Intracranial pressure in infants and newborns

Changes in brain function are dangerous enough for newborn babies. Increased intracranial pressure is a very common pathology in neonatal practice.

What it is?

After the birth of each child, doctors must assess the performance of vital organs. Intracranial pressure measurements are very important for the normal functioning of the brain in infants. The excess of normal indicators of cranial pressure indicates the presence of hypertensive syndrome. Doctors also call it intracranial hypertension.

Norm

Normal functioning of the brain and spinal cord is impossible without regular circulation of cerebrospinal fluid (CSF). Normally, it is formed in special cisterns of the brain - the ventricles. They are also needed to provide an accumulative function. An excess amount of cerebrospinal fluid can accumulate, leading to the development of hydrocephalic syndrome.

The resulting cerebrospinal fluid circulates freely between the meninges. Several such formations surround the brain at once: hard, arachnoid and soft. For better communication of cerebrospinal fluid between the meninges there are microscopic gaps. This constancy is ensured by the continuous formation and circulation of cerebrospinal fluid between the brain structures. This leads to the fact that normal intracranial pressure has strictly defined values.

Normally, in a newborn baby, it should be in the range from 2 to 6 mm. rt. Art. In infants, the cranial pressure can be 3-7 mm. As the baby grows and develops, the normal values of this indicator also change. High intracranial pressure for a long time leads to the development of persistent hypertensive syndrome.

Reasons for the increase

There are a lot of provoking factors that contribute to an increase in cranial pressure. It is no coincidence that neonatologists have noted more and more cases of a similar syndrome after the birth of babies. Hundreds of babies are born every day around the world who have congenital intracranial hypertension.

The following reasons lead to an increase in cranial pressure in newborns and infants:

Abnormalities in the structure of the placenta. Through this vital organ during all 9 months of pregnancy, the necessary nutrients penetrate to the baby. Defects in the structure of the placenta or supplying blood vessels lead to the development of disorders of venous outflow in the fetus. After birth, this condition is manifested by the development of intracranial hypertension.
Pathologies that have arisen during childbirth. Incorrectly chosen surgical tactics or unexpected complications can lead to traumatic brain injury to the baby. Often, such influences also lead to damage and micro-rupture of the meninges. If the cerebral ventricles or head veins are damaged, the symptoms of intracranial hypertension in a baby increase several times.

Intrauterine infection... The most dangerous are the 1st and 3rd trimester of pregnancy. Viruses and bacteria that enter the body of the expectant mother at this time very easily pass through the hematoplacental barrier. Once they enter the baby's body with the bloodstream, they can cause damage to the brain, which in some cases contributes to the development of intracranial hypertension in the baby after birth.
Traumatic injuries. When a child falls and hits his head, various disorders of the meninges often occur, as well as injuries to anatomically close cervical vertebrae. Such traumatic defects significantly disrupt the outflow of cerebrospinal fluid from the brain to the spinal cord. Ultimately, this contributes to the development of intracranial hypertension in the baby.

Neoplasms. They occur no more often than in 1-2% of cases. Actively growing tumors in the brain significantly compress the cerebral ventricles. This leads to a violation of the outflow of cerebrospinal fluid and the development of hypertensive syndrome.
Hemorrhage in the brain. In newborn babies, they often occur with massive traumatic brain injuries. In some cases, it can be congenital, resulting from increased fragility of the feeding vessels due to hemorrhagic vasculitis.
Inflammatory diseases of the brain. Infectious meningitis leads to impaired venous outflow, which contributes to the development of intracranial hypertension.

All the reasons contributing to the development of intracranial hypertension cause severe cerebral hypoxia.

This condition is characterized by an insufficient supply of oxygen and an increased content of carbon dioxide in the body. Prolonged oxygen starvation contributes to impaired brain activity and leads to the appearance of adverse symptoms characteristic of this condition.

Symptoms

With mild intracranial hypertension, it is difficult to recognize this condition. Usually the baby is practically not worried about anything. Symptoms can be mild or subtle. Moderate course and severe intracranial hypertension appear, as a rule, very clearly. They are accompanied by the appearance of unfavorable clinical signs, the elimination of which requires the appointment of complex treatment.

Among the symptoms of increased cranial pressure in newborns and infants:

Resizing the head. She becomes several centimeters more than the age norm. This symptom is quite clearly detected in newborn babies.

Bulging eyes. In severe cases, the eyeballs protrude slightly beyond the sockets. In this case, the upper eyelids cannot close tightly. This symptom can be determined independently. The irises of the eyes are visible during sleep.

Constant regurgitation. The most common symptom for babies in the first 6 months of life. Even when feeding in small portions, the baby may often regurgitate food. This condition leads to some loss of appetite and stool disorders.
Refusal of breastfeeding. This is due not only to a decrease in appetite, but also to the appearance of a bursting headache in the child. A newborn baby still cannot tell mom where it hurts. He only shows this by breaking his usual behavior.

The appearance of a headache... It can be of different intensity and severity. With severe pain syndrome, babies begin to cry harshly, asking for more hands. Pain is usually worse when lying down. This is due to the large filling of the veins with blood and increased intracranial hypertension.
Change in general behavior. A child with intracranial hypertension becomes moody. He may become more nervous. Newborn babies practically refuse any active games. Babies do not react to smiles turned to them.

Sleep disturbance. The increase in intracranial hypertension is observed mainly in the evening and at night. This makes it very difficult for the child to fall asleep. During the night, he can often wake up, cry and ask for his arms. During the day, the child's sleep is usually not disturbed.
Swelling of the veins. In newborn babies, this symptom can also be checked at home. The head veins become very inflated and well visualized. In some cases, you can even see their distinct pulsation.

Lagging behind in mental and physical development. A long course of intracranial hypertension leads to impaired brain activity. When conducting regular examinations, the pediatrician will be able to identify these violations, which will be clear markers of the possible development of increased intracranial pressure in the child.
Visual impairment... Often this symptom can be detected only with a long and sufficiently high cranial pressure. Decreased vision and double vision are detected in babies by the age of one.
Shaking hands or tremors of the fingers.

How to recognize?

Increased intracranial pressure cannot always be suspected at home. Mild forms of hypertension are not accompanied by the appearance of vivid symptoms.

Typically, hypertensive syndrome is detected during examination by pediatricians. They may also perform additional tests to detect hidden signs of intracranial hypertension.

To establish this condition, consultations of a neurologist, ophthalmologist are required. If the cause of the hypertensive syndrome is a traumatic brain injury, then an examination by a neurosurgeon will also be required. After the examination of specialists, additional analyzes and examinations are required.

To establish intracranial hypertension, use:

General blood analysis. Peripheral leukocytosis indicates the presence of various infections in the child's body. An increase in stab neutrophils indicates a possible infection with bacteria.
Biochemical study of cerebrospinal fluid. It is prescribed for traumatic injuries of the meninges, as well as for various neuroinfections. To evaluate the indicator, the ratio of protein and specific gravity is used. Also in the cerebrospinal fluid, you can detect possible pathogens and identify their sensitivity to antibiotics. The method is invasive and requires a lumbar puncture. Prescribed only by a pediatric neurologist or neurosurgeon.

Ultrasound of brain structures. Helps to establish anatomical defects in the brain and spinal cord. Using ultrasound, doctors measure intracranial pressure. In combination with neurosonography, it gives a fairly complete description of the existing pathology in the brain.

Electroencephalography. This method is used as an auxiliary. It helps to establish cerebral disorders.
Computed and magnetic resonance imaging. Provide highly accurate descriptions of all brain structures. With these methods, even the smallest traumatic injuries can be detected. These tests are safe and do not cause any pain in the child.

Effects

Prolonged increase in intracranial pressure is a condition that is very dangerous for a growing baby. Persistent hypertensive syndrome is accompanied by severe hypoxia. It leads to disruption of vital organs. With such a long state, various pathologies appear in the body. These include mental disorder, development of epileptic syndrome, lag in physical and mental development, visual impairment.

Treatment

It is possible to cure intracranial hypertension only after eliminating the causes of the underlying disease that caused this condition. Dr. Komarovsky believes that if they have not been eliminated, then the symptoms of intracranial hypertension can recur in the baby again and again. The therapy scheme is built by the attending physician after carrying out the entire complex of necessary examinations. Usually, the course of therapy is calculated for several months.

For the treatment of intracranial hypertension, the following are used:

Diuretic... These drugs contribute to the active excretion of urine, and, consequently, to a decrease in the total volume of fluid in the body. According to parents, such funds significantly improve the well-being of the child. Diacarb, furosemide, lingonberry leaf, parsley broth, glycerin have a diuretic effect. Medicines should be used taking into account the child's age.
Nootropics and drugs that improve brain activity. These include Actovegin, Pantogam and other products. Prescribe drugs for a course reception. With regular use, they help to normalize cerebral activity and significantly improve the well-being of the baby.

Relaxing massage. It helps to improve venous outflow, relieve increased tone, and also has a general strengthening effect. Therapeutic massage is used for babies 2-3 times a year for 10-14 procedures.

Revitalizing water treatments. Specially selected treatment programs adapted for newborns have a positive effect on the circulation of cerebrospinal fluid in the child's body. With regular water procedures, the child's immunity and defenses to various infections are also strengthened.

Antibacterial and antiviral agents. Assigned when infections are detected. The drugs are usually prescribed for 7-10 days. Monitoring the effectiveness of the prescribed treatment is assessed by improving overall well-being and by changes in the general blood test.
Antiemetics. Prescribed as an adjunct treatment. It is used to eliminate vomiting with severe intracranial hypertension.
Multivitamin complexes. These funds must necessarily contain a sufficient amount of B vitamins. These biologically active substances have a positive effect on the functioning of the nervous system.

Sedatives. Prescribed for increased irritability and nervousness in a child. Medicinal herbs that have a sedative effect can be used as sedatives. These include: motherwort, valerian, lemon balm. Warm lavender baths are also suitable for newborns.
Good nutrition. It is very important for babies to receive breast milk. This natural product is very well absorbed and provides the child's body with all the necessary nutrients. Together with mother's milk, the baby receives all the vitamins that are needed for the full functioning of his nervous system.
Ensuring the correct daily routine... A kid with intracranial hypertension should regularly walk outside. Walking with your baby in the fresh air has a positive effect on the circulation of the spinal cord.
Surgery. It is used for traumatic brain injuries that provoke the development of hypertensive syndrome. Restoration of the integrity of bone structures and elimination of intracranial hematomas is performed by a neurosurgeon.

Prevention

In order for the child's intracranial pressure to remain within the age norm, the following recommendations should be used:

Organize your baby the right daily routine... Babies should be sure to rest during the day and sleep well at night.
Walk with your child in the fresh air regularly. The intake of large amounts of oxygen is very helpful in eliminating hypoxia.
Favorable atmosphere in the house. Positive emotions are very important for babies in their first year of life. For the normal functioning of the nervous system and full-fledged mental activity, the child must feel completely safe.

Keep breastfeeding as long as possible.

Mother's milk is a vital and fully adapted food product for any baby. It contains all the nutrients and vitamins vital for the child.

Pay attention to any changes in your child's behavior. If the baby becomes more lethargic and capricious, and also begins to refuse to breast - be sure to show the baby to the pediatrician.

More details about intracranial pressure in infants can be found in the following video.