgical or conservative with medication.

If there is a significant deviation from the norm in the size of the ventricles, only surgery, accordingly, the child should also be examined by a neurosurgeon. In this case, during the operation, foci of neoplasms or fragments of skull bones that appear as a result of traumatic brain injuries can be removed. To reduce intracranial pressure, normalize blood circulation and metabolic processes, brain shunting is used.

Conservative therapy is prescribed for slight enlargement of the ventricles and includes the use of diuretics, nootropics, sedatives and vitamin complexes. If the disorders are caused by infections, then antibiotics are prescribed. The use of therapeutic exercises will also help improve the outflow of cerebrospinal fluid and reduce its stagnation.

Forecast

If pathology in the development of the ventricles was identified in the first days after birth, then the prognosis in most cases is favorable and depends on adequate treatment and the severity of the abnormalities.

Detection of the disease and therapy in older age can be complicated due to the formation of a large number of anomalies that arise as a result of the development of pathology, its causes and influence on other body systems.

Video: Increased intracranial pressure in a child