hydrocephalus
Introduction
Introduction to hydrocephalus Hydrocephalus is a general term for cerebrospinal fluid production or circulatory absorption process, resulting in excessive cerebrospinal fluid volume, increased pressure, and enlarged space occupied by normal cerebrospinal fluid, which leads to increased intracranial pressure and enlarged ventricles. The hydrocephalus is mainly manifested as a rapid and progressive increase in the head of the baby several weeks or months after birth. The normal baby increases 1.2-1.3 cm per month in the first six months, and the disease is 2-3 times. The skull is round, the forehead is protruding, the head and ankle are abnormally enlarged, the anterior ankle is enlarged, the cranial suture is separated, the skull is thin, and even transparent, and the Maceen sign can appear in the percussion. basic knowledge The proportion of sickness: 0.0036% Susceptible people: more common in young children Mode of infection: non-infectious Complications: nausea and vomiting
Cause
Causes of hydrocephalus
Congenital malformation (25%):
Such as midbrain aqueduct stenosis, aponeurosis formation or atresia, interventricular pore atresia (fourth ventricle median or lateral occlusion), cerebral vascular malformation, spina bifida, cerebellar tonsil sac.
Infection (20%):
Intrauterine infections such as various viruses, protozoa and treponema pallidum meningitis are not controlled early, hyperplastic fibrous tissue obstructs the circulation of cerebrospinal fluid, or intracranial inflammation of the fetus can also make the cerebral cistern, subarachnoid space and cobweb Membrane granule adhesion occlusion.
Bleeding, tumors and other (35%):
Fibrosis caused by intracranial hemorrhage, malabsorption of intracranial hemorrhage, etc. Any part of the cerebrospinal fluid circulation can be blocked, more common in the vicinity of the fourth ventricle, or choroid plexus papilloma. Some hereditary metabolic diseases, perinatal and neonatal asphyxia, severe vitamin A deficiency.
Prevention
Hydrocephalus prevention
1. Strengthen the application of B-ultrasound in prenatal diagnosis, early termination of pregnancy, prevention of birth of hydrocephalus, and reduction of birth rate of congenital hydrocephalus.
2, the promotion of eugenics knowledge, reduce the number of parity, is one of the ways to prevent hydrocephalus.
3. Advocating the appropriate age to have a certain significance in preventing the occurrence of hydrocephalus.
4. Strengthen eugenics education and improve the cultural quality of the population to enhance the people's ability to accept eugenics education and self-care awareness.
Complication
Hydrocephalus complications Complications, nausea and vomiting, electrolyte imbalance
Often have difficulty breathing, hypoxia, vomiting, sweating, fever, if the application of dehydrating agents and diuretics, it is prone to complications such as dehydration, acidosis and electrolyte imbalance.
Symptom
Symptoms of hydrocephalus common symptoms gray matter shift gray matter abnormal olfactory dysfunction nystagmus in people with convex intelligence disorder headache dizziness arteriovenous short circuit phenomenon
Fetal congenital hydrocephalus is more than stillbirth. After birth, hydrocephalus may appear at any age, most of them appear 6 months after birth. The younger patients have no cranial suture, and the head is easy to expand, so the symptoms of increased intracranial pressure Less, hydrocephalus is mainly manifested as a rapid and progressive increase in the head of the baby several weeks or months after birth. The normal baby increases 1.2-1.3 cm per month in the first six months of the head, and the disease is 2- 3 times, the skull is round, the forehead is protruding, the head and ankle are abnormally enlarged, the anterior iliac crest is enlarged, the cranial suture is separated, the skull is thin, and even transparent, and the perforation can appear "Maceen" sign. The forehead presents a swelled vein, the eyeball is under the spine, the upper sclera is often exposed (sunset sign), the sick baby is wilting, the head can not be lifted, and severe cases may be accompanied by brain dysfunction, manifested as epilepsy, vision and olfactory disturbance, Eye tremor, strabismus, limb paralysis and intelligent obstacles, etc., because the baby's head is compensatory, headache, vomiting and optic nerve head edema are not obvious.
Examine
Examination of hydrocephalus
1, the skull X-ray film can be seen in the enlarged cranial cavity, thinning of the skull and separation of the cranial suture.
2. Ventricular gas or water-soluble iodine angiography can show the shape and size of the ventricular system and the thickness of the cerebral cortex.
3, the skull two-dimensional ultrasound examination showed no shift in the midline wave, and the ventricular system expanded.
4, CT or MRI scan see the ventricular system is significantly enlarged, and sometimes can detect the cause of hydrocephalus.
Diagnosis
Diagnosis and diagnosis of hydrocephalus
1. Immature children: The head enlarges faster, some resembles hydrocephalus, but the ventricles are not large.
2, rickets: the skull is mostly square and has other symptoms of rickets.
3, deformed big head: large head, rapid growth, there is obvious mental deficiency, no eye drop phenomenon, ventriculography is normal.
4, chronic subdural hematoma, the head is increased slowly, more red or yellow liquid can be seen under the dura mater, there is bleeding in the fundus, CT can be diagnosed.
5, intracranial space-occupying lesions such as tumors, abscesses and so on.
In the elderly, hydrocephalus also needs to be differentiated from the expansion of the relative ventricle system caused by brain atrophy. The two can be differentiated from symptoms and imaging examinations. Simple brain atrophy, no typical symptoms of hydrocephalus, such as Dementia, urinary incontinence and gait instability, CT and MRI, brain atrophy, ventricular system enlargement, sulcal widening, the key is no edema around the ventricles.
