Unfortunately, even today’s highly developed neonatal medicine and modern pediatrics with all its achievements cannot protect kids from the hardest pathologies that lead to disability or death. Currently, cerebral ischemia in a newborn is one of the most serious pathologies in the field of pediatric neurology.
In infants, this disease is also called hypoxic – ischemic encephalopathy (HIE).
Factors causing brain ischemia in infants
Clinical signs of cerebral ischemia in a newborn arise due to a lack of oxygen in the tissues.
The most common causes of this disease:
- alcohol or nicotine addiction of the mother;
- infections, diseases of the heart and blood vessels, respiratory diseases in the mother during the period of carrying the fetus;
- the birth of a premature baby;
- complications that arose during childbirth (entwining a baby with an umbilical cord, childbirth using a cesarean section, stimulation with medications, prolonged childbirth, etc.);
- thrombosis and pathologies associated with poor blood coagulation;
- a woman in labor is either younger than 18 or older than 35 years.
All of the above factors in a certain way contribute to circulatory disorders, which provokes hypoxia.
The appearance of cerebral ischemia occurs in children of the older age group and in adults. The disease can be caused by blood clots, atherosclerosis, hypertension, and vascular inflammation. As a result of such pathologies, there is a difficulty in blood circulation of the brain and oxygen is supplied to it in insufficient quantities.
Symptoms of cerebral ischemia
The initial symptoms of cerebral ischemia in a child can be detected during the very first days of his life. Based on how badly the brain is damaged, the disease is assigned one of three degrees of severity.
1 degree of ischemia and its symptoms
Cerebral ischemia of the 1st degree in a newborn is the mild degree of pathology, which manifests itself, as a rule, in the first seven days of a baby’s life. Weak clinical signs lead to the fact that not all cases can diagnose the disease at a very young age and prevent possible complications.
Symptoms of the disease:
- the presence of severe headaches, which can be recognized by the restless state of the baby and disturbed sleep;
- inhibition of the general condition of the body;
- a slightly increased tone of muscle tissue: they are tight to the touch and are in a state of tension;
- evaluation of tendon reflexes causes an enhanced reaction. This is especially obvious when checking the knee reflex, which is performed by tapping the fingertips on the knees and elbow cavities.
In the very first days of life, the state of the baby is constantly monitored by a pediatrician. He carefully monitors how the baby develops and how all its organs function. Although it is extremely difficult to recognize a coronary artery disease in such an early period, it will allow timely treatment to begin and eliminate a possible complication.
2 degree and its symptoms
Grade 2 cerebral ischemia in newborns can be detected on the very first day of a baby’s life. This form of coronary disease is very dangerous, since in the future various CNS pathologies may occur.
Symptoms of the disease:
- periodically during sleep, the baby stops breathing, so the child should be under constant medical supervision. The baby has a slowing heart rate, his lips turn blue and he stops trying to breathe air. Holding your breath for more than 15 seconds is dangerous for the baby;
- the tone of muscle tissue weakens, they become soft to the touch, the arms and legs straighten;
- congenital reflexes are weakened. Assessing the reactivity of the central nervous system in the baby, a study of unconditioned reflexes is performed. With a mild reaction to the stimulus, we can conclude that a newborn had a violation of the functions of the brain;
- The skin turns pale, cyanosis appears;
- Sometimes the baby has hydrocephalic syndrome – an increase in the size of the head caused by the accumulation of fluid in the brain. Blood pressure rises, accompanied by severe pain in the head;
- A child develops syncope due to disturbed neural connections and increased pressure.
At this degree of cerebral ischemia, the formation of brain tissue occurs with impairments and the most important reflexes develop incorrectly.
Grade 3 ischemia and its symptoms
As a result of changes in the central nervous system, the risk of irreversible consequences increases. Lack of cerebral circulation can cause necrosis of the brain tissue, therefore, the implementation of important functions for life becomes impossible. Diagnosis of this degree of the disease in the infant is possible already in the first hours of life.
Symptoms of the disease:
- the baby has completely no congenital reflexes, he does not observe any reaction to stimuli;
- certain parts of the brain are affected, as a result of which it is difficult for the child to breathe and eat on his own. Also, the rhythm of the heart and light perception are disturbed;
- the supply of blood to the brain is difficult, which leads to a significant increase in intracranial pressure;
- involuntary muscle contraction occurs;
- the child may suddenly lose consciousness, from time to time he plunges into coma.
Grade 3 cerebral ischemia threatens the baby’s life and has a negative impact on his future development. Mental and physical development of a child can lag significantly.
Treatments for cerebral ischemia
When determining the method of therapeutic treatment, the doctor focuses on the symptoms present in the baby, the severity of the disease and the age of the baby. Children should be treated in a hospital under close medical supervision. In especially severe cases, compulsory placement of the baby in intensive care is required.
Treatment of the first degree of the disease can do without the use of medications, the doctor is limited to the appointment of massage. Numerous reviews of mothers of sick children indicate the effectiveness of this method. The purpose of this procedure is to normalize blood circulation and the supply of the required amount of oxygen to the brain. Massage relaxes muscles. In order to prevent further progress of the disease and eliminate negative consequences, it is necessary to regularly air the room where the babies are.
In severe forms of pathology, the baby has difficulties with the implementation of independent breathing, he is in an unconscious state. In this case, tracheal intubation and mechanical ventilation must be performed using a special apparatus. You can detect blood clots in a child by bilateral ultrasound of vessels, MRI and computed tomography. If a blood clot is detected, it is removed, which helps to restore normal blood flow. As an alternative treatment, a method can be applied in which a drug is added to the place where the thrombus is located, which helps to thin it. In the process of rehabilitation, anticoagulants are prescribed to reduce blood density and to avoid the appearance of new blood clots.
The presence of hydrocephalic syndrome is a great danger to the crumbs. This is due to the fact that an impressive volume of fluid causes compression of the brain tissue, preventing it from forming normally. You can remove excess fluid from the child’s body with the help of drugs with a diuretic effect. They are used if the child has a slight swelling of the brain. In more severe cases, surgery may be required. The shunt is installed to remove fluid into the abdominal cavity, followed by its natural removal from there. After the shunt is introduced, the baby is registered with doctors who regularly check the location of the tube and replace it as the baby grows.
Treatment of increased intracranial pressure is carried out using vasodilator drugs. A doctor prescribes them, combining them with blood vessels and drugs to restore the structure of brain neurons.
To minimize the risk of the occurrence and development of ischemic diseases in infants, the expectant mother must make every effort to supply oxygen to the fetus in sufficient volume.
To do this, she needs to observe a number of measures:
- take walks in the fresh air;
- get rid of alcohol and tobacco addiction;
- avoid stress conditions;
- Do not forget about compliance with the regime and a balanced diet;
- Do not avoid moderate physical exertion;
- control blood pressure;
- hemoglobin level control;
- maintaining normal body weight;
- beware of infectious diseases;
- timely pass the necessary examinations;
- strictly follow the recommendations of your doctor.
In the case when the disease nevertheless appeared and an accurate diagnosis is established, it is necessary to provide qualified medical care as soon as possible. The greatest effect can be achieved by eliminating the symptoms of the disease at its initial stage, rather than combating its complications.
The list of consequences caused by the disease
The consequences of cerebral ischemia in newborns can be completely different, based on the severity of the disease.
A mild degree of ischemic disease proceeds without causing negative consequences, the development of babies occurs similarly to healthy children. Even if the treatment of the disease was started in a timely manner, patients may continue to have disturbed sleep and attention, pain in the head, epileptic seizures may occur, and mental development may occur with some deviations.
The consequences after the 3rd degree of the disease are directly dependent on in which part of the brain the damaged areas are localized and what is the area of dead tissue. These may be problems with the functioning of the musculoskeletal system, sometimes the patient remains completely paralyzed. In the future, his condition may improve, since nerve cells have a wonderful feature – they are able to recover.
Possible complications of coronary disease can be predicted based on how severe oxygen deprivation was, how much brain area was affected, and how timely professional medical care was provided.
The first degree of the disease, as a rule, ends favorably for babies. Their development takes place in the same way as peers. Only in rare cases, excessive activity and hypotrophy are observed.
Second degree of the disease
May cause the following complications:
- From 10 to 20% of patients subsequently experience a slight increase in blood pressure and frequent spitting up;
- From 30 to 50% of patients have some disorders in their mental development.
Complications arising after the third degree of ischemia:
- Up to 50% of cases of the disease are fatal in the first days or a little later, when severe pneumonia or another infectious disease becomes the cause of death;
- Up to 80% of children receive irreversible complications. The child may have dementia, or he becomes an autist;
- In 10% of children, mental development occurs with minor deviations from the norm;
- In 10% of cases, the disease proceeds without any negative consequences for the child.
All types of cerebral ischemia in infants should be treated in a hospital setting under the constant supervision of doctors. Based on the results of the examination, the doctor chooses one of the most suitable methods of treating the disease.