Intracranial pressure in a child

An increase in the level of intracranial pressure often causes a real panic attack in parents. Confused, they do not know at all what to do with their child in such a situation, where to go.

What it is?

In modern pediatric practice, cases of increased intracranial pressure are increasingly recorded. In a child, this can manifest itself in different ways. Mild cases of the disease proceed even without a significant change in well-being. In babies, behavior is only slightly disturbed, nonspecific symptoms appear. More severe forms of the disease require urgent medical attention.

High pressure in the brain is also called intracranial hypertension or hypertensive syndrome by doctors. In this condition, there is a violation of the microcirculation of the cerebrospinal fluid. Normally, the cerebrospinal fluid circulates between the membranes of the spinal cord and brain. It washes the vital organs and carries all the essential nutrients.

Usually, an increase in intracranial pressure is not an independent disease. It arises for several different reasons. Currently, there are quite a large number of them. The provoking factors affect the circulation of cerebrospinal fluid, which ultimately contributes to an increase in intracranial pressure.

Norm

The outside of the brain is covered with several membranes: hard, arachnoid and soft. CSF fluid circulates freely between them. It is formed in special cisterns - the cerebral ventricles. They are created by nature not only for the formation of liquor, but also for its storage. Correct circulation of cerebrospinal fluid contributes to the normal level of intracranial pressure.

CSF circulation occurs between the membranes of the brain and spinal cord. There are special microscopic gaps between these anatomical structures. They contribute to the smooth flow of fluid and the maintenance of a stable level of intracranial pressure. CSF is formed regularly. This contributes to the preservation and maintenance of the level of intracranial pressure in strictly defined values.

Hypertensive syndrome can appear in a child as a result of deviations from the norm. The normal value of intracranial pressure in newborns is 2-6 mm Hg. Art. In older children - from 3 to 7 mm Hg. As the child grows and grows, the indicators of measurements of intracranial pressure change. In adults, normal intracranial pressure is usually 5 to 15 mm Hg. Art.

A small increase does not mean that the child is seriously ill. Even intense physical activity, severe psycho-emotional stress, or the consequences of a just suffered a cold can lead to the appearance of such a condition.

Causes

Various reasons lead to the development of hypertensive syndrome, which contribute to the violation of the outflow of cerebrospinal fluid. Excessive accumulation of cerebrospinal fluid in the cerebral ventricles and between the meninges leads to an increase in intracranial pressure, which can significantly exceed normal values.

Most often, the following reasons lead to an increase:

Intrauterine hypoxic state of the fetus. This condition occurs during complicated labor. Usually, expectant mothers before the birth of babies are found to have various pathologies of the placenta. In some cases, complications of labor lead to fetal hypoxia.
Injuries sustained during childbirth. Incorrectly performed surgery contributes to the infliction of head injuries to the baby during childbirth. This condition leads to mechanical damage to the cerebral cisterns - and even to micro-ruptures of the membranes.
Asphyxia of newborns. This pathological condition is accompanied by an increased accumulation of carbon dioxide in the blood of a newborn with insufficient oxygen. Prolonged oxygen starvation leads to impaired formation of cerebrospinal fluid and a violation of its outflow, which contributes to the development of a hypertensive state.

Various infections. Both viruses and some types of bacteria can lead to the development of intracranial hypertension. The microscopic size allows these microorganisms to easily penetrate the blood-brain barrier and cause inflammation in the brain. Often, the consequence of meningococcal infection leads to hypertensive syndrome.
Congenital anomalies. With Arnold-Chiari disease, some infringement of the medulla oblongata occurs in the occipital foramen - due to an anatomical structural defect. Ultimately, this condition is accompanied by a violation of the outflow of cerebrospinal fluid from the cerebral ventricles to the meninges of the spinal cord.
Various toxic poisoning. Toxins entering the body quickly spread throughout the bloodstream and easily penetrate the blood-brain barrier. Not only exogenous, but also endogenous substances can cause disturbances in the circulation of cerebrospinal fluid and an increase in intracranial pressure.
Injuries in the cervical spine. Often, subluxations, as well as displacement of the cervical vertebrae as a result of injuries and injuries, can lead to impaired circulation of the cerebrospinal fluid. Outflow disturbance contributes to an increase in intracranial pressure.

Neoplasms. Various tumors that grow in the brain and spinal cord can compress the cerebral ventricles. This leads to a violation of the outflow of cerebrospinal fluid. With large formations, hypertensive syndrome is quite pronounced.
Meningitis and inflammatory diseases of the membranes of the brain. The inflammatory process spreads rapidly to all brain structures. Cerebrospinal fluid is formed in a disturbed mode. There is a strong violation of the outflow of cerebrospinal fluid into the spinal space. This leads to the development of hypertensive syndrome.
Intracranial hemorrhage. In babies, this condition occurs as a result of traumatic brain injury or hemorrhagic vasculitis. Damage to blood vessels leads to impaired formation of cerebrospinal fluid, which triggers the development of intracranial hypertension.
Severe obesity. This condition contributes to the development of venous outflow disorders in the child.
Endocrine system diseases. Reduced function of the thyroid gland, as well as pathology of the adrenal glands, often become the causes of hypertensive syndrome in babies. The disturbed level of hormones contributes to the spasm of the vessels feeding the brain, which ultimately provokes the development of intracranial hypertension.

Symptoms

It is difficult to recognize a slight increase in intracranial pressure in a child. The symptoms of hypertensive syndrome are often nonspecific. They can be confused with other manifestations found in many inflammatory diseases.

An increase in intracranial pressure can be recognized by the following clinical signs:

Increase in head size... This symptom is especially pronounced in newborn babies. In severe hypertension, the size of the head may exceed age norms by several centimeters.
Changes in the eye sockets. The eyes bulge quite strongly forward. The upper eyelids usually cannot close tightly. This symptom can be detected independently. In babies, the irises of the eyes are clearly visible during sleep.
Distinct pulsation of the large fontanelle. This symptom occurs in newborn babies. On examination, the large fontanelle protrudes slightly above the scalp.
Strongly protruding veins. They are especially pronounced in babies in the first days after birth. With the appearance of hypertensive syndrome, the veins become crowded, they are very clearly visible.

Increased regurgitation. Quite a characteristic symptom for newborns. An increased level of intracranial pressure leads to compression of all vital centers that are responsible for the basic functions of the body. The kid can vomit food many times - throughout the day.
General condition change. Babies become very restless. The supine position only aggravates the painful condition. They feel much better on their hands. In a horizontal position, the filling of the veins is significantly increased, which contributes to an increase in intracranial pressure.
Sleep disturbance. Babies usually have difficulty falling asleep. Sleep becomes superficial and easily disturbed. Usually the child cannot sleep for more than a couple of hours. He constantly wakes up during the night, may be scared. Usually this symptom is very pronounced in babies aged 2-7 years.
Violation of general mental and physical development. When examining such a child, the attending pediatrician notices that the health indicators of the baby are very different from age norms. Baseline indicators of physical development in young patients with regular hypertensive syndrome deviate greatly from normal values.
The appearance of a headache. Its growth is most typical in the evening or towards the night. In some cases, the pain syndrome appears in children after waking up. The headache has a diffuse character. The intensity can be from very mild to unbearable and depends on the severity of the underlying disease.

Impaired speech. Doctors call it aphasia. If the work of individual centers in the brain is disrupted, the speech apparatus is damaged. It becomes difficult for the child to find words. During a conversation, he may confuse speech patterns or forget the simplest expressions.
Constant nausea. In severe cases, vomiting. Usually it is one-time, abundant enough. Vomiting with intracranial hypertension is not at all related to the food that the child received the day before. Usually it does not bring a strong improvement in the child's well-being.
Difficulty memorizing. School-aged children have learning problems. Even simple tasks can cause them significant difficulties. Children with persistent intracranial hypertension find it difficult to concentrate on specific objects.
Behavior change. The child, due to his painful condition, becomes very nervous, capricious. Many children refuse to eat, their appetite worsens. From the outside, such a baby looks rather depressed.

Diagnostics

It is currently not possible to measure intracranial pressure at home. All methods are auxiliary. Every pediatrician can check the symptoms of intracranial hypertension in a child. If you suspect the presence of hypertensive syndrome, it is better to show the baby to a neurologist. This physician has the necessary knowledge of the treatment needed to correct the adverse symptoms.

The following examinations will help to identify intracranial hypertension:

General clinical blood tests. They help to establish the presence of viral or bacterial infections in the body that could cause intracerebral infection.
Research of cerebrospinal fluid. It is prescribed only for special medical reasons (pediatric neurologists). Allows to identify special neuroinfections and consequences of spinal cord and brain injuries.
Consultation of an ophthalmologist and an extended examination of the fundus. A specialist can identify various spasms of blood vessels, which is an indirect sign of the presence of intracranial hypertension.

Neurosonography. Helps to establish some pathological changes that have arisen in the brain.
Ultrasound procedure. Modern techniques make it possible to describe the anatomical defects of blood vessels, as well as measure intracranial pressure.
Computed and magnetic resonance imaging. Sufficiently informative and highly accurate methods. They help doctors to correctly assess all the existing pathologies that have arisen in the brain and cerebral vessels. The method is especially indicated for babies in whom intracranial hypertension has developed as a result of birth trauma, as well as after traumatic injury.

Complications and consequences

Intracranial hypertension is a condition that can be very dangerous. With a prolonged or unfavorable course, it can lead to the onset of very unfavorable complications for life. These include: the development of status epilepticus, mental disturbance, the onset of symptoms of vascular dystonia in adolescence, decreased visual function, increased fatigue and excessive irritability. In some cases, among the consequences of the disease, doctors note hyperactivity.

Treatment

For the treatment of intracranial hypertension, it is very important to initially determine what is the cause of the condition. It is wrong to simply eliminate the consequences of the disease. This can only lead to a temporary improvement in well-being. However, after a while (if the cause has not been eliminated), the disease may develop again.

After establishing intracranial hypertension, the doctor will be able to make full recommendations for treatment. It is possible to cure hypertensive syndrome at home, but with regular monitoring by doctors. For treatment, you should choose only those drugs that are approved for use in pediatric practice.

Diuretic medicines can help eliminate adverse symptoms. They are discharged for a course appointment. Medicinal herbs that have a diuretic effect can also be used as remedies. These include lingonberry leaf, bearberry, parsley broth, celery juice and others. Such funds can be used for a long time - until the condition is completely stabilized.

To improve the functioning of the brain, special drugs are used that have a nootropic effect or have a positive effect on the tone of cerebral vessels. They contribute to the normal functioning of the cerebrospinal fluid within the interventricular space of the brain. As a nootropic drug, you can use the drug "Pantogam".

With intracranial hypertension, various symptomatic agents are prescribed. Antiemetic drugs help to eliminate adverse symptoms - nausea, vomiting. Vitamin polycomplexes enriched with group B are needed for the normal functioning of the nervous system and adequate circulation of cerebrospinal fluid. Intracranial hypertension is treated until the adverse symptoms are completely eliminated.